Sweet dreams

A good night’s sleep – it’s something we all dream of. And there are no shortage of tips and tricks on how to reach the rapid eye movement (REM) stage and enjoy your slumber.

But for the more than five million Canadians who live with sleep apnea, a disorder in which breathing stops and starts repeatedly during sleep, getting a good night’s rest isn’t easily accomplished.

For many, sleep apnea is a minor disorder presenting with occasional snoring throughout the night.

In a large number of cases, however, it can be more serious and cause the soft tissues of the throat to collapse, leaving a person choking or gasping for air.

This can lead to high blood pressure, organ damage, brain cognition changes and exacerbate other diseases such as diabetes and depression. Research has shown that it may have major downstream health effects, as well as impact those around them and burden the health care system.

The good news for many with sleep apnea is that there are several treatments. These range from conservative lifestyle changes to surgery depending on the seriousness of the disorder and health of the individual.

A common treatment is the use of a continuous positive airway pressure (CPAP) or an automatic positive airway pressure (APAP). Similar in function, the CPAP delivers one continuous pressure level of air, and the APAP automatically adjusts to meet each specific person's breathing needs, which often change throughout the night as we move in and out of different stages of sleep.

But while these are effective treatments, research has shown that after one year of using either a CPAP or APAP, 50 per cent of people stop using it. By the third year of use – nearly 100 per cent of people have abandoned the treatment.

Sleep studies are also used in providing care for those living with sleep apnea. But the studies also have proven to be challenging for patients. Many have shared that the experience feels artificial and that it doesn’t reflect what a typical night would be. Further, a sleep study does not necessarily incorporate direct feedback from the patient about what they are feeling and experiencing.

Drs. Brian Rotenberg and Leigh Sowerby are Otolaryngology - Head and Neck surgeons at St. Joseph’s who regularly provide a range of care options to people with sleep apnea. Concerned for their patients, they wanted to develop a unique approach to monitoring and treating the disorder.

They decided to develop an app that patients could use to test their own oxygen levels and share their experience while expressing how their symptoms were impacting their health.

These types of patient reported outcome measures (PROMS) have increasingly become a more valid of measuring disease and experience, and helped form the basis of Rotenberg and Sowerby’s approach to the app.

“We wanted to develop an app where patients could test their own levels and share more details about how they were feeling,” says Rotenberg.

Patients can easily download the app called Prominent to their phone. And with a personal code prescribed by their physician, they can track their symptoms and answer a series of questions to help monitor their disorder. The data is then uploaded to a private database, so that their physician can monitor their health and easily offer timely feedback and care.

The Apple version of the app is now in beta testing and Dr. Rotenberg says that he hopes to launch it by February. So far, the testing has been going well, with patients reporting great satisfaction with the technology. They expect to be in beta testing with the Android version of the app by January 2025.

Dr. Rotenberg says that this development would not have been possible without donor support, and he’s grateful to the Foundation for providing the grant funding for the research and creation of the app.

“Without the funding from donors, we wouldn’t be where we are today,” says Rotenberg. “It’s helped us to improve patient care.”

A true believer in the benefits of technology in advancing health care change for the better, he’s enthusiastic about the launch of the app.

“We need to continue to identify non-traditional ways to support our patients,” says Rotenberg. “In many instances they are just as valid, sometimes more convenient for the patient and can reduce overall health care costs.”