Heart Rate Characterization as an Initial Sleep Apnea Screening Tool

睡眠呼吸暂停影响全球10-25%的成年人，并导致高血压、II型糖尿病和心血管疾病等严重疾病。英国大约有800万人患有这种疾病，而且这个数字还在迅速增长。在睡眠过程中，呼吸完全停止之后突然觉醒的循环周期产生了一个明确的低心率和高心率交替的模式。这些在睡眠中呼吸停止的发作在轻微的睡眠呼吸暂停病例中较少发生，而在严重的睡眠呼吸暂停病例中更频繁发生。为了诊断睡眠呼吸暂停的存在和量化严重程度，患者必须被转介到医院或诊所的睡眠实验室进行过夜研究。睡眠实验室测试对病人来说很不方便，对医疗保健系统来说也很昂贵，睡眠研究结果需要训练有素的医生及时检查。此外，目前使用的睡眠呼吸暂停检测的睡眠研究方法几乎不可能跟踪呼吸暂停发作次数的长期变化。需要开发一种新的系统，可以持续跟踪睡眠呼吸暂停发作，以筛查患睡眠呼吸暂停风险较高的个体的发作次数增加，或者用作生物标志物，用于优化那些已经患有睡眠呼吸暂停诊断的患者的治疗方案。大多数患有睡眠呼吸暂停的人都没有意识到自己患有这种疾病。为公众提供一种负担得起的、实用的睡眠呼吸暂停筛查方法，可能会改变游戏规则，使医疗保健朝着更具预防性的方向发展。我们在脑干数字健康的目标是开发一种腕带可穿戴设备，结合智能手机应用程序，用于远程频繁筛查与睡眠呼吸暂停相关的循环心率模式。该设备将拥有用于检测脉搏波的高质量医疗级光学传感器，而应用程序将为用户提供最近记录的视觉表现以及长期数据趋势。关于在循环心率模式中花费的总时间、总发作数和每小时发作数的信息将呈现给用户。睡眠催眠图也将展示与呼吸暂停相关的循环心率发作与深度和快速眼动睡眠阶段的关联。

Sleep apnea affects between 10-25% of the global adult population and leads to serious ailments such as hypertension, Type II diabetes, and cardiovascular disease. Approximately eight million people in the UK suffer from the condition and this number is growing rapidly. During sleep, cyclic periods in which breathing stops completely followed by a sudden arousal produces a well-defined pattern of alternating low and high heart rates. These episodes of breath cessation during sleep occur less frequently in minor cases of sleep apnea and occur more frequently in severe cases of sleep apnea. In order to diagnose the presence of sleep apnea and quantify the severity, patients must be referred for an overnight study to a sleep lab in a hospital or clinic. Sleep lab testing is inconvenient for the patient and costly for the health-care system and sleep study results require a timely review by a well-trained physician. Furthermore, the sleep study method of sleep apnea detection used currently makes it nearly impossible to track long-term changes in apnea episode count.A new system needs to be developed that can enable ongoing sleep apnea episode tracking to either screen for increasing episode count in individuals at higher risk for developing sleep apnea or to be used as a biomarker that can be used to optimize treatment regimes in those patients that already have a sleep apnea diagnosis. Most people with sleep apnea are unaware that they suffer from the disorder. Providing the general public with an affordable and practical method for sleep apnea screening could potentially be a game-changer in the strive towards a more preventative approach to healthcare.Our goal at Brainstem Digital Health is to develop a wristband wearable device combined with a smartphone application for the remote frequent screening of sleep apnea-related cyclic heart rate patterns. The device will possess high quality medical grade optical sensors for the detection of the pulse wave while the app will provide the user with visual representation of the recent recording as well as long-term data trends. Information regarding total time spent in cyclic heart rate pattern, total number of episodes, and number of episodes per hour will be presented to the user. A sleep hypnogram will also be presented that will demonstrate the association of the apnea-related cyclic heart rate episodes with deep and REM sleep stages.