How Wesper Corrected A Misdiagnosis
Overview
Today we will review a recent case study from a woman who used Wesper after receiving a previous misdiagnosis. The misdiagnosis resulted in poor treatment and frustration until her Wesper home sleep apnea test turned things around.
The patient recently started using Wesper through her primary dentist after years of trouble sleeping, affecting her daily life. Like many people with sleep issues, she experienced symptoms for a long time before getting herself tested.
Through research and appointments with her doctor and dentist, it became clear that she might suffer from sleep apnea, and therefore went to get a sleep test at a sleep lab.
After this test, she was diagnosed with mild obstructive sleep apnea, a condition many people have. Because it was mild, treatment was limited to monitoring and trying a few incremental sleep tips.
Unfortunately, the sleep issues never resolved themselves. After years of living with the condition, a dentist finally recommended using Wesper Lab (the patches paired with a pulse oximeter) to monitor her sleep apnea during the oral appliance titration period.
After running a few Wesper tests, everything changed.
After 17 tests with Wesper, her diagnosis was severe obstructive sleep apnea. This change in diagnosis meant the patient could finally receive the treatment she needed, and her condition was taken seriously by her dentist and medical professionals.
Many times misdiagnosis can result in poor treatment. This risk increases exponentially with traditional sleep tests, which act as a one-night solution in an uncomfortable environment making the data unreliable. To best help patients, sleep tests must happen in the comfort of one’s home with a test that is as minimally invasive as possible, like Wesper.
Let’s dive into the case study!
Background
A 75-year-old woman with a BMI of 31 and a history of OSA (obstructive sleep apnea). When the patient previously received her diagnosis, her AHI was between 5 and 15, which put her clearly in the “mild” diagnosis.
After receiving multiple sleep tests through Wesper, her average AHI was 57.6. A 42.6 increase indicates how single-night studies can distort data, and tools like Wesper are needed to diagnose and treat patients with sleep apnea correctly.
To put it in perspective, the patient stopped breathing 57.6 times per hour. Without intervention, the symptoms of this severe obstructive sleep apnea were detrimental to her life, and her misdiagnosis caused frustration and inadequate care.
Furthermore, her ODI (the total number of times per hour of sleep that the blood oxygen level drops by ≥ 4% from baseline) was 62.41. The severity of this case became more apparent as we dived into the data.
Her average SPO2 was 88, which is very low and caused great concern from her dentist when they reviewed the findings through Wesper’s provider portal.
After comprehensive testing through Wesper Lab, the patient was prescribed a mandibular advancement device to control her breathing, allowing her to breathe better, sleep better, and get the support she needed.
Conclusion
Sampling longitudinal data via Wesper Lab has shown that the patient’s previous mild obstructive sleep apnea diagnosis was incorrect, resulting from insufficient data collection. A previously-conducted single night study has indicated Mild OSA, while multiple-night testing with Wesper revealed severe symptoms of sleep apnea.
Night-to-night variation of sleep study results is well documented in clinical science. Studies have reported that up to 85% of patients tested had significant variation in most diagnostic metrics in as little as four unique tests. Yet, most diagnostic sleep studies still rely on a single night.
This case study confirmed the presence of nightly variation in sleep apnea severity (Min/Max AHI: 12/107) and has demonstrated the importance of sufficient data collection for diagnostic accuracy.
Alternatively, if this patient was previously correctly diagnosed as having mild OSA and has since developed severe OSA, Wesper has proven the importance of confirmation studies before placing the patient on a new treatment (oral appliance), as well as periodic monitoring of the patient’s condition over time.
Because the oral appliance is usually recommended for the treatment of mild-moderate obstructive sleep apnea, the overseeing dentists will need to use Wesper to monitor for treatment efficacy of the prescribed oral appliance closely.
Metrics
- Apnea/Hypopnea Index (AHI) – the combined average number of apneas and hypopneas that occur per hour of sleep
- Respiratory Event Index (REI) – the total number of apneas and hypopneas divided by the total device (Wesper) monitoring time in hours.
- Oxygen Desaturation Index (ODI) – the number of times per hour of sleep that the blood oxygen level drops by ≥ 4% from baseline
- Mean SPO2: The average blood oxygen saturation score
- Minimum SPO2: The lowest blood oxygen saturation score
References
- https://pubmed.ncbi.nlm.nih.gov/28548301/