Wrist monitors may help diagnose sleep apnea following TBI

Paul Basilio, MDLinx | April 19, 2017

Researchers at the Peter O’Donnell Jr. Brain Institute at UT Southwestern Medical Center are participating in a national study to determine whether at-home medical devices can diagnose sleep apnea following traumatic brain injury (TBI).

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Researchers will examine whether wristwatch-like devices can be as effective in diagnosing sleep apnea as formal laboratory screening in patients with TBI.

The study will compare wrist actigraphy to full-scale polysomnography performed in a sleep lab. If the less invasive method is comparable, the potential for a reliable, accessible, less expensive method for diagnosis of sleep apnea could prove invaluable to patients with TBI. Sleep apnea in such patients can cause a critical setback in recovery, but most affected patients do not realize they are at higher risk or that their sleep is being disrupted.

“Optimizing sleep is essential for neurorecovery after TBI,” said Kathleen Bell, MD, Chair of Physical Medicine and Rehabilitation at UT Southwestern, and the project’s lead investigator.

Dr. Bell’s team recently published a large study that found that 50% of patients who are admitted for brain injury and 37% of patients with TBI were diagnosed with sleep apnea.

In the past, wrist actigraphs have been used informally to monitor sleep patterns. For this study, the devices will be upgraded with improved sleep-tracing abilities.

“We know that you can identify disturbances in sleep with wrist actigraphs,” said Dr. Bell, who also holds the Kimberly-Clark Distinguished Chair in Mobility Research. “What we don’t know is how effective these screening methods are stacked up against one another.”

Enrollment for the study will begin in May at six TBI Model System Research Centers across the country. Participants will be selected from inpatients enrolled in the TBI Model Systems.

Other locations include the University of Washington, Seattle; Ohio State University, Columbus, Ohio; Craig Hospital, Denver; Moss Rehabilitation Research Institute, Philadelphia; and North Texas TBI Model System, Dallas. Sleep specialists from the University of South Florida, Stanford University, and North Florida/South Georgia Veterans Health System are also participating.

Funding for infrastructure is provided by the Departments of Health and Human Services, Veterans Affairs, and Defense. Additional funding for the study comes from the Patient-Centered Outcomes Research Institute (PCORI) to further previous work from the multi-institutional team on how TBI affects sleeping patterns.

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