[HN Gopher] How on-the-wrist sleep apnea detection works
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How on-the-wrist sleep apnea detection works
Author : brandonb
Score : 129 points
Date : 2024-09-09 17:21 UTC (5 hours ago)
(HTM) web link (www.empirical.health)
(TXT) w3m dump (www.empirical.health)
| cromka wrote:
| Considering they use accelerometer for it, nothing really stops
| them from adding this feature to all Apple Watches, potentially
| even the Series 1, right?
|
| Reserving it to Series 10 and 9 really exposes their lack of
| hardware innovation. I mean, we were talking about them measuring
| glucose levels for years and this is what we get as a new
| flagship feature?
| brandonb wrote:
| I suspect they also need oxygen saturation (introduced in the
| Apple Watch Series 6 in 2020) in order to make their overall
| sleep apnea detection algorithm work. Given that it only works
| with the Series 9 or above, it's possible they're also using
| the the temperature sensor as another input into their
| algorithm.
| jerlam wrote:
| Did Apple resolve the patent issue that disabled oxygen
| saturation in the Series 9?
|
| Although it's possible that Sleep Apnea detection uses the
| oxygen saturation sensor but doesn't show its results
| directly.
| brandonb wrote:
| It wouldn't surprise me if they did the latter. The oxygen
| saturation sensor is fundamentally just another optical
| sensor with a different wavelength of light -- so if you
| feed all three wavelengths, plus the accelerometer, into a
| neural network, you may be able to pick up on oxygen-
| related physiological signals without explicitly processing
| an oxygen timeseries.
| MBCook wrote:
| No. I was very curious to see if it might be a last minute
| thing where it came back but the pages for the series 10
| clearly don't list it and if you use the comparison tool
| it's highlighted as gone.
|
| I hope it's just still disabled. It would suck for someone
| to buy a new watch, the fix the dispute in 2 months, and
| you never get the feature until you buy another new watch.
|
| They're clearly not bending. I don't know if they've given
| up or waiting on an appeal or maybe home a new
| administration will tell the ITC to go away or what.
| skygazer wrote:
| They're still appealing, but the underlying patent expires
| in 2028, so maybe they'll wait it out.
| cromka wrote:
| They explicitly only mentioned accelerometer. If they used
| more sensors, in particular temperature sensor, it's hard to
| imagine they wouldn't mention in, especially that it would
| justify them limiting the feature to Series 9 and 10.
|
| However, reading on PAT (Peripheral arterial tone) and
| existing FDA-approved devices using that, they indeed use
| oxygen but not temperature. See for example "WatchPAT ONE"
| device.
| dwighttk wrote:
| Perhaps they aren't worried about justification
| swatcoder wrote:
| They absolutely could be segmenting features by generation even
| if they could introduce them into earlier products and it's
| pretty normal across the industry to do so, _but_ "well, it
| seems to use the accelerometer" provides no evidence of that on
| its own.
|
| Without knowing more details about the implementation, it may
| rely on combining data from other sensors as well, it may need
| a certain frequency/resolution from a sensor that's not
| available in earlier generations of hardware, it might place
| too much demand on compute or power to maintain prior products'
| expected behavior, etc
| pdpi wrote:
| > , it might place too much demand on compute or power to
| maintain prior products' expected behavior, etc
|
| Love it or hate it, this mentality of "the feature is
| technically possible but we won't enable it because we're not
| happy with the compromises it demands" is, by design, exactly
| the sort of logic that Apple is known for.
| mikestew wrote:
| _nothing really stops them from adding this feature to all
| Apple Watches..._
|
| I'm confident there's more to it than just sensor availability.
| Compute power for starters, as well as the fact that a Series 1
| accelerometer may not have the necessary resolution, etc.
|
| _Reserving it to Series 10 and 9 really exposes their lack of
| hardware innovation._
|
| Ah, the ol' "Apple didn't build what I want, ergo, Apple
| doesn't innovate" trope.
| cromka wrote:
| That's manipulative. I did not mention I expected anything in
| particular. If anything, your defensive narrative makes you
| come off as a fanboy.
| a_vanderbilt wrote:
| Sure it probably comes down to sensor specs, but the same
| question can be asked about Apple Ingtelligence and the new
| iPhones. If the model is in a private cloud, why is it
| restricted to newer iPhones? Surely the preprocessing isn't so
| intensive that only the latest iPhones can do it. It's
| artificial segmentation in the interest of driving
| (historically weakening) sales.
