Sleep Studies: WatchPAT vs. PSG | Why WatchPAT |  Why Your Patients Will Choose WatchPAT | How it Works | WatchPORTAL | Ease of Use | Diagnostic Accuracy  | Unique Clinical Features | Detecting Apnea, Hypopnea, and RERA Events | Detecting REM | Detecting Sleep Architecture | Monitoring Sleep Time vs. Study Time | What does WatchPAT Measure | Measuring 6 Channels| Sleep Medicine in Two Steps | Split Night Sleep Studies |

WatchPAT—Number One in Home Sleep Testing | Medical Insurance Reimbursement | Downloads

WatchPAT— The Number One Evidence-Based Home Sleep Testing Device

WatchPAT is an FDA-approved portable diagnostic device that uses the most innovative technology to ensure the accurate screening, detection, and the follow-up treatment of sleep apnea. Its ease of use is unparalleled in the marketplace and it is greatly complemented by the fact that WatchPAT testing is done in the comfort of your patient’s own bedroom, an environment that best reflects the pattern of their sleep habits. That fact alone may prove to be a lifeline for the millions of undiagnosed patients who are unwilling to spend the night away from home in a hospital sleep center. And for those patients who are waiting for a polysomnography (PSG) but can’t be tested due to sleep center backlog, WatchPAT offers an immediate solution. WatchPAT has been validated against PSG.

Sleep Studies: WatchPAT vs. PSG

Numerous validation studies demonstrated a high degree of correlation in RDI and AHI between WatchPAT and PSG sleep studies. With WatchPAT, both RDI and AHI scores are highly reproducible, showing correlation between home and in-laboratory sleep studies.

WatchPAT has excellent reliability with minimal failure rate (approximately 1%) during data acquisition or data analysis, and requires minimal technician time compared to PSG.

WatchPAT monitors changes in peripheral arterial tone (PAT) and activity, as well as in blood oxygen saturation levels. It also identifies sleep apnea events just like the equipment used in PSG sleep studies performed in hospital sleep labs.

WatchPAT has been the subject of numerous clinical trials resulting in over 130 peer-reviewed papers and abstracts. Of these, 13 manuscripts validate WatchPAT by comparing it head-to-head with PSG. In fact,more validation articles vs. PSG have been published in peer-reviewed journals about WatchPAT than with any other portable sleep-testing device. 

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Why WatchPAT?

• Ease of use: Wrist-worn device

—Only three leads for patients to wear—no canullas, no cumbersome head straps

• Sleep study report in real time

—more time with the patient

• Actual sleep time and sleep state

• Access to raw data—enabling standard sleep expert PSG analysis and manual override if deemed professionally necessary. Raw data cannot be altered

• Lowest failure rate of all sleep apnea ambulatory devices

• The most precise, user-friendly ambulatory sleep apnea monitor available

Why Your Patients Will Choose WatchPAT

Sleep apnea is one of the most underdiagnosed ailments in medicine, due in part to the fact that many patients simply are unwilling or unable to be tested in a sleep laboratory. Many patients readily admit feeling uncomfortable spending a night at a monitoring facility, hooked up to sensors and equipment while they sleep. Rather than endure this perceived hardship in an attempt to obtain a definitive diagnosis of sleep apnea that would then lead to treatment, many patients instead choose to continue life with sleep apnea.

The good news is that WatchPAT has removed this patient hurdle and in doing so has changed the sleep apnea landscape forever without sacrificing diagnostic accuracy. All the patient has to do is slip WatchPAT on their wrist, apply the snore and body position sensors, and oximeter.

WatchPAT technology avoids contact with the face and head, a major benefit (and large cause of study failure) when compared to other ambulatory devices.

Thanks to Itamar Medical’s advanced technology, it is possible for patients to conduct self-testing in the comfort of their own bed. WatchPAT performs the following tasks:

• Screen for sleep apnea: WatchPAT screens for sleep apnea in people who appear to be healthy.
• Diagnose sleep apnea: Validated results confirm RDI and AHI.
• Monitor treatment: Retesting with WatchPAT provides you with valuable information about whether treatment may need adjustment.

Some of the benefits associated with at-home testing with WatchPAT are obvious. This portable device can help patients take an active role in monitoring and perhaps, improving their health. Moreover, it offers privacy and convenience—the most sought after elements of a sleep test—because testing is conducted at home. Finally, WatchPAT provides quick results, which allows you to begin treatment immediately.

WatchPAT: How it Works

Step by Step Reference Guide
Step by Step Video

WatchPORTAL

When the patient returns the WatchPAT, you now have two choices:

1. Download WatchPAT directly to your computer and review the results. The regular, comprehensive WatchPAT sleep study report is available instantly, with a suggested diagnosis provided—all part of the WatchPAT software. You may also review and analyze the actual PSG traces as well.

