With the popularity of wearable performance and sleep trackers like Apple Watch, Google Fitbit, Whoop, Oura Ring, Garmin, Samsung Galaxy, and Withings ScanWatch, we get a lot of questions about what causes obstructive sleep apnea. By the end of this article, you should be able to understand what a low oxygen saturation on your wearable means for your health and performance.
Wearables are the new Primary Care (or are they?)
Wearables are no longer just concerned about your Daily Steps, but rather your clinical health. They can now detect irregularities with your heart and breathing with good accuracy. While the companies which make these devices are most interested in selling the devices and the monthly subscriptions, the product managers can easily sort the high-risk customers and warn them of serious life-threatening problems like heart disease and sleep apnea. In essence, the wearables are the new Primary Care. “Call Your Doctor” is the next step.
The companies are tiptoeing into the care space, not sure how to make a successful handoff to Specialists who can clinically treat the health problems. The onus to take action is still on the customer. But, the wearable companies know that the long term financial value of its customers increases dramatically when they save their lives.
The FDA and other regulatory agencies are legitimizing the technology
All the wearables are racing to get approval for their technology. The FDA’s stamp of approval enables the brands to capture more share of mind and share of wallet. Their total available market increases from health enthusiasts to now include the medical community, employers and health insurers.
Samsung Electronics recently announced that the sleep apnea feature on the Samsung Health Monitor app has received De Novo authorization from the U.S. Food and Drug Administration (FDA). This feature, which detects signs of sleep apnea using a compatible Samsung Galaxy Watch and phone, was the first of its kind to be authorized by the FDA following previous approval by Korea’s Ministry of Food and Drug Safety (MFDS), announced last October in Korea.
Similarly, Withings offers two distinct devices: Sleep and Sleep Analyzer. Sleep measures sleep quality and snoring. The Sleep Analyzer, an enhancement of Sleep that was released in Europe, offers medical-grade sleep apnea detection.
The sleep apnea feature enables users over the age of 22 who have not been diagnosed with sleep apnea to detect signs of moderate to severe obstructive sleep apnea (OSA) over a two-night monitoring period, a common and chronic sleep condition that often goes undiagnosed and untreated. To utilize the feature, users can simply track their sleep twice for more than four hours within a ten-day period.
Insurance companies will stall access to care
With more than 120 million Americans facing heart problems and 54 million suffering from Sleep Apnea, the insurance companies see easy detection as a double edged sword. They want to keep patients out of costly emergency rooms, but they don’t want to pay for preventive treatments.
For instance, most insurers now cover home sleep testing, but patients and physicians need to plow through copious roadblocks to get approval for the diagnosis and treatment of sleep apnea. Their acceptance of wearables to detect problems will likely be very slow. The industry is more likely to see acceptance from Medicare than private insurers like United, Cigna, Blue Cross, now that the FDA has legitimized the wearables.
What are these devices trying to measure?
Quite simply...the amount of oxygen in your blood. The more, the better. You breathe in air through your lungs. Oxygen enters your bloodstream and moves through your body in red blood cells. The devices use a pulse oximeter, or a process called pulse oximetry, to measure your oxygen saturation levels - this is the amount of oxygen carried by the red blood cells. You're fully saturated if your red blood cells are carrying the maximum amount of oxygen (100% saturation). If you’re wicked technical, you’ll want to know that a multi-wavelength sensor called PPG (photoplethysmography) emits and measures red and infrared reflections in the blood vessels. What really matters is the percentage of oxygen carried by your blood cells.
How to measure obstructive sleep apnea (OSA)?
The over-the-counter devices have some limitations, so you need a Home Sleep Test to diagnose your Sleep Apnea. BlueSleep uses a home sleep test which you place on your index finger. You might think you can bypass the test and jump to a CPAP or oral device, but insurance companies require a medical grade Home Sleep Test to pay for treatment. The test accurately measures pauses in your breathing and oxygen levels during the different stages of sleep over consecutive days. Based on your scores, you could have mild, moderate or severe sleep apnea (or no sleep apnea at all).
Who cares about Sleep Apnea oxygen levels?
Your brain, for one. Normal oxygen levels are between 94% to 98% or more. If you stop breathing for 30 seconds or more during sleep, your oxygen level could drop to 80% or less. In other words, your sleep apnea is causing...hypoxemia. Technically, if you’re taking shallow breaths for 10 seconds or longer while asleep, and your airflow drops below normal, you have experienced hypopnea. In any case, you're not getting enough oxygen during sleep, and you might have a morning headache, excessive daytime sleepiness, and be gasping for air during sleep (also, you’re likely snoring heavily). None of these are good for you, not to mention your bed partner’s alarming elbow jabs and morning scowls from your snoring. If your sleep apnea goes untreated, a bad break up is the least of your worries. High blood pressure, weight gain, heart problems, among others, are likely to make life difficult and shorter.
So how come oxygen levels drop at night when you’re sleeping? During deep sleep and especially REM sleep, the throat can collapse, and air no longer gets to the lungs (apnea), or air has difficulty getting to the lungs (hypopnea). If this happens frequently (5 or more times an hour), it can cause damage to all the blood vessels in the body and repeated brain arousals (the brain wakes up), or awakenings (you wake up and can’t get back to sleep). That’s not good, because you lose out on necessary sleep.
What’s your action plan?
If your wearable device indicates low oxygen levels, or you’re snoring heavily and feeling sleepy all day, then do your health a favor and get tested for Sleep Apnea at bluesleep.com. A Home Sleep Test is easy and inexpensive, especially if you’ve got insurance. The next step is getting treated with a custom-made oral device (OAT) or a CPAP (if your sleep apnea is very severe). BlueSleep patients with severe apnea showed an 87% decrease in disease severity with an oral device. Sleep better. Live longer.
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