| cromka wrote:
| Yeah, I thought the same when they announced it. All in all,
| I feel that artificial segmentation is more frequent than
| ever and this can't be good indicator for their future
| growth, can it?
| a_vanderbilt wrote:
| It's definitely a sign of the decline of hardware
| innovation. It's not for lack of trying, however. Apple has
| experimented with Touch Bars, VR, and LIDAR cameras,
| largely to little effect. They just aren't disruptive
| enough. So how then do they segment if not hardware?
| Software.
|
| I think that growth is going to slow no matter what they
| do. Western and Japanese markets are saturated, and Chinese
| markets (once most promising) are bringing fierce
| competition both from local competition and the government.
| MBCook wrote:
| It's not all in a private cloud. Much is on device, and as we
| all know AI stuff loves CPU and RAM.
|
| They appear to have restricted it to 8 GB of RAM devices or
| more (when those appear).
|
| During The Talk Show interview at WWDC with John Gruber an
| Apple exec (Joz?) said they did it because of user experience
| issues, seeming implying speed.
|
| And given how hard AI hits hardware I think that's relatively
| believable.
| diebeforei485 wrote:
| Probably requires the newer generation accelerometer.
|
| There are also other issues like power consumption overnight.
| Older watches have smaller batteries and slow charging. People
| will update the software, use the new features, and complain
| that Apple software updates are killing the battery (waking up
| to low battery plus slow charing means not being able to charge
| up before leaving for work). This has the effect of Apple only
| backporting new features if they don't consume too much
| battery.
| hartator wrote:
| Is it released or they are waiting for fda approval?
|
| Little unclear on macrumors.
| peppertree wrote:
| Waiting for fda.
| tootie wrote:
| I wouldn't put a ton of stock into this, but it could still be
| useful. The WatchPAT device is purpose-built for this test and
| includes a full fingertip oximeter and while it's FDA-approved,
| it's still not very accurate. It's also a notoriously tricky
| condition to diagnose and can't really be done just by looking at
| numbers. I think there's value in the test being accessible to so
| many more people, it will likely have a positive outcome on
| detection and treatment, but I would not expect you to push a
| button and get a confirmed diagnosis.
| carlmr wrote:
| >can't really be done just by looking at numbers
|
| Depending on the numbers, why not?
|
| If it's sensor accuracy a single night might not be enough, but
| if it detects the condition averaging over a few weeks even
| unreliable measurements can be made more reliable (given
| they're just noisy).
| tootie wrote:
| Not a doctor, but I was given a diagnosis of severe sleep
| apnea from an overnight in-lab study. Sought a second opinion
| who decided it wasn't sleep apnea at all. AHI or T-90 are
| convenient indicators, but pulmonologists will actually look
| at the shape of your graph and listen to symptoms. All humans
| are different and don't always conform to formulas.
|
| That being said, your observation that a nightly watch user
| can collect lots of data is an interesting one. If Apple (or
| whoever) can come up a more heuristic analysis than just
| computing AHI, they may end up with something better.
|
| Also, not that you asked, but my sleep situation is a bit
| complicated and I actually ended up with a CPAP anyway.
| lysace wrote:
| The gatekeeping in the CPAP field is so insane.
|
| 1. Yes, we should regulate manufacturers intensely.
|
| 2. No, we shouldn't regulate to whom companies should be allowed
| to sell them. The defaults are good enough for most. Provide an
| easy to use control for max pressure and people will figure it
| out. Perhaps a knob?
|
| I claim: During the past decade, the risk of being maltreated by
| a personally set-up CPAP unit has been far, far smaller than the
| risk of not being treated at all. (Ways to access these menus
| have been been shared online for 10+ years, many use them.)
|
| I wonder how many premature deaths happen every year because of
| this - including secondary victims from traffic accidents.
|
| These things should be $500 mass-market consumer units that you
| pick up at Target, Walmart, etc.
| a_vanderbilt wrote:
| The health industry as a whole is insane. I support the use of
| regulation and law where it ensures safety and efficacy but in
| the U.S. it's currently a patent and legal minefield. So much
| of it comes directly from special interests who want
| gatekeeping to keep out new/disruptive competition.