2. At the click of a button, use WatchPortal to automatically send sleep data via the Web to enable remote sleep diagnosis by a Board-certified sleep expert.

• WatchPORTAL is part of the WatchPAT system and available to all owners.
• WatchPORTAL now makes it simple, efficient, and convenient to automatically upload and analyze your patient sleep studies.

Of all the ambulatory at-home sleep-apnea testing devices on the market, only WatchPORTAL offers the easiest way to effortlessly upgrade your practice into the high-tech world of Electronic Medical Records with the ease of plug-and-play.

One easy step: Connect WatchPAT to your computer’s USB port & click <Uplink Study>.

The rest is all transparent and automatic. Your data is fully backed up locally and on the Web. Unlike other ambulatory devices, there is no extra charge for this service.

If needed, sleep interpretation is available from our national network of Board-certified sleep physicians.

WatchPAT: Ease of Use

WatchPAT represents the best that 21st century medicine and science have to offer for at-home testing. Thanks to WatchPAT’s ease-of-use and automated data analysis, your patients don’t have to wait to get their diagnosis. Once they return the WatchPAT to your office, you download the information into your computer and receive an immediate detailed sleep report. It is recommended that such test report be review by a Board-certified sleep physician who can review and optionally override the results according to their expertise. This instantaneous report generation—compared to a lengthy wait in most hospital-based settings—allows you to initiate sleep apnea treatment the same day and without delay for your patient.

WatchPAT: Proven Diagnostic Accuracy

The functions of REM (Rapid Eye Movement) and dreaming are associated with consolidation of memory, processing newly learned material, stimulation of the brain, and solving daytime problems and conflicts.

REM deprivation can cause memory disruption and impair the recollection of newly learned materials.

REM sleep detection is necessary to characterize and correctly analyze a sleep study. The importance of WatchPAT in the detection of sleep apnea lies in its unique features, including the detection of wake, sleep, and REM states, and its proven diagnostic accuracy in apnea assessment.

WatchPAT’s Unique Clinical Features

WatchPAT is by far the easiest ambulatory sleep apnea diagnostic device to use. In just a matter of minutes, the patient applies the snore and body position monitors, oximeter, WatchPAT wristappliance, and PAT probe. Once that’s done, all that’s needed is a night’s sleep, and WatchPAT takes care of the rest.

How WatchPAT Detects Apnea, Hypopnea, & RERA Events

WatchPAT utilizes Peripheral Arterial Tone (PAT), a special physiological signal that mirrors changes in the autonomic nervous system (ANS) caused by respiratory disturbances during sleep. WatchPAT’s automatic algorithm analyzes the PAT signal amplitude along with the heart rate and oxygen saturation to identify breathing problems while you sleep. Using specific signal patterns, the algorithm provides two indices that allow a diagnosis of sleep apnea:

• AHI (Apnea/Hypopnea Index), which is an index used to calculate sleep apnea severity based on the total number of complete cessations (apneas) and partial obstructions (hypopneas) of breathing per hour of sleep.

• RDI (Respiratory Disturbance Index) is used to assess severity of sleep apnea by measuring respiratory efforts, or RERAs (Respiratory Effort Related Arousals). A RERA is an arousal from sleep that follows 10 seconds or more of increased respiratory effort but does not meet the criteria for apnea or hypopnea.

How WatchPAT Detects REM

Rapid eye movement (REM) sleep, one of the two basic states of sleep, is notable for the presence of rapid eye movement, brain activity, dreaming, and the absence of motor function. REM sleep is associated with considerable attenuation of the PAT signal and physiology coupled with specific variations in the PAT amplitude and rate. Based on this specific variability in the PAT and pulse rate signals, WatchPAT easily differentiates REM from NREM sleep.

How WatchPAT Detects Sleep Architecture

The cyclical pattern of NREM and REM sleep is detected by WatchPAT and recorded on its built-in actigraph. The proprietary software’s automatic actigraph algorithm discriminates between sleep and wake states in normal subjects and patients with sleep apnea.This algorithm makes WatchPAT superior to any other actigraph devices because most are unable to detect sleep architecture in patients with sleep apnea.

WatchPAT’s zzzPAT algorithm is based on 14 features extracted from two time series of PAT amplitudes and inter-pulse periods (IPP). Those features are then further processed to yield a prediction function that determines the likelihood of detecting a deep sleep epoch stage during Non-REM sleep periods.

