Sleep Apnea And Online Screeners: Pros And Cons

With the number of convenient health tracking tools available today, it’s no surprise that you can now keep track of and analyze your sleep using digital tools available for your smartphone, computer, and tablet. Many different online screeners and sleep tracking apps now exist to help you keep track of your sleep: you can manually log or automatically sync up data about your bedtime, your wake time, your sleep fragmentation, and even, potentially, signs and symptoms of sleep disorders, including snoring and sleep apnea.

Some researchers refer to this category of tracking and recording health data at home to later share with a doctor as “telemedicine.”

But how good are these consumer digital health tools, really? Is it possible for an average person to gather accurate enough sleep data on your own to make a preliminary diagnosis of a problem as serious as obstructive sleep apnea?

The short answer is no. The majority of consumer health tools are not FDA-approved, and some are actually considered entertainment or recreation. There’s no substitute for a doctor’s visit; only a board-certified physician with experience in sleep medicine can make a diagnosis and create an apnea treatment plan.

However, online screeners for OSA can help to orient you in the direction of taking your sleep more seriously—and for that reason, many physicians and sleep medicine dentists encourage their use by patients who have yet to seek out an apnea diagnosis. The rationale is that these consumer sleep tools—which can be easy and even fun to use—can help you to understand your sleep better, and maybe even notice potential problems that were escaping your awareness in the past.

Ultimately, the decision whether or not to try an online apnea screener or sleep tool is yours. At Premier Sleep Associates, we believe in providing balanced information to potential clients and patients. For that reason, we’ve put together our own list of Pros and Cons about consumer sleep tracking tools and apnea screeners, so you can decide for yourself whether this DIY approach to sleep tracking is something you’d like to try. (Remember, though: to get apnea treatment, you’ll need a diagnosis from a board-certified physician with training in sleep medicine.)

Pros: Reasons to Use Online Apnea Screeners or Sleep Apps

• Instant access: no waiting for kits or appointments. Today’s online sleep tools are instantly downloadable onto your computer, tablet, or smartphone. Unlike a home sleep test kit or an appointment at a sleep center, you don’t have to wait for equipment or an appointment to begin analyzing your sleep quality. Apps like Drowzle mobile software, for example, allow patients to record sleep audio files, which get uploaded automatically to the cloud for analysis. The program analyzes your sleep breathing based on sound and breathing patterns. You then get a score and analysis sent to your mobile phone every day. Drowzle, in their own words, “collects and analyzes symptom data for sleep apnea risk, including severity of daytime sleepiness and personal chronic disease risk factors.” (3) The resulting daily scores are no substitute for an overnight supervised sleep study, home sleep test, or diagnosis by a physician, but the data does help you know your risk, based on how often you’ve ceased breathing in the night and for how long (according to the app’s collected data).

• Better awareness of sleep quality and sleep disorders. Downloadable apnea screeners and apps like Drowzle and SnoreLab, which records snoring only, help to raise awareness of what sleep disorders like sleep apnea look like. Using the tools can help you to get familiar with symptoms. Even if you don’t have apnea symptoms now, you may develop them in the future; after using an app, you may be more familiar with the signs and symptoms of OSA and its health ramifications. Sleep apps also help you gain an understanding of your own sleep.

• Ability to establish a baseline. Tracking your sleep with a consumer sleep tool helps you to get familiar with your basic levels when you’re undiagnosed and untreated for a sleep disorder like apnea. When you know what’s normal for you (and how that feels), you’ll be better equipped to detect the signs that things are getting worse. And if and when you get diagnosed and treated later, you’ll be able to see the data to show you how much your sleep breathing has improved with the help of oral appliance therapy or CPAP therapy.

• Feeling connected to your therapy. In our experience, consumer apps can be a useful supplement to treatment even after you’ve been diagnosed and treated for apnea. When diagnosed apnea patients continue to use apps like Drowzle, they feel more connected with their therapy. Being able to see the numbers and levels change over time helps patients feel like they’re getting results, even if they don’t feel their symptoms have dramatically improved at first. (Though the majority of our patients with mild to moderate apnea recognize improvements after the first night of therapy.) The community that comes with online tools can also be a helpful way to stay engaged with therapy. Hearing about others’ successes and strategies for improving OSA can be motivating. For many people, being able to track sleep data and talk to others with apnea makes them feel empowered and involved. We find that patients who are engaged like this are more likely to stick with their therapy over the long term.