| smaudet wrote:
| On the other side, as a consumer, I don't really want
| "new/disruptive competition" - I want stability and a legal
| guarantee my rights aren't being trod all over.
|
| Large companies e.g. Google/Apple are just inherently
| untrustworthy in this regards, smaller overseas ones are no
| better (little to no regulation).
|
| So please, no, stay the ** out of my health, thanks.
| IOT_Apprentice wrote:
| Google, Meta et al ARE FAR worse than anything might
| complain about Apple. Between the sleep apnea and hearing
| aid/hearing loss features you should be applauding these
| features to the world. As a consumer I have family members
| that will be leveraging these features immediately,
| including myself.
| a_vanderbilt wrote:
| You can have gains in both today if certain issues are
| addressed. Innovation doesn't mean a lack of liability or
| responsibility for negligence.
|
| In the U.S. you already have relatively minimal rights in
| healthcare. Your stability and legal guarantees are already
| compromised compared to your worldly neighbors. I too
| distrust tech companies in healthcare due to their
| differing motivations and organizational cultures.
|
| I want the red tape to go away, but I also want strong
| regulations and safety nets to ensure the drugs and devices
| we are prescribing to people are effective and safe.
| jjk166 wrote:
| That's the cool thing about competition though - you can
| continue spending your money on the current super expensive
| option if you like. But others who may not value that
| stability can choose something else.
|
| Personally, I consider big pharma companies the absolute
| least trustworthy, and I would never choose to purchase
| anything from them if I would not literally otherwise die.
| Regulations are not fundamentally bad, but the current
| situation is obviously a case of regulatory capture.
| jrockway wrote:
| I'm just happy that the "service mode" screens are easy to get
| to. Changing the ramp-up from 10 minutes to 45 minutes made a
| big difference for me.
|
| (I'm honestly surprised someone doesn't make the vendors
| require a 1000 character passphrase that locks you out of the
| device after 2 failed attempts.)
| tlb wrote:
| That should have been done from day 1. Now, however, there are
| 1000s of doctors who make fat stacks prescribing CPAP machines,
| and they'll fight tooth and nail to not lose their whole
| business.
| TMWNN wrote:
| > Changing the ramp-up from 10 minutes to 45 minutes made a
| big difference for me.
|
| What change did you see in your sleep routine?
| IOT_Apprentice wrote:
| The car salesman who we worked with leasing our Lexus had a
| bad flu and didn't wear his mask ONE night and died in his
| sleep. We found out when we went back to the dealer. He left
| wife and a special needs son. I lie my father before me
| suffer from extreme sleep apnea. I want to make sure my sons
| have the detection this will bring.
| phickey wrote:
| They don't advertise themselves as such, for obvious reasons,
| but there is at least one online CPAP dealer in the US that
| will sell to you without prescription verification. (Why should
| I wait 3 months for an appointment, drive an hour round trip,
| and $50 copay, to renew my rx so I can buy more masks, which
| wear out after a year or two?)
| jzig wrote:
| What to search for? Link?
| rootusrootus wrote:
| I don't know who will do it without any kind of
| prescription, but it's pretty trivial to get an at-home
| test from someone like 1800cpap and they'll write a
| prescription based on the results. I bet they have a nearly
| 100% rate of writing prescriptions, given the obvious
| conflict of interest.
| bluGill wrote:
| > I bet they have a nearly 100% rate of writing
| prescriptions, given the obvious conflict of interest.
|
| Even if they are honest I'd expect near 100% - people who
| don't expect they have issues are not going to be getting
| the at home test in the first place.
| firesteelrain wrote:
| I used Lofta and it was about $189ish. Then, I got the
| subscription from them and bought my CPAP from CPAP.com using
| my HSA.
| binalpatel wrote:
| Agreed with both - #1 especially:
| https://www.propublica.org/article/philips-kept-warnings-abo...
| simcop2387 wrote:
| > 2. No, we shouldn't regulate to whom companies should be
| allowed to sell them. The defaults are good enough for most.
| Provide an easy to use control for max pressure and people will
| figure it out.
|
| I'm iffy on the machines themselves for this, mostly because
| I'm just ignorant about the risks and potential issues. But
| this absolutely should be the case for the consumable/wear
| items that go along with it. There's been a lot of push-back on
| retailers being able to sell things like the masks, the hoses,
| filters, etc. to the public at large that can't be used without
| a machine anyway.
