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Clare Williams was in her early thirties when she was unexpectedly diagnosed with obstructive sleep apnea (OSA), the most common sleep-related breathing disorder. Contrary to the typical profile of someone with the condition, Clare was a young, thin woman. People diagnosed with OSA are usually obese, middle-aged men.
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“For a long time, doctors ignored my symptoms because I didn’t fit the profile and they didn’t understand how serious the damage was from restless nights,” she said.
Solutions for insomnia
Dr. Erna Sif Arnardotir, a sleep specialist with 20 years of experience in the field, is dedicated to finding ways to diagnose patients like Clara Williams earlier and treat OSA in these patients more successfully.
– The problem is that sleep is a relatively new field of medicine, and it’s not always taken seriously compared to other fields. Doctors typically have two to four hours of sleep education, she said, and if they want to learn more, they have to seek further education after completing their formal education.
But sleep disorders can have a disproportionate impact on a person’s life. It is estimated that he suffers from OSA 175 million Europeansthe disorder has been linked to a number of negative health effects, including an increased risk of diabetes and heart disease, as well as chronic daytime sleepiness, which can affect a person’s ability to function normally in their daily life.
Arnadottir questions how seriously doctors currently treat sleep disorders. “Their approaches vary, and we want to change that,” she says.
Arnardotir is the lead researcher on the project Sleep Revolutiona four-year international research project funded by the European Union. The €15 million project, which will end in 2025, involves 39 partner institutions and companies in Europe and Australia, including European Sleep Research Society I European Sleep Apnea Database (ESADA)The goal of this project is to revolutionize the diagnosis and treatment of OSA.
As a biomedical scientist, Arnardottir is a firm believer in using new technologies and artificial intelligence (AI) to address this stubborn health problem.
– Our goal is to use UI to assess the severity of sleep apnea and tailor treatment to each patient – says Arnardottir, director of the Sleep Research Institute at Reykjavik University and secretary of the European Sleep Research Society.
Hold your breath
OSA is considered moderate when a person experiences fewer than 15 interruptions or periods of reduced breathing per night and severe when a person experiences one episode per minute or less. Interruptions in breathing are the main feature of the disorder and are caused by closing or obstructing the throat, which can lead to loud gasps, choking sounds, and snoring after airflow is reestablished.
– I would wake up in the morning with a sore throat and a headache, and I would be completely exhausted. “Sometimes I would literally fall asleep on my feet,” Williams said.
This exhaustion is understandable. With each episode of obstructive sleep apnea, patients briefly wake up, though they usually don’t remember it, which can lead to a significant decrease in the quality and depth of their sleep.
Often, a person is not aware that they are constantly waking up, which is why it may be years before they seek medical help. When they do seek medical help, it is often a long time before they are seen in a specialized sleep clinic.
– Waiting lists for sleep clinics are long, almost two years at some hospitals. Arnadottir says this is unacceptable given the severity of sleep apnea.
Home diagnosis
Scientists in the Sleep Revolution project hope to use technology to bring more advanced sleep tests from the clinic to the patient’s home, speeding up the diagnostic process. As a result, the tests will become simpler and more cost-effective, which will shorten the waiting time for sleep assessments.
“Today’s sleep clinics work as if we still keep records on paper, they just count the number of times a person stops breathing,” Arnardotir said. “These data, used as an indicator of OSA severity, do not take into account the physiological effects of these interruptions, such as disrupted sleep, reduced blood oxygen levels, and stress on the cardiovascular system. The index itself does not adequately take into account the symptoms of OSA patients and needs to be updated, Dr. Arnardotir said.”
Scientists working on the Sleep Revolution project studied the use of a sleep monitoring device that patients used at home. Over three nights, the device collected data about sleep and sent it to healthcare professionals, who could remotely assess the patient’s condition and long-term health risks.
– The data collected by the device, together with an app and a wearable wristband worn for a long time, will predict each person’s risk of developing the disease. We believe that sleep apnea is not equally dangerous for everyone. First, we have to find and treat those who are most at risk, Arnadottir said.
Currently, 1,000 patients suspected of having OSA from across Europe are being assessed in clinics and at home with the help of the study’s equipment.
The program was first tested in Iceland with the help of pilot patients who used the app and smart wearable devices for three months. Everything was then translated into 15 different languages for testing across Europe, from Sweden to Romania, Greece, Turkey, Norway and Estonia. All the data collected is stored on a central server located in Iceland, and the project partners have access to it.
By moving the diagnostic procedure from the hospital to the home, it can be performed over several nights, which would be too expensive in a hospital setting. This makes it possible to detect changes in OSA severity and sleep quality from night to night, as well as to observe a person’s more natural sleep at home.
Improvement of casting process
Williams, 50, now knows the cause of her apnea is a rare genetic disorder called Ehlers-Danlos syndrome that predisposes her to the condition, and she follows a regimen to stay healthy.
At night, he uses a CPAP device to prevent interruptions in his breathing. The shoebox-sized device ensures a steady flow of air through the mask, but it has its drawbacks: It’s difficult to fit, and the mask can become too loose, escaping from the face and sending loud puffs of air.
Serve as a Patient Coordinator European Lung FoundationThe organization, which aims to improve lung health by encouraging doctors to work closely with patients, realizes that many patients with sleep apnea do not like CPAP devices and some even sleep without it, endangering their health.
Lifestyle changes
Lifestyle interventions are another part of the research team’s strategy to help people reduce the severity of OSA, as there is a strong correlation between obesity and sleep apnea. “We want people to have a more personalized health care experience,” Arnadottir said.
In a series of experiments, groups of patients with OSA received instructions from exercise specialists or the SLEEP REVOLUTION app to strengthen muscles, including those in the mouth and throat. In addition, patients received nutritional advice, as excess weight can lead to airway obstruction.
It is expected that interventions to reduce OSA symptoms and severity will be shared with doctors to help them detect and treat OSA more quickly.
– Unfortunately, people who end up receiving treatment often have been suffering from sleep apnea for years. It would be much better if we could make the diagnosis earlier, says Arnadottir.
By Victoria D’Alessio
Research in this area is funded by the EU Horizon programme. The views of the interlocutors do not necessarily reflect those of the European Commission.
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This article was originally published in č magazine horizonEU Journal of Research and Innovation.
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