December 29, 2021

Snoring & Concerned about Sleep Apnea... But Don't Want to do a Sleep Study? Try a Home Sleep Test!

Go2Sleep Smart Ring


There are many individuals who snore... but only a percentage of those who snore actually suffer from a sleep disorder like obstructive sleep apnea which has health consequences. Ideally, a formal sleep study should be performed to determine if any medical sleep issue is present given snoring is one of several symptoms that may suggest an underlying problem.


However, it is not uncommon that such snorers do not want to see a doctor let alone get a sleep study done. 


For such individuals, it may be worthwhile to do a home sleep test using an AI-powered pulse oximeter you can purchase online including Amazon. Such pulse oximeters are worn during the night while it continuously measures oxygen levels and heart rate while you sleep. These devices sync with a smartphone (apps are free) where the data is downloaded and analyzed. Although a bit pricey ($50-$100), think of it as a doctor's copay, but something you can keep. The devices come in many different forms include:


• Finger (Emay Finger Pulse Ox)

• Wrist (Emay Wrist Pulse Ox, Wellue USleep)

• Ring (Go2Sleep Smart Ring, Wellue O2Ring)

• Face Sticker (Sunrise Sleep)


Devices using a ring tend to not be as accurate as devices utilizing a finger/wrist.


Please be aware that such devices can not formally diagnose you with a sleep disorder... BUT, if it consistently shows abnormalities in your sleep, you most likely do have a sleep disorder and should get an insurance accepted sleep study done. BUT... If these devices show normal sleep data consistently, then you probably have normal or at worst a mild sleep disorder which may not need any medical intervention.


Regardless of which pulse oximeter you ultimately use, they all produce a summary report regarding the quality of your sleep. From a sleep apnea perspective, the most important value is the ODI 4% (oxygen desaturation index). Defined as the number of times per hour of sleep that the blood's oxygen level drop by at least 4% from baseline that persists for more than 10 seconds. The other useful information is the oxygenation (SpO2) graph that provides a quick global view of your entire night's sleep. Here is what a normal oxygen graph looks like.


Normal SpO2 Graph.


The closer to 100% (above 94%) and straighter the line, the more normal the test. An abnormal oxygen graph may look something like this:


Abnormal SpO2 Graph.

The thicker and more variable the line, the more abnormal the test results.


The general rule of thumb is if the ODI 4% is greater than 9, you should probably see a doctor and get a formal sleep study done. If the ODI 4% is less than 9 (zero being totally normal), you either have benign snoring problem or at most only a mild obstructive sleep apnea condition. ODI 4% greater than 30 is always considered severely abnormal and should definitely be evaluated further.


Do keep in mind that although there is a correlation between AHI (apnea hypopnea index) determined on formal sleep studies and ODI 4% in pulse oximetry tests, it is not a precise correlation based on research comparing the two. AHI > 5 is considered abnormal (normal <5, mild 5-15, moderate 15-30, severe >30).


Reports usually contain additional sleep information such as pulse graph, ODI 3%, mean O2, etc, but from a medical sleep apnea perspective, these other numbers are more interesting than relevant.


The nice thing with such sleep devices are that you can use it on as many nights as you want... or share its use with other family members. A definite advantage compared to a formal sleep study which is for one night only.


Of note, the latest versions of the Apple Watch does have a pulse and oxygen monitor... BUT is not adequate for determining whether a sleep condition is present or not as the watch's oxygen monitor only spot checks oxygen levels... not continuously which is necessary given oxygen dips may occur only transiently during sleep. This may change in future versions of the watch.


Reference:

The Value of Oxygen Desaturation Index for Diagnosing Obstructive Sleep Apnea: A Systematic Review. 2021 Feb;131(2):440-447. doi: 10.1002/lary.28663. Epub 2020 Apr 25.

Wrist Pulse Ox with screen Wellue Ring Pulse Ox Finger Pulse Ox Wrist Pulse Ox 



Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.


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