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New "At Home" Sleep Evaluation Device
AustinGeog just posted this at apneasupport
Just saw this in google news:
Sculley is the John Sculley in Apple.
Watermark is launching a wire-free, in home sleep device that primary care physicians can use to diagnose sleep apnea.
The Watermark's ARES, as the sleep apnea device is called, is an FDA approved physiological recorder that a patient dons like headphones before going to bed. It has electrodes and nasal tubes that can be used to monitor and store up to 3 nights of nocturnal data, measuring, among other factors, blood oxygen saturation, airflow, pulse rate and snoring levels. Via USB, a doctor can upload the data to Watermark's network for analysis by sleep medicine professionals.
"The health care industry managed to miss the PC revolution, managed to miss the Internet revolution," Sculley says. "We think it's really ripe for moving to an era where you can distribute technology to people (so) consumers can do things more themselves, eventually taking responsibility for their own health and wellness."
To keep insurance costs at bay, Watermark is focusing its marketing efforts for ARES on primary care doctors who would prescribe the device to patients at a pre-reimbursed cost of around $250.
Views: 81
Replies to This Discussion
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Permalink Reply by Mike on
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I'm confused over whether primary care docs can make a proper diagnosis of sleep apnea based on results from home tests. are they entitled to, or do they need to forward the results to a Board-certified sleep doctor to make a formal diagnosis?
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Permalink Reply by Henning on
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ARES is a screening tool. There have here in Denmark and Sweden been several attempts to develop a screening tool for primary care physicians.
It has been with mixed success. First of all it requires training of primary care physicians, and there may be gaps in the screening. (Especially in borderline cases as well as with central apneas). So the main risk with screening is to overlook some cases that should be addressed.
On the other hand, a lot of more patients can be screened, so a lot of more patients can come into treatment quickly.
All in all I think that screening will find most of the patients.
Henning
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I agree with you.
A positive screening should always be followed by a PSG. So the problem is still in my optics that screening may show false negative.
But you can still screen (and treat) a lot of more people than today.
Henning
j n k said:The problem with using a home test as a screening tool is that it may do OK at proving someone breathes badly when asleep but may be less useful for proving someone breathes well when asleep. A screening tool is most useful when it does both sufficiently well--proving the negative AND the positive. And to do that, EEG is necessary, in my opinion.
As I see it, if a doc (1) is already pretty sure his patient needs CPAP, insurance should take his word on that and just allow the person to go for titration. If a doc (2) is not so sure, then he should get a lab diagnostic rather than a home test, since a home test is not all that useful for ruling out sleep-breathing problems. In both instances, in my opinion, the usefulness of home diagnostics would be questionable, clinically speaking. Until the bean counters figure that out, though, home tests serve the purpose of getting the severe patients to a lab quickly.
I know I am rather opinionated on this issue. I do, however, respect all other opinions on the topic.
jeff
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Permalink Reply by RockRpsgt on
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jnk, your post are contradicting. How can you say that the PSG is a waste of money and then talk of the importance of the EEG? They are same thing. The PSG, whether it be for titration or baseline purposes, is an invaluable resource in helping physicians diagnose current and future problems for patients. The PSG if performed right can negate the need for other testing procedures which monitor less parameters. There is no other test quite like it. I have helped my docs catch things that years of diagnosting testing have missed.
Do you guys really think that so many doctors are qualified to read the data presented by home testing? I don't as not even all certified sleep docs understand the data. There are not even any protocols for these machines as of yet. I recently had a pt who went to his physician with complaints of snoring, hypertension, and daytime fatigue. His doc told him that he probably had a deviated septum and put him on anxiety and blood pressure meds. PSG result was moderate apnea with severe PLMS. Which brings up another question what if the sleep problem is not apnea? Home testing's only parameter is respiratory.
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Permalink Reply by Judy on
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Whoopeee, 99! Youse a poet, and didn't know it. But your feet show it. They look like Longfellow's.
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It makes more sense when you put the two thoughts together jnk. Thanks. I recently suggested a home study to a pt with severe anxiety.
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I was just reading up on this ARES device and checked out their website. It says this is a Type II HST and measures EEG - is this right? Looks like it does not measure thoracoabdominal movement, which seems to be important according to this article:http://www.sleepreviewmag.com/issues/articles/2010-03_01.asp
j n k said:The problem with using a home test as a screening tool is that it may do OK at proving someone breathes badly when asleep but may be less useful for proving someone breathes well when asleep. A screening tool is most useful when it does both sufficiently well--proving the negative AND the positive. And to do that, EEG is necessary, in my opinion.
As I see it, if a doc (1) is already pretty sure his patient needs CPAP, insurance should take his word on that and just allow the person to go for titration. If a doc (2) is not so sure, then he should get a lab diagnostic rather than a home test, since a home test is not all that useful for ruling out sleep-breathing problems. In both instances, in my opinion, the usefulness of home diagnostics would be questionable, clinically speaking. Until the bean counters figure that out, though, home tests serve the purpose of getting the severe patients to a lab quickly.
I know I am rather opinionated on this issue. I do, however, respect all other opinions on the topic.
jeff
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