|
| > These things should be $500 mass-market consumer units.
|
| Fundamentally yes. I'd be fine with it being something as
| simple as the local pharmacy can keep them in the back and you
| bring in the prescription from the doctor and they file it away
| saying that you're allowed to buy/replace it if there's some
| reasonable evidence that they need some modicum of control for
| safety of people. It shouldn't be any harder than getting some
| antibiotics.
|
| As it is now I'm using a 10+ year old machine because I've
| changed insurance companies multiple times since and my current
| one wants a full sleep study before they'll sign off on
| anything at all (like allow the doctor to prescribe or let me
| order one). And they wouldn't tell me if they'd cover the sleep
| study or not.
| titusjohnson wrote:
| > I'd be fine with it being something as simple as the local
| pharmacy can keep them in the back and you bring in the
| prescription from the doctor
|
| Just curious, why do you think a Dr. should be involved at
| all?
| bluGill wrote:
| You should have a Dr who keeps track of all your medical
| information. I want my doctor to know each time I take an
| Aspirin or put on a bandage. Most of the time those are
| meaningless activities (and I don't tell my doctor), but
| once in a while there is something more going on and I need
| to be forced into the ER.
| wilsonnb3 wrote:
| I generally agree with you but even people with a prescription
| who have sleep apnea have a lot of trouble using their CPAP
| consistently and correctly, even after it is titrated by
| professionals in an overnight session.
|
| _Some_ people obviously are capable of diagnosing and solving
| their own medical problems and are willing to learn and do the
| work but most people aren 't.
|
| I don't think that opening up CPAPs to the masses would
| suddenly "solve" sleep apnea, most people will still need to go
| through a similar process that exists now.
|
| Regulation that streamlines the involvement of insurance
| providers would probably be enough IMO, they are the real
| reason it is difficult to get a CPAP most of the time.
| lysace wrote:
| > Regulation that streamlines the involvement of insurance
| providers would probably be enough IMO, they are the real
| reason it is difficult to get a CPAP most of the time.
|
| The obvious solution is to bypass the insurance providers.
|
| Also: when it comes to fitting masks to faces and figuring
| out the optimal pressure rates - these seem like pretty
| obvious application of machine learning algorithms, don't you
| think?
| rootusrootus wrote:
| > these seem like pretty obvious application of machine
| learning algorithms, don't you think?
|
| Anecdotally, my impression is that most CPAP users are
| using APAPs at this point, like the very popular Resmed
| AirSense 10. Titration amounts to giving it a pretty wide
| range and letting the machine itself figure out the right
| pressure. It's not a complex learning algorithm, but seems
| to do the job.
| wilsonnb3 wrote:
| I think APAP's are more about comfort and less about
| effectiveness, although making them more comfortable to
| use does make them more effective.
|
| The algorithm is more about detecting that you aren't
| asleep and thus don't need the full pressure at the
| moment and less about altering the target pressure
| setting on the fly.
|
| I could be wrong though, I use is a bipap which works a
| bit differently than CPAP or APAP.
| rootusrootus wrote:
| I have personal experience with the Airsense 10 and it
| doesn't detect sleep/awake, as far as I can tell. At
| least not for me; it starts at low pressure, ramps up
| over a set time to the bottom of the range, and then
| adjusts as necessary. Low flow or an apnea event will get
| it to increase the pressure. Sometimes if you are
| breathing kinda slow lying there awake you can trip it up
| and feel it start pulsing the pressure to get more air
| moving.
|
| To my understanding (no personal experience), Philips
| APAPs have a different algorithm to try and achieve the
| same goal, and are regarded as less aggressive about it
| than Resmed.
|
| There's also a new Resmed Airsense 11 out but I don't
| know anything about it and what changed.
|
| BiPAPs are definitely a different beast, for sure. My dad
| used one of those. Not automatic at all, right? Constant
| pressure, but different between inhale and exhale?
| wilsonnb3 wrote:
| > The obvious solution is to bypass the insurance
| providers.
|
| That is one solution but I think it would be better to make
| it easier for people to go through the current process
| rather than making them pay out of pocket (assuming that it
| what you meant by "bypass the insurance providers").
|
| Assuming that we aren't going to also fix the entire
| American medical system, making it easier for people to use
| the insurance they already have to get a medical device
| they need seems like the best approach to me.
