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How on-the-wrist sleep apnea detection works

empirical.health

41–50 of 170 posts

Re: How on-the-wrist sleep apnea detection works

#41
post #17

Earlier quoted context omitted.

That's only in the US, right? (My flimsy understanding is that blood oxygen measurement is how at-home sleep studies work?)

At-home sleep studies measure heart rate (maybe ekg, some probe is on your skin), blood oxygen, sound, and the direction of gravity relative to your testing device (to classify results by "back", "side", "prone", etc.) I did one of these and it was the worst night of sleep I ever had. It's somewhat invasive. Meanwhile, I sleep with my watch every night with no problems.

Interesting. I keep meaning to get one done. Probes don't seem like that big a deal?

Re: How on-the-wrist sleep apnea detection works

#42
post #8

The gatekeeping in the CPAP field is so insane. 1. Yes, we should regulate manufacturers intensely. 2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out. Perhaps a knob? I claim: During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far…

The health industry as a whole is insane. I support the use of regulation and law where it ensures safety and efficacy but in the U.S. it's currently a patent and legal minefield. So much of it comes directly from special interests who want gatekeeping to keep out new/disruptive competition.

On the other side, as a consumer, I don't really want "new/disruptive competition" - I want stability and a legal guarantee my rights aren't being trod all over.

Large companies e.g. Google/Apple are just inherently untrustworthy in this regards, smaller overseas ones are no better (little to no regulation).

So please, no, stay the ** out of my health, thanks.

Re: How on-the-wrist sleep apnea detection works

#43
post #36
post #8

The gatekeeping in the CPAP field is so insane. 1. Yes, we should regulate manufacturers intensely. 2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out. Perhaps a knob? I claim: During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far…

That should have been done from day 1. Now, however, there are 1000s of doctors who make fat stacks prescribing CPAP machines, and they'll fight tooth and nail to not lose their whole business.

> Changing the ramp-up from 10 minutes to 45 minutes made a big difference for me.

What change did you see in your sleep routine?

Re: How on-the-wrist sleep apnea detection works

#44
post #38

Earlier quoted context omitted.

Sure it probably comes down to sensor specs, but the same question can be asked about Apple Ingtelligence and the new iPhones. If the model is in a private cloud, why is it restricted to newer iPhones? Surely the preprocessing isn't so intensive that only the latest iPhones can do it. It's artificial segmentation in the interest of driving (historically weakening) sales.

Yeah, I thought the same when they announced it. All in all, I feel that artificial segmentation is more frequent than ever and this can't be good indicator for their future growth, can it?

It's definitely a sign of the decline of hardware innovation. It's not for lack of trying, however. Apple has experimented with Touch Bars, VR, and LIDAR cameras, largely to little effect. They just aren't disruptive enough. So how then do they segment if not hardware? Software.

I think that growth is going to slow no matter what they do. Western and Japanese markets are saturated, and Chinese markets (once most promising) are bringing fierce competition both from local competition and the government.

Re: How on-the-wrist sleep apnea detection works

#45
post #8

The gatekeeping in the CPAP field is so insane. 1. Yes, we should regulate manufacturers intensely. 2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out. Perhaps a knob? I claim: During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far…

Agreed with both - #1 especially: https://www.propublica.org/article/philips-kept-warnings-abo...

Re: How on-the-wrist sleep apnea detection works

#46
post #17

Earlier quoted context omitted.

That's only in the US, right? (My flimsy understanding is that blood oxygen measurement is how at-home sleep studies work?)

At-home sleep studies measure heart rate (maybe ekg, some probe is on your skin), blood oxygen, sound, and the direction of gravity relative to your testing device (to classify results by "back", "side", "prone", etc.) I did one of these and it was the worst night of sleep I ever had. It's somewhat invasive. Meanwhile, I sleep with my watch every night with no problems.

