'Today, in the process of treating sleep breathing disorders in children and adults, because it is a problem occurring in all age and population groups, we encounter many problems. Starting with diagnostics, which is uncomfortable, complicated and too short, and ending with therapy, which is often inadequate to treat the cause, and is not conducted comprehensively', says Wojciech Kukwa, PhD, MD, head of the Otolaryngology Clinic of the Medical University of Warsaw at the Czerniaków Hospital in Warsaw.

Currently, the 'gold standard' for diagnosing sleep breathing disorders is polysomnography. It requires the use of specialist equipment and is performed almost exclusively in hospital conditions. It is burdensome for the patient, who has to sleep all night connected to sensors that record, among other things, brain waves (EEG), eye movements (EOG), muscle tension, respiratory movements of the chest and abdomen, airflow through the mouth and nose, saturation and heart rate (ECG).

'The entire process is extremely complicated and expensive. And we have a considerable number of patients to examine - according to the latest statistics, there are over 3.5 million such people in Poland, and a billion in the world', Kukwa emphasises.

The solution to these problems may be the Clebre system he has developed. Its foundation is a wireless sensor that continuously monitors the quality of breathing during sleep. The patient uses it at home, every night, even for several months, i.e. during the entire treatment process. Thanks to this, the measurements are reliable and the diagnostics complete. According to its creators, the system will change not only the course of the examination, but above all the treatment of snoring and apnoea.

'We wanted to revolutionise the current process based on what has happened with many other medical procedures over the past decades. For example, in the past, patients with hypertension had to go to a doctor's office for measurements, which is unimaginable today. Now, every patient has the appropriate equipment at home and is tested several times a day, not once every few weeks. It is similar with glucose tests for diabetics, etc.', he explains.

According to the expert, this should also be the case with sleep quality measurements. 'After all, all medicine is moving in this direction: personalisation, easier access and - if possible - monitoring the patient's condition at home', he says.

In the Clebre method, the patient receives a sensor and an application for use at home. The sensor, completely non-invasively applied to the skin of the neck every night, monitors breathing, snoring, apnoeas, heart rate, the position of the sleeping body and their physical activity. The application that summarises the collected data is also used for communication between the patient and the doctor, who can monitor the treatment effects on an ongoing basis. This is particularly important in the treatment of snoring and apnoea, because there is no single, standard therapy for this type of condition.

'There are many very different causes of breathing disorders during sleep. The most common are definitely overweight and obesity. Excess fat tissue accumulates not only on the abdomen, thighs, etc., but also on the tongue, palate, and in the walls of the throat. The result is narrowing of the airways and poorer airflow at night, until finally there is an interruption in breathing, i.e. apnoea', Kukwa says.

Among other common causes, the expert lists: improper nasal patency, e.g. caused by an incorrect structure of the nasal septum, enlarged tonsils, third tonsil in children, malocclusion, nasal polyps.

'As you can see, the examination alone does not solve the problem. The disease must be treated in a personalised way, depending on the cause, and in the long term. It often requires the cooperation of many specialists and a lot of involvement of the patient. It is also necessary to constantly monitor the progress of the therapy at home', he adds.

Thanks to the results collected by Clebre, the attending physician can prepare an individual treatment plan for the patient, including, depending on the needs: dietary consultation, use of CPAP devices, surgical intervention, psychological counselling, speech therapy exercises, orthodontic treatment, etc.

According to the expert, it is extremely important for people to be aware that snoring is not just a funny symptom that can be joked about in the family circle.

'Most snorers have apnoeas. If they repeat themselves dozens of times an hour, this can add up to about half an hour without breathing during one night. This has huge health consequences. And most often we assume that if nothing hurts, it is not dangerous. Meanwhile, adults with apnoeas statistically have more frequent and earlier heart attacks, strokes, diabetes, hypertension and other cardiometabolic problems. In children, apnoeas lead to disorders in proper physical and intellectual development. In everyone, they cause a mood decrease', the laryngologist explains.

'There is a lot of talk about eating healthily and moving, but few people mention proper breathing. But it is a key issue. Sometimes we hear that you can survive three weeks without food, three days without water. Without breathing, it is only three minutes', he illustrates.

He adds that there are no medications for breathing disorders. The therapeutic process is long, often multi-specialist, and requires a high level of patient awareness. Such awareness comes easier when you have a sensor at home that measures, analyses and visually shows whether the therapy and the effort put in are producing results. 'We can already see today that this approach to treatment produces measurable effects for patients', he says.

'Our sensor allows us to build a full, objective picture of the patient's condition and monitor its changes. Thanks to this, we help both patients and doctors navigate the treatment process appropriately', Kukwa concludes.

Katarzyna Czechowicz (PAP)

PAP - Science in Poland

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