|
| > Also: when it comes to fitting masks to faces and
| figuring out the optimal pressure rates - these seem like
| pretty obvious application of machine learning algorithms,
| don't you think?
|
| Yes but I don't think that means we should take the human
| expert(s) out of the loop.
|
| I rather quickly changed the pressure settings on my bipap
| in the hidden menu after the titration but many, maybe
| most, people aren't like me and need there to be someone
| they can just say "this isn't working for me" to instead of
| being left on their own.
| renewiltord wrote:
| Absolutely, but most safety departments will happily do low
| probability kills over massive population over high probability
| kills over low population. You can lose thousands to the former
| to save 10s to the latter.
| BeetleB wrote:
| > During the past decade, the risk of being maltreated by a
| personally set-up CPAP unit has been far, far smaller than the
| risk of not being treated at all.
|
| There have been over 500 _confirmed_ deaths due to the Philips
| CPAP. The number of unconfirmed deaths would be an order of
| magnitude higher, in my opinion.
|
| Thing is, the CPAP issue could be argued for both sides:
|
| "See how a small manufacturing defect could cause so many
| deaths? We definitely need to regulate this heavily!"
|
| OR
|
| "See how many people died due to Phillips because they didn't
| have alternatives?"
| lysace wrote:
| "1. Yes, we should regulate manufacturers intensely."
|
| These were units prescribed by licensed people. The issue
| here was the manufacturer.
|
| As such I'm not sure what your complaint is.
| BeetleB wrote:
| > As such I'm not sure what your complaint is.
|
| What made you think I was complaining?
| lysace wrote:
| > The number of unconfirmed deaths would be an order of
| magnitude higher, in my opinion.
| BeetleB wrote:
| That's an estimate. Not a complaint.
| lysace wrote:
| Mkay.
| rootusrootus wrote:
| The Philips CPAP deaths were caused by a faulty machine, not
| by anything the users did wrong. Whether it was bought OTC or
| prescribed by a doctor would have no impact.
| DebtDeflation wrote:
| Not only that, but it wasn't a problem with the pressure
| settings or anything related to the function of the device,
| it was chunks of the sound deadening foam breaking off and
| people inhaling them in their sleep.
| eddieroger wrote:
| I'd argue the problem is gatekeeping access to medicine, since
| I don't think this is unique to CPAP. It should be easy to get
| in to a doctor, receive a test and diagnosis for sleep apnea
| (or anything), and proceed to treatment. Regulation is an after
| effect of the system. Maybe sane defaults are good most of the
| time, but no-one should be in a spot where they have to rely on
| defaults for care.
| maxglute wrote:
| Yeah you should be able to rent them instead of wasting months
| diagnosising or trying to find time in a sleep lab. Take it
| home for a whirl, if you sleep much better, and other QoL
| indexes improves, congradulations.
| bluGill wrote:
| The machines themselves should be able to figure this out.
| Automation is good.
| abtinf wrote:
| I've always wished I could put Apple Watch into a "constant
| oxygen monitor mode" for sleep. That seems to be the obvious way
| to assess sleep apnea.
|
| Anyone know why that isn't the method?
| a_vanderbilt wrote:
| If I had to venture a guess, maybe it's an industry regulation
| or power usage issue. Simply being able to assess sleep apnea
| isn't enough, it has to pass the regulatory burdens as well.
| zwily wrote:
| They still don't have the regular oxygen monitor mode back yet
| because of a patent dispute. That might be part of it.
| tptacek wrote:
| That's only in the US, right?
|
| (My flimsy understanding is that blood oxygen measurement is
| how at-home sleep studies work?)
| jrockway wrote:
| At-home sleep studies measure heart rate (maybe ekg, some
| probe is on your skin), blood oxygen, sound, and the
| direction of gravity relative to your testing device (to
| classify results by "back", "side", "prone", etc.)
|
| I did one of these and it was the worst night of sleep I
| ever had. It's somewhat invasive. Meanwhile, I sleep with
| my watch every night with no problems.
| tptacek wrote:
| Interesting. I keep meaning to get one done. Probes don't
| seem like _that_ big a deal?
| twojacobtwo wrote:
| I think this depends on your doctor/clinic and where you
| are. The last one I took home just had an oxygen sensor
| and the skin probe/patch. The doctor said they get (hand
| wavey) 95%+ of the same diagnostic capability from the
| simpler setup and far fewer claims of poor quality sleep
| caused by the equipment.
