Urgent Need For Low-Cost In-Home Diagnostics For Obstructive Sleep ApneaTuesday, December 5, 2017
Today’s guest post comes from Christy Turer, MD, Assistant Professor of Pediatrics, Internal Medicine, and Clinical Sciences at University of Texas Southwestern (UTSW) Medical Center, Dallas, Texas, USA.
This week, I saw a 50 year-old female patient with obesity (BMI 44) who desperately needs screening and treatment for obstructive sleep apnea (OSA).
Over the past four years, her heart function (ejection fraction) has declined from >60% to now ~20% with significant pulmonary hypertension, almost certainly related to undiagnosed, untreated OSA based on multiple nightly witnessed apneas.
Although she now sleeps with oxygen, this does nothing for her hypopnea-related, sympathetic overdrive-mediated, cardiac dysfunction.
Without CPAP treatment, her life expectancy is two years or less.
Unfortunately, within the public health system for which I work (county system that offers free or discounted healthcare to poor residents in a metropolitan city, USA), the average wait time for a sleep study is 1-2 years.
To be fair, this patient has had a previous attempt at a sleep study in a sleep lab a couple of years ago. At that time, however, the study was inconclusive, because she could not fall asleep in the sleep lab’s unfamiliar environment.
It is frustrating not being able to help my patients with suspected sleep apnea, especially, when I know that help could be available.
It is high time we had a technological disruption that enables cheap, reliable, in-home OSA assessment for patients.
Christy Turer, MD
Dr Turer is a standing member of the US Food and Drug Administration’s Pediatric Advisory Committee, a consultant to the FDA’s Endocrinologic/Metabolic Drugs Advisory Committee, and Past-Chair of the Obesity Society’s Clinical Management of Obesity Section. She has authored numerous scientific articles and lectured widely on primary-care evaluation and management of overweight/obesity and related metabolic comorbidities across the lifespan. Her comments do not reflect the views of UTSW, FDA, or any of her funding sources.