Army healthcare providers in Europe are now deploying new technology to remotely diagnose and help Soldiers suffering from sleep problems. This technology involves the use of at-home monitoring devices used to measure one’s sleep and breathing patterns.
“Home, or remote sleep testing, is one of the relatively new methods used to diagnose obstructive sleep apnea,” said Lt. Col. Matthew Rodgers, officer-in-charge of the Sleep Disorders Center at Landstuhl Regional Medical Center. “Sleep apnea is a common and treatable medical condition that can cause poor sleep quality for patients and bed partners as well as cause or worsen other underlying medical conditions.”
Sleep complications are fairly common in the military community and are exacerbated by the early-rise culture that can disrupt normal sleep patterns. These complications include bouts of insomnia resulting from night operations, pre-dawn physical fitness workouts, sustained combat operations, and other such disruptions.
According to medical experts, while the ‘gold standard’ for sleep testing is the in-lab polysomnogram, home or remote testing has been used as an option for a number of years in the civilian medical community and offers several benefits to the patient.
“Remote, or home sleep studies offer the patient several benefits,” added Rodgers. “Among those benefits are; convenience, comfort, and allowing patients to sleep in their own sleep environment/bedroom versus the artificial environment of a sleep laboratory.”
Faced with the COVID epidemic, social distancing requirements, limited bed space and lengthy wait times for an in-house sleep study, Army medical experts at Landstuhl Regional Medical Center were forced to think outside the box and be innovative in the way they conduct sleep studies.
“It was all about access to care,” said Rodgers. “We had patients who needed a sleep study and it was not logistically feasible for all of those patients to come TDY to LRMC. Remote testing saves time and money and allows us to treat patients even at remote outlying clinics. Consider a Soldier travelling all the way from Vicenza, Italy to LRMC for sleep testing. The Soldier would have to ride a bus or drive their POV to LRMC one week and not return home until the following week. The Soldier would be away from work for a full week. You also have to consider the transportation and TDY costs. For one Soldier that could easily be $10,000 dollars. That same TDY trip for one Soldier could cover the cost of two remote, or in-home sleep tests.”
“In the past year, we completed 1,300 remote sleep tests,” Rodgers added. “The remote sleep study project is relatively new with some outlying clinics just starting their operations. For example, we’ve done 33 remote sleep tests in Vicenza, 15 in SHAPE, 8 in Grafenwoehr, and 24 in Rota thus far. We expect Stuttgart to start their operations within the next week or so.”
According to medical officials, remote, or in-home, sleep studies aren’t as accurate or effective as in-patient or lab studies, but they are a good option for diagnosing most sleep-related conditions.
“The remote device does a great job of identifying moderate and severe sleep apnea,” Rodgers added. “It is less accurate, however, at diagnosing more mild cases of sleep apnea. It is almost unfair to compare the home sleep studies accuracy to in-lab studies as they are so different. But we feel the convenience, cost savings, comfort and improved access to care makes the home sleep test a reasonable option for our patients. When we have questionable cases, we can always proceed with in-lab studies or even repeat the home testing.”
Medical experts recommend Soldiers consult with their primary care manager if they are having sleep-related issues.
So how do Soldiers go about getting a sleep study scheduled?
“As with any specialty medical care, the patient will need a referral from their PCM to the sleep clinic,” added Rodgers. “Our providers will then review the Soldier’s sleep symptoms and history and determine if a sleep study is indicated. We will then we jointly decide which type of sleep study is best for the individual.”