| renewiltord wrote:
| Amusingly my Apple Watch pulse ox showed low so I did a
| sleep study. It's invasive, but it plugs into your
| nostrils (and in my case held them open). Slept like a
| baby. Next day 99% was the lowest reading. No problem.
| Now I use these sleep strips from this company called
| Intake. Sleep well. Holds nose open. I have a deviated
| septum, apparently. I think it's from falling off a tree
| onto my nose as a child, and being hit in the face by
| basketball numerous times. But probably not.
|
| What was funny was that at-home sleep study was damned
| good sleep because it held my nose open!
| cromka wrote:
| PAT uses oxygen, so they actually do use exactly that.
| swatcoder wrote:
| There's a ton of cleverness involved in keeping an extremely
| compact device with radios and sensors running for tens of
| hours on a tiny battery while making it seem like it's always
| awake and ready to go when you need it to be.
|
| But the reality is that everything that needs any kind of power
| is being aggressively idled down and time sliced and being made
| sample-based as can be gotten away with. You can easily get a
| sense of this with heart rate monitoring, if you dig into Apple
| Health and observe the pattern of samples it takes.
|
| Almost certainly, running the sensor at such a high frequency
| that you could call it "constant" would drain the battery long
| before you woke up.
| runjake wrote:
| 1. Because of the lawsuit around the pulse oximeter
| intellectual property, as other commenters mentioned.
|
| 2. That would require more battery life than the Apple Watch
| offers.
|
| There are third-party options that do constant monitoring that
| either directly or indirectly support Apple Health. You'll need
| some additional intelligence, in the form of an app or
| something, to analyze that data. WatchOS won't do it at
| present.
| GaggiX wrote:
| The new Apple Watch 10 has an 18-hour battery life, so if you use
| it while you sleep, you won't have much left.
|
| I have no idea how some people can charge their smartwatch 1 or
| more times a day.
| smelendez wrote:
| People probably use it principally as a fitness (and sleep?)
| tracker, and charge it while they work
| GaggiX wrote:
| I mean it's still a watch so hopefully people are going to
| use it as a watch.
| a_vanderbilt wrote:
| I find that integrating it into my routine made my current
| watch (SE1) battery a non-issue. I wear it starting in the
| morning, charge it on the way to work, and then to bed. Repeat
| ad infinitum. Battery usage at night is way lower in my
| experience, and it usually survives til morning or close to it.
| jerlam wrote:
| I used to charge my watch every time I took a shower, which was
| every morning. Never had to think about battery life or
| charging the watch "out of band". But then again, it wasn't an
| Apple Watch.
| xyzAbc_ wrote:
| It is a non-issue for me with the Apple Watch 9. It's charged
| super quick e.g. if the battery is low after waking up you can
| plug it in do your morning routine and pick it up. Vice versa
| in the evening before going to sleep.
|
| Also did some bike packing this year and charging it with a
| power bank was also not an issue. At one point my power bank
| was empty and my apple watch ran out of power as well - this
| has been the only time I whined for more battery life.
| 4fterd4rk wrote:
| I keep the charger plugged into my computer. I slap the watch
| onto the charger every morning as I drink my coffee and read my
| e-mails/news. It's... not difficult to imagine...
| tstrimple wrote:
| I picked the Apple Watch Ultra mainly for the extended battery
| life. I charge it 15 minutes or so every other day. One of the
| more useful features I've discovered is it will give you a low
| battery warning if it detects that you need to charge before
| bed to maintain overnight power rather than just a fixed
| percent based warning. That's made it very easy to keep it
| topped up for tracking my abysmal sleep.
| jghn wrote:
| I can only speak for my S7 but with the fast charging mode it
| doesn't take long. My routine is I wake up, take off my watch,
| scan my phone for a bit, and take a shower. Almost every day
| it's fully charged by that point.
| MBCook wrote:
| The S9 was 80% in 45 minutes. The S10 is now 30 minutes.
|
| A nice jump but not earth shattering.
| runjake wrote:
| I'm not an qualified expert, but I spend a lot of time reading
| about and using this stuff and I'm extremely skeptical sleep
| apnea detection is very accurate without the pulse oximeter
| functionality.
|
| But gosh, I hope this is accurate across the Watch's wide user
| base.
