RE: REM and Sleep Stage Tracking at Home
All four sleep lab visits in about eight weeks to identify my disorder and then titrate to bi-level and ASV, confirmed that apnea and hypopnea, even when treated with CPAP, Bi-level PAP and ASV, had disrupted my sleep architecture, this meaning that the "normal" progressions between and proportions of N1, N2 to N3/N4 and REM sleep were disrupted.
Even with ASV that has almost completely suppressed all apnea and hypopnea events, and a subsequent change in my RLS meds that has cleared up both pre- and during-sleep PLMs, I was still waking up more times during the night than I wanted to and sleeping less than the "recommended amount." On good nights, REM rebound is evident, but I have remained concerned that I was not getting enough deep sleep. Further PSGs are just too expensive.
While each of the devices I mentioned in my original post may not be perfect, or an equivalent to a PSG, they each claim to have trials that show they do provide an indication, using their technologies, into the distribution of time in bed between these different stages. I have read up on some of these.
None of the replies to my original post have explained the technologies completely and quite a bit of personal research was done before making the investments. These go well beyond what fitness trackers that use actigraphy to provide indications.
I am still a relative newbie here, and in addition to the help members have provided with their posts, I have spent a lot of time researching devices that can provide an interested "patient" visibility beyond the respiratory information that the modern machines such as the ResMed AirCurve vAuto originally and the ASV are able to provide me.
My doctors have told me repeatedly that they don't trust the data from the ResMed machine that all of us using SleepHead rely upon. Further, they have also said they don't trust any consumer-level device to measure anything. The doctors only trust the PSG which besides being very expensive can only be conducted in the clinic, and it is not representative of the home environment. In fact, my ASV titration in the clinic showed a AHI of 10.1 but ASV at home has delivered an AHI of 0.0 and variance has only been 0.1 or so on a very few occasions almost 50 days into treatment.
I do not think the exact numbers from the consumer sensors are that important. I think the trends are. Further online research will show that the S+ is not merely a microphone and that it uses RF to sense breathing in addition to measuring light and noise whose elimination is critical to good sleep hygiene. I am surprised that its breathing analysis algorithms could not be applied to the data the ResMed XPAP machines collect. There are two divisions, one clinical and one consumer, for a reason.
The EarlySense captures realtime heart rate and respiratory rate and uses changes in them to make predictions of light, deep, REM sleep and wake time. It consequently can also sense bed entry and exit. The EarlySense algorithms were developed clinically and like the S+ (good or bad) makes predictions into light, deep and REM sleep and time awake. This company also has two divisions, one clinical and another consumer, for a reason.
Both of the above devices produce their versions of hypnograms showing the sequence between awake, light, deep and REM sleep. Their data was vastly different in the beginning but have now converged.
The Dreem is altogether a different device. It measures brainwave activity using sensors on the forehead and captures the data in EEG electronics located in the top of the headband. That data is transferred on waking to the smartphone and to their cloud so the analysis can be shown on the iPhone shortly after. A hypnogram is produced based only on the brainwave activity. About ten days in I can see a loose correlation between the data it produces with the S+ and the S-80. It claims to use sound to stimulate deep sleep. I can see this correlation in the before and after data as well.
My sleep doctor, a pulmonologist, thinks that having technology in the bedroom is a poor idea. However, he is completely convinced that sleeping with an ASV machine and a mask is different. A night-table based and under the bed sensor is far less intrusive, even when having to tell them to start on the iPhone when starting the ASV machine. Wearing a headband is actually not a bit worse than wearing a full face CPAP mask.
Your critical remarks are appreciated and with more experience, especially as a moderator, is also appreciated. The Apneaboard has been rather silent about these devices and further discussion from many members might produce further insight.
I am not meaning to advertise these devices, but I am trying to say in my own words that the technology behind sleep measurement and tracking at home is again advancing and there are some potential solutions that we can use to help monitor what's going on while we are sleeping to see that good sleep hygiene and use of our therapies is having some positive effect on the underlying physiology.
While I agree that treating apnea and respiratory events during sleep is critical to helping us get well, I think more insightful monitoring of physiology during our time asleep can help us improve our sleep hygiene and also indicate the rate of our progress towards good health.
The other devices referenced in the initial reply to my post have not been shown clinically to treat apnea; the cleaning machine offers no better cleaning of our equipment than the DMEs and machine manufacturers recommend. The measurement devices I wrote about are not a PSG, but they do gather data and provide indications that can be used over time to provide physiological insight.
The devices and their software are insufficient on their own to provide meaningful insight. It's important IMHO at least to save the key findings from such devices in a spreadsheet and to chart progress with graphs (like Sleepyhead does). In my own case there is a trend (with setbacks) spanning 100 days of treatment that is giving me further encouragement and also some data to talk to the doctor about at my next visit. The spreadsheet and graphs were very informative to drive the progression from bi-level PAP (that induced central apnea) to ASV.
Interested people with our affliction or other kinds of sleep deprivation (which is a recognized trend in the US society at least) would be well served to read more about these three and perhaps other devices to determine if these modest investments could provide insight they may benefit from. I only hope that a robust and perhaps less antagonistic or sarcastic discussion amongst others that have experimented with them can continue here.
(This post was last modified: 10-17-2016 05:08 AM by rwelliot.)