A Second Opinion with Wesper

In the realm of sleep medicine, the efficacy of treatment modalities for obstructive sleep apnea (OSA) remains a crucial consideration, particularly when symptoms persist despite intervention. This case study presents the journey of a middle-aged man diagnosed with moderate OSA, who sought a second opinion through Wesper Home Sleep Apnea Testing (HSAT) after experiencing ongoing symptoms despite oral appliance therapy (OAT) titration. The longitudinal Wesper data revealed a sobering reality: moderate to severe OSA persisted even with fully titrated OAT, prompting a reevaluation of treatment efficacy and patient management strategies.

The findings underscore the significance of comprehensive sleep testing and the potential limitations of conventional diagnostic approaches in accurately assessing OSA severity and treatment efficacy. Despite undergoing OAT titration based on polysomnography (PSG) diagnosis, the patient's symptoms persisted, highlighting the importance of ongoing monitoring and reassessment in sleep apnea management. Moreover, this case study sheds light on the growing trend of patients seeking second opinions through accessible and reliable home sleep tests like Wesper, emphasizing the pivotal role of HSATs in confirming diagnoses, guiding treatment decisions, and ensuring optimal patient care in sleep medicine.

 

 

Background

I present a middle-aged man with a history of moderate obstructive sleep (OSA) apnea and excessive daytime sleepiness. The patient was diagnosed with OSA with polysomnography (PSG) and prescribed oral appliance therapy (OAT). His OAT was titrated to the furthest setting. Six months post-titration, the patient purchased a Wesper kit for a second opinion because he felt his OSA symptoms have not improved and wanted to identify if his sleep apnea persisted while wearing his OAT. 

Findings 

The user completed five Wesper tests while wearing his OAT. The longitudinal Wesper data clearly demonstrated that moderate to severe OSA was still present with the use of his fully titrated OAT. The patient had an average AHI of 25 across five tests with a minimum recorded AHI of 16.7 (moderate) and a maximum recorded AHI of 35.4. The average ODI across 5 tests was 26.04 (min/max: 15.7/36.6). The average mean SPO2 was 91.46% and the average minimum recorded SPO2 was 83.8%. The data also demonstrated nightly snoring, with an average snoring time across of 52.2 minutes. 

Apnea-Hypopnea Index

Meeting With the Wesper Sleep Expert 

During the consultation with the Wesper Expert, the patient confirmed that he was still having severe OSA symptoms that haven’t improved after using his OAT for 6 months. Based on his previous PSG diagnosis, his OAT offered no improvement, and on 2 out of 5 nights, his OSA fell within the severe range, which was worse than his PSG diagnosis of moderate OSA. 

The patient expressed that his current sleep provider closed shortly after his PSG and he was unable to have further testing, including confirmation that his OAT was reducing his AHI. The patient, therefore, used Wesper to collect sufficient evidence to get a referral from his primary care physician to a new sleep physician in his area.

Conclusion

This case study demonstrated a common scenario for patients, in which not enough sleep testing was completed to gain an accurate understanding of the patient’s OSA severity. Further, limited testing means that providers cannot always be sure about the efficacy of treatments like oral appliance therapy. Easy to use and affordable home sleep tests (HST), like Wesper, that are capable of mu lti-night testing provide ample evidence during the titration period and can be used to track long-term patient outcomes months after being placed on therapy.

Additionally, due to testing limitations, more patients are seeking second opinions with HSTs like Wesper to confirm if their diagnosis, or lack of diagnosis was correct.