|
| I wouldn't say it's likely, but I do wonder if the pulse oximeter
| is being used surreptitiously. In any case, if you _could_ use
| the pulse oximeter, this functionality would immediately become
| much more powerful.
| rootusrootus wrote:
| IIRC the pulse oximeter isn't all that useful for sleep apnea
| detection anyway, because on the watch it does not run
| continuously. Just takes measurements every X minutes. I
| _think_ the oxygen level drop happens on a short enough
| timescale that you need the continuous monitoring to pick up on
| it.
| runjake wrote:
| I think the pulse oximeter would be most helpful in concert
| with the accelerometer, as described in the article.
| TechDebtDevin wrote:
| Watch Sp02 detection is usually at rather long intervals to
| conserve battery and typically have not resulted in any sort
| of detection of low 02 (in my experience, I have very bad
| sleep apnea)compared to a pretty dependable and accurate $30
| on the finger oximeter.
| m463 wrote:
| > sleep apnea detection
|
| I don't think it has to be as accurate as other things like
| blood glucose levels, because with those people might use the
| results to inject insulin.
|
| Detecting sleep apnea might be more like afib detection. It
| just tells someone they should be checked out.
| jrockway wrote:
| This is a neat feature. I read Reddit and r/applewatch shows up
| in my feed a lot. 99% of the questions are "do I have sleep
| apnea?" At least the watch can give them my cut-n-paste response
| "you should talk to your doctor about a sleep study" now.
| breck wrote:
| If you're interested in this, I'd recommend reading the 1870
| [public domain] book "Shut Your Mouth and Save your Life".
|
| Internet Archive has it: https://archive.org/details/b28114450
|
| Also look into "mouth taping".
| VeejayRampay wrote:
| mouth taping is dangerous for many reasons, you should not be
| advocating it in a public forum
| breck wrote:
| You are right, on the list of things that are dangerous, you
| would find mouth taping, probably right next to using a fork.
| mikestew wrote:
| You're right, medical advice from the 1870s and TikTok
| videos, what could go wrong?
|
| But I did "look into 'mouth taping'" as you suggested, and
| I'll bet half the page titles were "Mouth-taping: is it
| safe?" or "...does it work?" At what point does
| Betteridge's Law of Headlines[0] kick in?
|
| [0]
| https://en.wikipedia.org/wiki/Betteridge's_law_of_headlines
| breck wrote:
| > You're right, medical advice from the 1870s and TikTok
| videos, what could go wrong?
|
| Have you read the book? Do you think I'd be recommending
| something that didn't have a very strong dataset backing
| it?
|
| > At what point does Betteridge's Law of Headlines[0]
| kick in?
|
| Nothing is easier to manipulate than digital symbols.
| Thus, when talking about patterns one finds in digital
| symbols, one much be very very careful to build a
| trusthworthy dataset. Do you have a trusthworthy dataset
| on Betterridge's headlines?
| wizzwizz4 wrote:
| > Do you really think someone would do that? Just go on
| the internet and tell lies?
|
| -- Buster Baxter (written by Matt Steinglass, 2005)
|
| People make stuff up, especially online. If you expect
| others to believe you about your "very strong dataset",
| you should _provide_ that very strong dataset (complete
| with provenance).
| breck wrote:
| Did you miss the very first thread, where I provided a
| link to the book containing the dataset, which came out
| 100 years before "online" invented?
| wilsonnb3 wrote:
| You want to at least give a brief overview as to why I should
| trust medical advice from a book written before germ theory was
| widely accepted?
|
| This has all the hallmarks of quackery.
| breck wrote:
| > why I should trust medical advice from a book written
| before germ theory was widely accepted?
|
| Why do you think how to live healthy is a modern invention?
| Don't you think people had to figure that out ages ago, or
| else we wouldn't be here?
| wilsonnb3 wrote:
| Because medical science was in its infancy in 1870 and you
| should only trust medical advice from then if it is
| obvious, like don't light yourself on fire, or it has been
| substantiated and backed up with peer reviewed science at
| some point in the last 150 years.
|
| Your argument is just a mix of the appeal to nature fallacy
| and noble savage trope that people use to justify all sorts
| of medical treatments with no proven benefits.
| breck wrote:
| > no proven benefits.
|
| The Romans had great health. Proof: here we are thousands
| of years later alive and using their letters.
