Hello all, Wondering what you guys think of something I was proposed last week... There is this company that has developed a shirt that tests for sleep apnea. The shirt has wires and and a little box attached. The company wants me to promote it in my office. What do you guys think? Will there be a need for this? Personally, it seems invaluable (I researched it). No need to take time off to get tested!! Pull over for the night put the shirt on and in the morning give the shirt back and the readings get sent to the MD for interpretation. The test will run from $299-$399. Seems like a good deal for those with no insurance. BTW the $299 rate is for OOIDA members I believe. I'm not posting links so as not to be construed as advertising. Your input is appreciated.
A shirt wouldn't be able to monitor all aspects of a polysomnogram (the clinical name for a sleep disorder test), specifically the EEG portion. While it would (I presume) be able to identify if one stops breathing, it wouldn't be able to confirm the specific type of sleep apnea one might have (i.e. OSA or CSA) As a former polysomnography tech, I see this as an early warning detection to determin if one should talk to his or her doctor and schedule a full polysomnogram, at best. At worst, it could seriously misdiagnose someone who might have something more severe than sleep apnea.
Crow, Fancy for me a polysomnography tech is on this forum...lol. Here is a quote from some of their literature. I guess I didn't realized there are a few extra things besides a shirt (i.e. device under the nose and on finger). "The first step in receiving treatment is having a sleep study performed to diagnose for the disorder. We can provide home diagnostic sleep studies to you anywhere in the country and in the sleeping environment of your choice. Common and more costly testing requires one overnight sleep study, in a lab, to diagnose sleep apnea, then a second sleep study is done using CPAP while a technicians adjusts the CPAP pressure (titrated) to relieve the obstruction. Our testing is simple and can be delivered, to you, via UPS. Its easy to use and simply requires you to wear a shirt that places a belt around your chest and abdomen, a sensor under your nose and a clip on your finger. All you have to do is put it on and go to sleep. Its a painless procedure that monitors and records information that will determine if sleep apnea is present. All testing is confidential and results are read and interpreted by a board certified physician." Your input is greatly appreciated!!
As I said, this will help diagnose sleep apnea, but it doesn't determine whether one's sleep apnea is obstructive and treated best with CPAP or central sleep apnea which is best treated with medication. Obstructive sleep apnea (OSA) is the most common form of sleep apnea, but CSA is still a possibility for some. Central sleep apnea in layman's terms is when the brain "forgets" to tell the respiratory system to work. Another problem I see with this shirt and "home remedy" method is the lack of an EKG reading. In the short time I was a PSG Tech, I personally dealt with two patients who had previously no knowledge of any heart arrythmias. I assume the clip on the finger is the PulsOx sensor which measures the saturated oxygen (SaO2) levels in the blood as well as monitoring one's pulse. Monitoring just the pulse won't likely identify any arrythmias. Also, in severe OSA, CPAP treatment alone will not keep SaO2 levels in the safe range (our lab had a minimum of 90% and a patient might need oxygen supplement. Now, to be honest, the arguments I've presented against this shirt are all extreme examples at the far end of the spectrum. I can't say I'm all for this product. I will say that it should be used with caution and one should consult their doctor regarding it.
Crow, You have been extremely helpful I will ask more questions of the company and proceed with caution. Much Thanks!!
The test being used is a type III portable test. It tracks respiratory effort at both the chest and stomach and by nasal cannulla flow (the little thingy you put at your nose). If a patient is showing no nasal cannula flow and no respiratory effort at the same time that would indicate a potential central apnea (the brain is forgetting to tell you to breathe) apneas can be obstructive (your throat closes down and blocks), central (where your brain forgets to tell you to breathe) or mixed.(you have some of both). A type III portable test is not sensitive enough to positively diagnose central apneas for treatment.. but a type III will indicate if centrals may be present enough to refer the patient to a sleep lab for additional testing. The issue is.. central apnea are a VERY rare form of sleep disorder. I don't know the percentages but in testing several hundred drivers for sleep apnea I am aware of only one driver that showed possible central apneas in their portable study. That driver was refferred to a sleep lab for additional testing. With the lowest cost for an in-lab sleep study being in the $ 1,000-1,200 range and average costs running about $ 2,000 getting a definitive portable test for obstructive apnea at $ 299-399 makes business sense to me. There is NO "home remedy" involved. The portable tests are intrepreted by a physician board certified in sleep medicine who makes diagnostic and treatment reccomendations. Treatment is by a Auto-titrating CPAP. This is a type of CPAP that senses the appropriate pressure and adjusts it as needed. This removes the need for an in-lab study to set the CPAP pressure while you are sleeping in the lab. APAP is a widely used treatment. Most drivers tested for sleep apnea in a lab will be treated with an APAP. Scarecrow in his post notes that his examples are "extreme examples at the far end of the spectrum". Sleep apnea testing and treatment for truck drivers is a complicated issue. Often information in sales literature will not go into the technical details because most drivers are more concerned about cost and getting their DOT medical card. Like Roadside Well Care I will not mention names or links to avoid "advertising". But consider this.. the testing being discussed using a portable test and sleep shirt... is offered with an OOIDA discount and is advertised in Landline. The company is a MAJOR sponsor of the St. Christopher Fund which is a charity to help drives with medical issues who do not have insurance. With OOIDA being VERY opposed to any form of mandatory sleep apnea testing for truck drivers. Would OOIDA allow advertising and sponsor a company who is not treating drivers right? This company sponsors the MeRV which if you listen to Dave Nemo on XM you know all about. PLEASE ASK QUESTIONS!!!! GET MORE INFORMATION,,,,,,
These tests make all kinds of since. First we do not have the labs it would take to test the drivers we have in the time frame that they want them tested. Second, the regular in lab test has like 24 leads, the In home test picks up 18 leads. I have been privileged to do both types of test. The new versions of the in home tests have been compared with the in lab. And they are remarkably close. As Truckerdad57 stated the only thing we need to know is.. Do you have Sleep Apnea and do you have Central Sleep apnea,. And as he said the in home tests can pick that much up. So the answer to Roadside Well Care is yes they are worth having and in about 90 plus percent of the cases that will be the only test people will need. Gary
Thank you all for your input. After considering that central apneas are so rare and reading the literature on the portable unit in question and it's ability to detect obstructive apnea, I am going to proceed with a few tests and see how things go. So much thanks to everyone!!
I think that if you have the right test that it will detect the centrals, however, you need the lab to detect what appropriate treatment will be.
