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Sleep Apnea and Sleep Quality

Sleep apnea is an important disease defined as the involuntary cessation of breathing, which lasts for at least 10 seconds or more due to the collapse of the upper respiratory tract in the "breathing" phase of varying degrees during sleep and is accompanied by a decrease in oxygen saturation in the blood. It is also defined as 5 or more episodes of hypopnea per hour characterized by a decrease in respiratory depth of more than 50% and mild hypoxemia. Respiratory arrests (apnea) or superficial (hypopnea) can recur hundreds of times during the night, and only a few of them are noticed by the relatives of the patient (Kaynak and Ardıç, 2011). Sleep apnea is a vital disease that requires immediate treatment. If it is not treated in time, it causes problems such as heart attack, stroke, impotence, irregular heartbeats, uncontrollable blood pressure, and can result in death if precautions are not taken. In addition, it causes excessive daytime sleepiness, which can cause accidents, work inefficiency and social problems (Demir, 2011). Studies show that one third of traffic accidents are caused by sleepiness caused by sleep apnea syndrome (World Sleep Day Accident and Sleep Apnea Panel Press Bulletin, 2012). It is known that the Chernobyl nuclear power plant accident was caused by an employee with sleep apnea.

Definitive diagnosis of sleep apnea and measurement of its severity; In sleep laboratories, so-called "polysomnography - sleep test" (PSG), the patient's respiratory characteristics during different stages of sleep, oxygenation of the blood, heart movements using electrocardiography (ECG), brain functions using electroencephalography (EEG), eye functions using electrooculography (EOG) movements are performed with an examination in which muscle functions are recorded simultaneously using electromyography (EMG) (Correa and Laciar, 2009). However, a special sleeping room needs to be built for this examination, which can be provided by a limited number of centers as it is a costly solution. In addition, the sleep test room can be used by only one patient during the day, so diagnostic service can be provided for a limited number of patients (Correa and Laciar, 2009). This method, which requires the patient to stay in the hospital overnight for measurements, is not preferred by some patients unless it is necessary. For this reason, the diagnosis of sleep apnea, which is a difficult disease to be noticed, becomes more difficult. Experts dealing with sleep disorders stated the need for portable polysomnographs that can be used at home, claiming that it would be more meaningful in terms of cost-effectiveness to identify possible sleep apnea in the patient, to record the sleep process of the patients at home with the help of a portable device, and to examine the patients with serious problems in the polysomnography laboratory. Considering that "simple snoring" was detected in approximately 15% of patients who underwent polysomnography in hospital conditions, it was thought that unnecessary blocking of sleep laboratories could also be prevented with measurements made at home. Today, patient tracking device solutions (ApneaLinkTM etc.) developed for use at home require the patient to wear breathing apparatus, resulting in an unnatural and uncomfortable sleep pattern as a result of restricted movement during the night. Therefore, making existing devices more wireless is extremely important for the patient and the physician.

In sleep laboratories, where several patients can be evaluated each night, patient appointments can be made months later. In home diagnostic solutions, on the other hand, the main problem is the incorrect placement of the cables before sleep and the cables coming out during sleep.

Prof. Dr. Füsun Eyüboğlu

In the light of this information, within the scope of our Remote Sleep Apnea Monitoring and Decision Support System R&D project, real-time heart rhythm, respiratory movements, oxygen concentration measurements in the blood, recording, interpretation and detection of apnea areas are used to be used in sleep apnea early diagnosis and treatment follow-up. A portable measuring device has been developed. The recorded data can be presented to physicians in the form of reports created with graphics, data processing and classification algorithms. The development of integrated and web-based software, which enables all data to be interpreted, viewed and analyzed as a report, was also carried out. A common practice opportunity has been created for potential patients, where they can be followed up at home without the PSG test, pre-evaluation can be made, time and resource costs can be reduced, and their living standards can be increased. A wireless, innovative and unique solution that does not require a breathing apparatus, using electrical impedance measurement techniques, has been realized by overcoming the difficulties in use, inaccuracies and misinformation arising from cables and breathing apparatus in existing methods applied at home.