| vlachen wrote:
| I don't mouth-tape, and I use a CPAP. However, since I prefer
| the nasal cushion type, I did run into issues with my partner
| regarding my mouth falling open and horrible "pumping air
| through your sinuses" noises emanating from my face hole.
| Instead of spending more from the home health shop, I just
| grabbed headband that came in some past 5K race bag, and I
| strap it around my head prior to the CPAP head gear. In my
| particular case, that very slight amount of pressure keeps my
| mouth closed (and spouse happy.) I have to wonder if just using
| the chin-strap would be enough to turn off the damnable
| machine. Given the results with the chin strap, I have
| considered mouth taping, but I'm not about to shave just for
| that test.
| breck wrote:
| > I'm not about to shave
|
| I mouthtape and I got a full beard! Just use the 3M medical
| tape from Walgreens.
|
| I don't do it every night, but I do it on occasion. Used to
| do it more. I find it's helped me just sleep mouth closed as
| normal now.
| code_biologist wrote:
| Sleepy me tends to rip off things like headbands.
|
| I have a beard and use GrifGrips sports tape to mouth tape.
| I've found the level of adhesiveness to be a perfect balance
| of strength and removability. Not the cheapest, but quality
| stuff.
| yareally wrote:
| You mean the crazy theory this guy came up with after observing
| how Native Americans breathe through their noses?
|
| https://en.wikipedia.org/wiki/George_Catlin#Observations_on_...
| pjohri wrote:
| I used a PAT device that showed mild apnea.
|
| I then used an at home sleep study that came back negative.
| eh_why_not wrote:
| _> Undiagnosed sleep apnea affects more than 23.5 million people
| in the US alone, leading to $150B of wasted medical spend every
| year._
|
| What do they mean by "wasted medical spend" here?
|
| (1) Patients incorrectly spending money on a misdiagnosis, or (2)
| apnea solution providers not making money off people when they
| could?
| brandonb wrote:
| (OP here) a third category: downstream complications of sleep
| apnea, primarily car crashes and heart attacks. Diagnosing and
| treating people with undiagnosed sleep apnea would prevent
| these entirely, which is obviously much healthier for the
| person and reduces medical cost for the entire system
| (including the patient themselves for co-pays, taxpayers for
| government costs, etc).
| eh_why_not wrote:
| Thanks, I think it would be informative if you put this
| spelling out in the article. People like myself not immersed
| in health fields won't immediately know what you mean without
| it.
| brandonb wrote:
| Just updated the article to spell that out. Thanks for the
| feedback!
| dave333 wrote:
| Amazing that you can get much the same functionality in a off
| brand $30 watch these days - at least monitors sleep and blood
| oxygen - although it explicitly does not do medical diagnosis.
| Still every senior should have one for many reasons.
| TechDebtDevin wrote:
| I have extremely severe sleep apnea with 60-100 events per
| minute, and baseline blood oxygen is low to start with because
| I live at altitude. I'm very into wearables and have tested
| most of the top SpO2 capable watches and none of them detect my
| sleep apnea outside a very rare detection of low O2.
| emporas wrote:
| Sleep apnea is very easily fixed. You have to increase blood
| pressure on the head by a lot, for a little bit of time each
| day, half an hour to an hour and it is 100% fixable.
|
| Additionaly increasing blood pressure on the head helps for
| sleeping more. I do that and sleep for an average of 10 hours a
| day. 12 hours or 14 hours/day of sleep for me, is not rare
| either.
|
| Also increasing the blood pressure on the head helps fix myopia
| 100%, like that woman astronaut who returned to earth and her
| eyes worked perfectly again.
| dave333 wrote:
| Raising the foot end of the bed eg with a few thick books
| under the mattress is supposed to give health benefits by
| stopping the blood pooling in the lower legs where DVT blood
| clots most likely occur. Wondering if it also benefits by
| increasing blood pressure in the head?
| emporas wrote:
| Yep, exactly that, or similar. Use gravity to pull blood
| towards the head. It's not rocket science, although if you
| want to do that on space, you may need to learn a little
| bit of rocket science.
|
| In space that's the default situation. The heart pulses
| maniacally to keep blood circulating all around, but in no
| gravity places the legs are a pretty small organ, they
| don't need that much blood. So in space, a lot of blood
| ends up on the head. We can simulate that on earth for half
| an hour/day and it has numerous benefits.
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