I think this depends on your doctor/clinic and where you are. The last one I took home just had an oxygen sensor and the skin probe/patch. The doctor said they get (hand wavey) 95%+ of the same diagnostic capability from the simpler setup and far fewer claims of poor quality sleep caused by the equipment.

Re: How on-the-wrist sleep apnea detection works

#47
post #8

The gatekeeping in the CPAP field is so insane. 1. Yes, we should regulate manufacturers intensely. 2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out. Perhaps a knob? I claim: During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far…

> 2. No, we shouldn't regulate to whom companies should be allowed to sell them. The defaults are good enough for most. Provide an easy to use control for max pressure and people will figure it out.

I'm iffy on the machines themselves for this, mostly because I'm just ignorant about the risks and potential issues. But this absolutely should be the case for the consumable/wear items that go along with it. There's been a lot of push-back on retailers being able to sell things like the masks, the hoses, filters, etc. to the public at large that can't be used without a machine anyway.

> These things should be $500 mass-market consumer units.

Fundamentally yes. I'd be fine with it being something as simple as the local pharmacy can keep them in the back and you bring in the prescription from the doctor and they file it away saying that you're allowed to buy/replace it if there's some reasonable evidence that they need some modicum of control for safety of people. It shouldn't be any harder than getting some antibiotics.

As it is now I'm using a 10+ year old machine because I've changed insurance companies multiple times since and my current one wants a full sleep study before they'll sign off on anything at all (like allow the doctor to prescribe or let me order one). And they wouldn't tell me if they'd cover the sleep study or not.

Re: How on-the-wrist sleep apnea detection works

#48
post #32

If you're interested in this, I'd recommend reading the 1870 [public domain] book "Shut Your Mouth and Save your Life". Internet Archive has it: https://archive.org/details/b28114450 Also look into "mouth taping".

mouth taping is dangerous for many reasons, you should not be advocating it in a public forum

Re: How on-the-wrist sleep apnea detection works

#49
post #42

Earlier quoted context omitted.

The health industry as a whole is insane. I support the use of regulation and law where it ensures safety and efficacy but in the U.S. it's currently a patent and legal minefield. So much of it comes directly from special interests who want gatekeeping to keep out new/disruptive competition.

On the other side, as a consumer, I don't really want "new/disruptive competition" - I want stability and a legal guarantee my rights aren't being trod all over. Large companies e.g. Google/Apple are just inherently untrustworthy in this regards, smaller overseas ones are no better (little to no regulation). So please, no, stay the ** out of my health, thanks.

Google, Meta et al ARE FAR worse than anything might complain about Apple. Between the sleep apnea and hearing aid/hearing loss features you should be applauding these features to the world. As a consumer I have family members that will be leveraging these features immediately, including myself.

Re: How on-the-wrist sleep apnea detection works

#50
post #21
post #6

I wouldn't put a ton of stock into this, but it could still be useful. The WatchPAT device is purpose-built for this test and includes a full fingertip oximeter and while it's FDA-approved, it's still not very accurate. It's also a notoriously tricky condition to diagnose and can't really be done just by looking at numbers. I think there's value in the test being accessible to so many more people, it will likely have…

>can't really be done just by looking at numbers Depending on the numbers, why not? If it's sensor accuracy a single night might not be enough, but if it detects the condition averaging over a few weeks even unreliable measurements can be made more reliable (given they're just noisy).

Not a doctor, but I was given a diagnosis of severe sleep apnea from an overnight in-lab study. Sought a second opinion who decided it wasn't sleep apnea at all. AHI or T-90 are convenient indicators, but pulmonologists will actually look at the shape of your graph and listen to symptoms. All humans are different and don't always conform to formulas.

That being said, your observation that a nightly watch user can collect lots of data is an interesting one. If Apple (or whoever) can come up a more heuristic analysis than just computing AHI, they may end up with something better.

Also, not that you asked, but my sleep situation is a bit complicated and I actually ended up with a CPAP anyway.

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