Photography by Kevin Van Paassen
Imagine being evaluated for a sleep disorder from the comfort of your own bed. For those seeking insights into their sleep habits, this concept is becoming a reality.
Researchers at Sunnybrook’s Sleep Disorder Clinic are increasingly using in-home devices, like movement and heart-rate monitors and tracking apps, to make it happen.
Home monitoring allows people to be assessed without having to come to the hospital’s sleep clinic for conventional in-laboratory sleep testing. It also allows Sunnybrook to help far more people than it otherwise could, and the early trial results are showing in-home testing to be as successful as some in-hospital techniques.
“We are using novel techniques to detect sleep apnea – the most common and disabling sleep disorder – periodic leg movements in sleep, as well as sleep-wake cycles,” says Dr. Mark Boulos, a sleep and stroke neurologist in the Sleep Disorder Clinic. Dr. Boulos is overseeing the trials, which involve hundreds of participants.
Dr. Boulos is especially excited by the data the team is collecting from watch-like devices patients wear around their ankles, which monitor leg movements at night.
“There is growing evidence of a potential link between periodic limb movements in sleep and silent and overt stroke, coronary artery disease and increased mortality,” he says.
In-home assessments also allow Sunnybrook to diagnose more stroke survivors with obstructive sleep apnea, a condition where breathing can be interrupted multiple times a night. The trials have also shown promising results among patients with cognitive impairments, a group Dr. Boulos says can be hard to treat for sleep issues.
While testing for sleep apnea at home is done in other parts of the country and the world, it is not commonly done in Ontario. That means this research could be practice-changing for the province.
“With the techniques available at home, we [can] move the sleep lab into the patient’s own bedroom,” Dr. Boulos says. “We can diagnose and treat more people, likely improving patient outcomes, which is always what we want to see.”