Cons: The Pitfalls/Downside to Consumer Sleep-Tracking Tools

• Not FDA-approved. Consumer sleep tracking tools are generally not approved by the FDA for diagnosis of sleep disorders. This means that even the very best, most sensitive or accurate tool is not sufficient to provide you a diagnosis of obstructive sleep apnea. To get treatment for OSA, you’ll need to visit a physician, who will need to refer you to a sleep center for a polysomnography or home sleep test.

• Sound files may be less than perfectly accurate. Some snore-recording apps may take in room noise or the sound of someone else snoring (such as your bed partner). If you share a bedroom or bed, such results can throw off your readings.

• Readings can’t detect changes in your sleep habits. Is your bedroom stuffier tonight than it was yesterday? Do you have a cold, flu, or allergies that makes breathing more difficult? Maybe you’ve changed sleep position, turned on a humidifier, or put on nasal strips before going to bed. Any one of these factors can affect your snoring and sleep breathing—but the app won’t know this unless you self-report the change. Consumer sleep-tracking tools are sophisticated and sensitive, but they can’t see everything you do. The accuracy of your results depends in part on your remembering to self-report any changes you make to your sleep behaviors.

• False negatives. Consumer sleep tools like Drowzle are very good, but they’re imperfect. Some tools do provide false negatives. If your consumer sleep tool tells you you don’t have a likelihood for apnea, don’t take this result as the final word. Listen to your symptoms. If you snore, wake up with a headache or sore throat, or have excessive daytime sleepiness, see your doctor and ask to take the STOP BANG questionnaire—a screening tool that helps reveal your likelihood of having apnea. Taking this questionnaire begins a dialogue that can help you get a referral to a sleep specialist for a more accurate diagnosis.

Conclusions

Digital sleep tracking and snore-recording tools are definitely helpful, and on the whole we at Premier Sleep feel they’re a positive addition to the personalized health tool kit. Anything that gets you thinking about your sleep and snoring, and paying more attention to them, is a positive.

However, even the very best consumer sleep-tracking apps and diagnostic tools (such as Drowzle) have their limitations when compared to rigorous supervised or at-home sleep testing that’s interpreted by a board certified sleep medicine physician. No sound-based app can measure your blood oxygen levels (you need a pulse oximeter for that). A sound-based analysis of your breathing patterns cannot accurately determine your breathing effort, either.

These apps, while helpful in getting you to be conscious of your sleep breathing, cannot tell you about your sleep position nor determine whether you have an obstruction in your airway. They can’t tell the difference between central sleep apnea (related to the nervous system/brain) and obstructive sleep apnea.

At Premier Sleep Associates, we feel that if you’re not yet diagnosed with obstructive sleep apnea but have some symptoms like snoring or daytime sleepiness, using a sleep app or apnea screening tool can be a good first step to help point you in the direction of a diagnosis. These tools can also help you gather data to share with your doctor.

If you’re putting off seeing a sleep doctor or going to a sleep clinic for some reason—for example, if you’re skeptical you have apnea—using a consumer app at home may help you overcome your resistance and get you a step closer to pursuing a diagnosis and treatment. However, note that no downloadable sleep application or consumer digital device is a substitute for a supervised sleep test or a home sleep test using FDA-approved medical equipment.

Curious about sleep apps and online screeners? Here are a few choices you can compare:

• SnoreLab ($7.99, for iPhone or Android). SnoreLab, a consumer app, records and analyzes snoring and has a community component. (Link)

• Snore Control (Free and $2.99 versions, iPhone). Like SnoreLab, this consumer app records your snoring and allows you to listen to files and share with friends. (Link)

• Drowzle (Free, for iPhone or Android, through invitation only). Drowzle is still in beta testing and is currently available only by invitation through employers or participating medical providers. Designed for telemedicine uses as well as personal use, the app records your sleep breathing and takes symptom surveys from you to help you develop your personal sleep apnea profile. Results can be shared with your doctor or dentist to help determine if you need further testing. (Link)