Everything You Need to Know About Apnea Monitors
Sleep apnea is a common medical condition that causes brief and repeated pauses in breathing while resting. These pauses must last at least 10 seconds to qualify for this definition.
There are two types:
- Obstructive sleep apnea (OSA)
- Central sleep apnea (CSA)
OSA is by far the most prevalent type, and it is the result of laryngeal muscle failure to keep the airways open. A common trait associated with this type is snoring, which makes it challenging to diagnose.
On the other hand, CSA is caused by the brain's inability to control normal breathing.
According to the National Sleep Foundation, around 18 million Americans are diagnosed with one of the two types.
When diagnosing this condition, patients need to be observed while asleep and connected to special devices called apnea monitors that detect several vital signs, including heart rate, breathing frequency, and electrical changes when air flows in and out of the lungs. There are a few characteristics that make an individual most prone to having the condition. These common characteristics include being overweight, male, and although children can have it as well, adults that are older than 40.
In this article, we will cover all the information you need to know about these devices, their history, mechanism of action, indications, and market-leading companies.
Apnea monitors were first released into the market in the 1960s to observe and manage the condition in premature newborns who often died because of sudden infant death syndrome (SIDS).
Since then, at-home devices have gained enormous popularity, especially in the pediatric age groups.
Adults who go to the doctor's office with signs and symptoms that resemble apneic episodes might also benefit from having monitors record them to confirm or eliminate the diagnosis.
How do they work?
The technology used to detect apneic episodes while asleep varies from one device to another. While some companies design their devices to see breathing patterns for any abnormal pauses, others focus on changes in electrical and intrathoracic pressure to check for breathing arrest.
You see, breathing is closely connected to heart activity and pressure in the mediastinum (thoracic compartment). Any changes in cardiovascular or pressure parameters may indicate that something is wrong with the lungs.
Most of the devices used are equipped with audiovisual alerting systems that go off when the patient is in the middle of an apneic episode.
Overall, these devices are crucial for the prompt diagnosis of obstructive and central sleep apnea.
Indications to Use
As discussed earlier, this is the number one indication to use apnea monitors. This condition is often subtle and will not be clinically relevant until other associated complications start to manifest.
Most patients who suffer from the condition are unaware that they have it because they wake up startled in the middle of the night but lose those memories in the morning.
As a result, patients may deal with the condition for an extended period of time without realizing it. Unfortunately, depriving the body of oxygen even for brief episodes can damage different organ systems, especially the brain.
Due to this reasoning, the only definitive method for diagnosis is by using these types of monitors to detect any abnormalities in breathing, cardiac activity, and intrathoracic pressure.
Sudden infant death syndrome, or SIDS for short, is a relatively common medical condition without an established origin that leads to cardiorespiratory arrest in infants and, eventually, death.
Unfortunately, SIDS occurs during sleep, which prevents any intervention from the parents to save the infant's life.
While physicians have yet to determine the exact cause of SIDS, there are still some documented risk factors, including:
- Congenital disabilities
- Respiratory disease
- Low birth weight
- Napping on the stomach (i.e., ventral decubitus)
Most theories around SIDS believe that it is strictly connected to the respiratory system, hence why physicians monitor at-risk babies to diagnose any various conditions.
In fact, they were first developed to detect respiratory maladies in infants during the 1960s when physicians were bogged down by the increasing rates of sudden death in newborns and infants without an apparent cause.
This is a common chief complaint seen in hospitals.
Patients will explain how they are experiencing extreme fatigue during the daytime, even after getting sufficient rest.
The National Sleep Foundation classifies non-refreshing rest as a type of insomnia that is caused by interrupted periods of rest.
A common etiology of non-refreshing periods of rest is the recurrent obstruction of airways (a.k.a. sleep apnea). Therefore, using these monitors to diagnose patients with non-refreshing rest can improve patients' quality of life and optimize their performance.
Risk and Contraindications
The use of apnea monitors is relatively safe, and no serious adverse effects were ever reported.
Aside from a benign rash at the site of electrode placement, patients do not present with any side effects since this diagnostic procedure is non-invasive.
A common issue with these devices is lost or interrupted recordings because of an electrical power cut, as not all devices have backup batteries.
Moreover, some parents might get obsessed with the recordings of home monitors, which may affect their quality of life; therefore, the use of these devices should be limited to the indications mentioned above.
According to a 2019 report, the market for these monitors is estimated to grow by about 66% in 5 years, which translates to $7.5 billion in 2024 and $4.5 billion in 2019.
Physicians and health economy experts attribute these changes to the large number of patients with undiagnosed sleep apnea that are getting familiar with their condition due to awareness campaigns.
The largest market in this niche in the medical industry is North America, followed by Europe, then Asia. When it comes to these devices, each country has significant players that control the market of that region.
Here is a shortlist of the biggest medical brands that produce apnea monitors:
- ResMed (US)
- Koninklijke Philips (Netherlands)
- Fisher & Paykel Healthcare (New Zealand)
- SomnoMed (US)
- Oventus Medical (Australia)
- Compumedics (Australia)
- Löwenstein Medical (Germany)
- Drive DeVilbiss Healthcare (US)
- BMC Medical (China)
- Braebon Medical (Canada)
- Panthera Dental (Canada)
The first three companies on this list accounted for more than 94.4% of the global market for these devices in 2018, which showcases the enormous gap between these brands.
This report analyzed the entire market of devices, which includes various medical equipment such as CPAP, PSG, oximeter, APAP, masks, oral appliance, etc.
Due to the diversity of producing companies, each brand may have different specs that meet their target patient group. Obviously, devices designed for children will be different from those used by adults.
Here are some general specifications published by the World Health Organization (WHO):
- Approximate dimensions (mm): 150 x 120 x 120
- Approximate weight (kg): 0.75
- Consumables: Batteries, cables, electrodes/sensors
- Price range (USD): 200 - 5,000
- Typical product lifetime (years): 8
- Shelf life (consumables): NA
Additionally, they are designed for hospital and at-home use. For hospital use, pneumologists, somnologists, cardiologists, nurses, and other healthcare professionals may order sleep monitoring for patients suspected of having the condition. In contrast, home monitors are prescribed by doctors, especially for infants with worried mothers.
An apnea monitor is an essential piece of medical equipment that facilitates the diagnosis of several conditions with subtle signs and symptoms. They were originally developed to observe infants at risk of SIDS.
The diagnosis of OSA has skyrocketed in the past few years because of the increased prevalence of risk factors (e.g., obesity, sedentary lifestyle) and government and healthcare institutions' successful awareness campaigns. Individuals are at even worse risk if they are at least 40 years old or male.
Hopefully, this article helped you gain a better understanding of the condition, associated devices, and the market for them because this will become increasingly critical as the industry grows and evolves.