Sleep apnea diagnostics by iDoc (synonym: sleep screening by iDoc) is a diagnostic procedure in sleep medicine based on the use of a mobile sleep analyzer, which can thus be used for outpatient examination of sleep behavior primarily when sleep apnea syndrome is suspected. The mobile device enables the analysis of sleep in the patient’s known environment and represents an alternative to conventional sleep monitoring in a professional sleep laboratory. The quality of the procedure is guaranteed via a specialist evaluation of iDoc’s sleep apnea diagnostics.
Indications (areas of application)
- Sleep-related breathing disorders (SBAS) – almost 8% of the population suffers from sleep apnea or sleep-related breathing disorder. The associated nocturnal respiratory arrests not only lead to significantly increased fatigue during the day, they can also negatively affect existing diseases (e.g., hypertension/high blood pressure) in their symptomatology, prognosis, and progression. In particular, sleep apnea syndrome represents a cardiovascular risk factor, as under oxygen desaturation (insufficient oxygen supply) results in reduced perfusion (undersupply) of the myocardium (heart muscle), which can lead to ischemia (death of cells). Furthermore, atherosclerotic processes are enhanced via the release of inflammatory mediators (CRP, IL-6, IL-18, TNF-alpha). Also in apoplexy (stroke), sleep-disordered breathing is given a crucial role, as 66% of all patients with apoplexy suffer from sleep apnea syndrome.
Contraindications
Relative contraindication
- Sleep diagnostics should not be performed on an outpatient basis if the patient is in a massively reduced general condition, in order to treat disease-related complications more quickly.
Before the examination
When sleep apnea syndrome is suspected, a 4-step diagnostic procedure is typically used:
- Primary care physician – the primary care physician should identify the symptomatology through a detailed history and examination of the patient and, if necessary, initiate a referral to a specialist.
- Clinical examination – the focus of the clinical examination should be particularly on the detection of endocrine (diseases of metabolism and hormonal function), cardiac (heart disease), neurological (diseases of the peripheral and central nervous system) and psychiatric diseases.
- Sleep apnea diagnostics – if the examination and medical history (self and other) give evidence of sleep apnea syndrome, sleep apnea diagnostics should be performed by iDoc.
- Polysomnography (examination and measurement of certain biological parameters during sleep) – if necessary, there is still a need for further investigation of sleep in a sleep laboratory using polysomnography.
The procedure
iDoc sleep apnea diagnostics is based on the use of pulse oximetry (a method for non-invasive determination of arterial oxygen saturation) as a valid screening method for sleep-related breathing disorders. Pulse oximetry is a single-channel measurement for ascertaining the suspected diagnosis of sleep apnea, which is suitable for this purpose according to the DGSM (German Sleep Society). The assessment of the collected data by sleep diagnostics is carried out by the iDoc assessment service. These are specialists trained in sleep medicine. The high level of professional competence enables not only an adequate assessment of the collected data, but also the initiation of further diagnostic and therapeutic measures.
After the examination
Depending on the findings obtained, additional diagnostic and therapeutic measures may be necessary in the presence of sleep apnea syndrome. Dental measures such as the insertion of a so-called protrusion splint (snoring splint) as well as surgical procedures such as a soft palate reduction and tightening of the soft palate can lead to symptom relief or freedom.
Possible complications
iDoc sleep apnea diagnosis is completely free of complications because it is a noninvasive determination using pulse oximetry.
