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How on-the-wrist sleep apnea detection works

empirical.health

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

#81

Post by BeetleB »

lysace wrote: post #75
BeetleB wrote: post #69

Earlier quoted context omitted.

> During the past decade, the risk of being maltreated by a personally set-up CPAP unit has been far, far smaller than the risk of not being treated at all. There have been over 500 confirmed deaths due to the Philips CPAP. The number of unconfirmed deaths would be an order of magnitude higher, in my opinion. Thing is, the CPAP issue could be argued for both sides: "See how a small manufacturing defect could cause so…

"1. Yes, we should regulate manufacturers intensely." These were units prescribed by licensed people. The issue here was the manufacturer. As such I'm not sure what your complaint is.

> As such I'm not sure what your complaint is.

What made you think I was complaining?

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

#82

Post by rootusrootus »

lysace wrote: post #70
wilsonnb3 wrote: post #55

Earlier quoted context omitted.

I generally agree with you but even people with a prescription who have sleep apnea have a lot of trouble using their CPAP consistently and correctly, even after it is titrated by professionals in an overnight session. Some people obviously are capable of diagnosing and solving their own medical problems and are willing to learn and do the work but most people aren't. I don't think that opening up CPAPs to the masses…

> Regulation that streamlines the involvement of insurance providers would probably be enough IMO, they are the real reason it is difficult to get a CPAP most of the time. The obvious solution is to bypass the insurance providers. Also: when it comes to fitting masks to faces and figuring out the optimal pressure rates - these seem like pretty obvious application of machine learning algorithms, don't you think?

> these seem like pretty obvious application of machine learning algorithms, don't you think?

Anecdotally, my impression is that most CPAP users are using APAPs at this point, like the very popular Resmed AirSense 10. Titration amounts to giving it a pretty wide range and letting the machine itself figure out the right pressure. It's not a complex learning algorithm, but seems to do the job.

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

#83

Post by lysace »

BeetleB wrote: post #81
lysace wrote: post #75

Earlier quoted context omitted.

"1. Yes, we should regulate manufacturers intensely." These were units prescribed by licensed people. The issue here was the manufacturer. As such I'm not sure what your complaint is.

> As such I'm not sure what your complaint is. What made you think I was complaining?

> The number of unconfirmed deaths would be an order of magnitude higher, in my opinion.

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

#84

Post by rootusrootus »

runjake wrote: post #22

I'm not an qualified expert, but I spend a lot of time reading about and using this stuff and I'm extremely skeptical sleep apnea detection is very accurate without the pulse oximeter functionality. But gosh, I hope this is accurate across the Watch's wide user base. I wouldn't say it's likely, but I do wonder if the pulse oximeter is being used surreptitiously. In any case, if you could use the pulse oximeter, this…

IIRC the pulse oximeter isn't all that useful for sleep apnea detection anyway, because on the watch it does not run continuously. Just takes measurements every X minutes. I think the oxygen level drop happens on a short enough timescale that you need the continuous monitoring to pick up on it.

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

#85

Post by wilsonnb3 »

lysace wrote: post #70
wilsonnb3 wrote: post #55

Earlier quoted context omitted.

I generally agree with you but even people with a prescription who have sleep apnea have a lot of trouble using their CPAP consistently and correctly, even after it is titrated by professionals in an overnight session. Some people obviously are capable of diagnosing and solving their own medical problems and are willing to learn and do the work but most people aren't. I don't think that opening up CPAPs to the masses…

> Regulation that streamlines the involvement of insurance providers would probably be enough IMO, they are the real reason it is difficult to get a CPAP most of the time. The obvious solution is to bypass the insurance providers. Also: when it comes to fitting masks to faces and figuring out the optimal pressure rates - these seem like pretty obvious application of machine learning algorithms, don't you think?

> The obvious solution is to bypass the insurance providers.

That is one solution but I think it would be better to make it easier for people to go through the current process rather than making them pay out of pocket (assuming that it what you meant by "bypass the insurance providers").

Assuming that we aren't going to also fix the entire American medical system, making it easier for people to use the insurance they already have to get a medical device they need seems like the best approach to me.

> Also: when it comes to fitting masks to faces and figuring out the optimal pressure rates - these seem like pretty obvious application of machine learning algorithms, don't you think?

Yes but I don't think that means we should take the human expert(s) out of the loop.

I rather quickly changed the pressure settings on my bipap in the hidden menu after the titration but many, maybe most, people aren't like me and need there to be someone they can just say "this isn't working for me" to instead of being left on their own.

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

#86

Post by wilsonnb3 »

rootusrootus wrote: post #82
lysace wrote: post #70

Earlier quoted context omitted.

> Regulation that streamlines the involvement of insurance providers would probably be enough IMO, they are the real reason it is difficult to get a CPAP most of the time. The obvious solution is to bypass the insurance providers. Also: when it comes to fitting masks to faces and figuring out the optimal pressure rates - these seem like pretty obvious application of machine learning algorithms, don't you think?

> these seem like pretty obvious application of machine learning algorithms, don't you think? Anecdotally, my impression is that most CPAP users are using APAPs at this point, like the very popular Resmed AirSense 10. Titration amounts to giving it a pretty wide range and letting the machine itself figure out the right pressure. It's not a complex learning algorithm, but seems to do the job.

I think APAP's are more about comfort and less about effectiveness, although making them more comfortable to use does make them more effective.

The algorithm is more about detecting that you aren't asleep and thus don't need the full pressure at the moment and less about altering the target pressure setting on the fly.

I could be wrong though, I use is a bipap which works a bit differently than CPAP or APAP.

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

#87

Post by BeetleB »

lysace wrote: post #83
BeetleB wrote: post #81

Earlier quoted context omitted.

> As such I'm not sure what your complaint is. What made you think I was complaining?

> The number of unconfirmed deaths would be an order of magnitude higher, in my opinion.

That's an estimate. Not a complaint.

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

#88

Post by breck »

vlachen wrote: post #63
breck wrote: 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".

I don't mouth-tape, and I use a CPAP. However, since I prefer the nasal cushion type, I did run into issues with my partner regarding my mouth falling open and horrible "pumping air through your sinuses" noises emanating from my face hole. Instead of spending more from the home health shop, I just grabbed headband that came in some past 5K race bag, and I strap it around my head prior to the CPAP head gear. In my par…

> I'm not about to shave

I mouthtape and I got a full beard! Just use the 3M medical tape from Walgreens.

I don't do it every night, but I do it on occasion. Used to do it more. I find it's helped me just sleep mouth closed as normal now.

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

#89

Post by maxglute »

lysace wrote: 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…

Yeah you should be able to rent them instead of wasting months diagnosising or trying to find time in a sleep lab. Take it home for a whirl, if you sleep much better, and other QoL indexes improves, congradulations.

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

#90

Post by firesteelrain »

phickey wrote: post #40
lysace wrote: 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…

They don't advertise themselves as such, for obvious reasons, but there is at least one online CPAP dealer in the US that will sell to you without prescription verification. (Why should I wait 3 months for an appointment, drive an hour round trip, and $50 copay, to renew my rx so I can buy more masks, which wear out after a year or two?)

I used Lofta and it was about $189ish. Then, I got the subscription from them and bought my CPAP from CPAP.com using my HSA.
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