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medilog® diagnostic tool

Sleep Apnoea

What is Sleep Apnoea?
Sleep Apnoea is most easily defined as the absence of breathing during sleep. Derived from the Greek meaning "without breathing", apnoea comes in two main forms: Obstructive and Central. Obstructive Sleep Apnoea (OSA) is characterized by repeated episodes of complete or partial collapse of the upper airway causing breathing to stop. OSA is often accompanied by snoring and excessive sleepiness during the day. Central Sleep Apnoea (CSA) is a much rarer condition where the brain fails to initiate breathing during sleep.

What causes Sleep Apnoea?
Any partial or complete obstruction in the region of the nose, throat or mouth area preventing air from entering the lungs can cause OSA. The obstruction causes a narrowing of the airway and an increase in pharyngeal resistance with the generation of excessive negative pressure during inspiration. This narrowing requires an increase in muscle activity to keep the airway open, and there is evidence that patients with OSA lack airway muscle tone. Physical properties which may contribute to the narrowing of the airway include:

• Neck obesity (anatomically short, fat neck)
• Mandibular-pharyngeal abnormalities (incorrect jaw shape)
• Loss of muscle tone in the airway (due to vibratory trauma from long term snoring or simply from an excess of alcohol intake or sedatives)
• Size of surrounding soft tissue structures (e.g. tongue, soft palate)

Why should Sleep Apnoea concern us?
There is a basic lack of awareness about sleep apnoea in the general public and even with doctors, and as a result it’s estimated that 80 to 90% of OSA sufferers go undiagnosed.

It is estimated that OSA affects up to 24% of middle aged men and 9% of middle aged women.

As well as the side effects listed above, lack of treatment for sleep apnoea can lead to:

• health and safety implications of microsleep, a disturbed sleep pattern – particularly with drivers and machinery operators
• strokes
• high blood pressure
• heart attacks
• diabetes

The big problem is that the symptoms of sleep apnoea often go undetected and therefore untreated for many years. By the time patients finally show signs of the problems, their health can have deteriorated considerably, and the subsequent hidden cost to health systems is therefore enormous. With causal effects increasing, it is not unreasonable to conclude the lack of awareness about sleep apnoea could create a health "time bomb".
Cardiologists are increasingly demanded by authorities and on medical congresses to examine patients for sleep apnoea if arrhythmias are present.

medilog^®DARWIN Apnoea uses the high speed sampling and high amplitude resolution of the medilog^® AR12 recorder (included) to provide accurate analysis of the ECG and respiration. Analysis results are displayed in simple graphics which can be interpreted easily by general practitioners (GPs), nurses and technicians to see if the patient requires further testing and/ or needs treatment for heart related conditions.

medilog^®DARWIN Apnoea puts a reliable, affordable and non-invasive screening device in the hands of people that can make a difference.

Find all apnoeas at a glance using the coloured apnoea overview screen. No ECG beat or arrhythmia editing is necessary.

Is the apnoea causing the pause, or the pause causing the apnoea? Check using side by side synchronised ECG and respiration curves Determine sleep quality using the unique frequency spectrogram. Shows autonomic, sympathetic and vagal activity. 

medilog^®DARWIN Apnoea is part of the medilog^®DARWIN Holter system; howewer, it can as well be purchased individually.

If you haven’t got a medilog®... you can’t find Apnoea events without expensive and time consuming Polysomnographic testing.

medilog^®DARWIN Apnoea allows you to:

• Reduce costs by detecting Apnoeas in advance of Polysomnographic screening
• Pre-screen to ensure you need to carry out invasive diagnostics, therapy or surgery (treatment for pauses instead of apnoea)
• Monitor patients more effectively following introduction of pacemakers or CPAP (see definition below)
• conduct annual apnoea examinations - as for example requested in some European countries for bus drivers - quickly and conveniently.

Treatment for Sleep Apnoea
Once detected, most patients with severe sleep apnoea will be put on "CPAP" treatment. CPAP, or Continuous Positive Airway Pressure therapy, involving air being passed traditionally through a nasal mask, provides for a constant airflow to hold the patient’s airway open. This maintains uninterrupted breathing during sleep and as a result enables a better sleep pattern to develop. Some other techniques such as mandibular implants or surgery have also been used, in addition to change in diet for patients with less severe apnoea.

Patient with apnoea of over 20 seconds:

Patient without apnoea:

Overview of all medilog® diagnostic tools (PDF, 35.8 kB)