Monitoring Sleep Time Vs. Study Time: A WatchPAT Advantage

The amount of time actually spent sleeping is essential for determining the Respiratory Disturbance Index, or RDI. Most ambulatory home testing devices lack “real sleep” monitoring and are only able to calculate “total study time”—how long the monitor was actually used. The RDI is then calculated by dividing the total number of respiratory events by a substantially longer time period, thus providing a lower RDI than the actual one.

WatchPAT detects the sleep/wake state and REM sleep stage along with “total sleep time,” providing the most accurate estimation of sleep architecture.

WatchPAT Measures the Following: 

● Real Sleep Time—measures actual time asleep—not just time in bed, like other home devices, providing a more accurate assessment of sleep apnea. 

● RDI and AHI—special indices that determine the severity of sleep apnea.

● ODI (Oxygen Desaturation Index)—measurement of blood oxygen levels. When not enough oxygen reaches the brain, a person awakens from sleep.

● Heart Rate—the number of heart beats per minute while sleeping.

● Body Position—notes whether you sleep on your back (supine), front (prone) or side, which all influence apnea.

● Snoring Intensity (dB)—loud snoring is a major indicator of sleep apnea.

● Sleep Stages and Architecture (wake/light/deep)—the cyclical pattern of various NREM and REM sleep stages summarized in a chart called a hypnogram.

● REM/NREM Sleep—dreaming sleep characterized by rapid eye movement (REM), the shortest portion of the sleep cycle; Non-REM (NREM) sleep, the largest portion of the sleep cycle, has three separate stages and distinct electrical brain wave patterns.

● Sleep Fragmentation—repeated short interruptions of sleep throughout the night, reducing the total amount of time spent in the deepest level of sleep.

● Sleep Statistics

WatchPAT Measures 6 Channels

● PAT—Peripheral Arterial Tone, which is a physiological signal that mirrors changes in the autonomic nervous system caused by respiratory disturbances during sleep.

● Oximetry—the measurement of oxygen levels in the blood.

● Actigraphy—the measurement of body movement while sleeping.

● Heart Rate—the number of heart beats per minute while sleeping.

● Body Position—notes whether you sleep on your back (supine), front (prone) or side, all which influence apnea.

● Snoring—loud snoring is a major indicator of sleep apnea.

Sleep Medicine in Two Steps: There’s No Place Like Home

Most obstructive sleep apnea can be diagnosed in office with an initial screening. Here are the two quick and easy steps that can help you screen and diagnose your patients:

Step One: Screen patients with a questionnaire

Sleep Disorder Questionnaire

Step Two: Send patients for a sleep study for certified interpretation of sleep apnea

—Offer your patients the most convenient option first, with a WatchPAT sleep study. It can be performed that night in the patient’s home. Results are available immediately, or can be quickly validated by a Board-certified sleep expert. 

—An appointment can be made for a PSG, typically in the next few weeks.

Some of the benefits associated with at-home testing with WatchPAT are obvious. This portable device can help patients take an active role in monitoring and perhaps improving their health. Moreover, it offers privacy and convenience—the most sought after elements of a sleep test—because testing is conducted at home. Finally, WatchPAT provides quick results, which allows you to begin treatment immediately.

Split Night Sleep Studies

The beauty of WatchPAT is the ease with which it can be used for a split night sleep study for assessing the efficiency of obstructive sleep apnea (OSA) treatment.

In the first part of the study, the patient sets an alarm clock for a reasonable sleep period (about three hours), affixes their WatchPAT and goes to sleep. WatchPAT records this initial sleep episode.

At the alarm, simply have the patient affix a CPAP mask or oral appliance, press the WatchPAT button,and go back to sleep. WatchPAT records this second part of the sleep test.

When the WatchPAT is returned to the physician’s office, the results of the split night test can be downloaded to the office computer for review by clicking “Sleep Report for Selected Time Range.” Alternatively, you can also upload via WatchPORTAL and have the results of this dual test automatically sent to a sleep specialist for analysis.

WatchPAT: Number One in Home Sleep Testing

WatchPAT is the most easy-to-use ambulatory sleep apnea device currently available. The following chart describes all of its major features:

Medical Insurance Reimbursement

At-home sleep studies for sleep apnea using WatchPAT are reimbursable with codes 0204T and 0203T throughout 2010. A new uniform CPT takes effect on January 1, 2011, which will be announced by the American Medical Association on November 1, 2010.

Currently, coverage varies from insurance carrier to carrier. At-home sleep studies with WatchPAT are typically covered by most insurance carriers. Even so, some insurance policies specifically exclude coverage for the diagnosis and/or treatment of sleep disorders. Patients need to contact their local carrier regarding their specific policy plan. Itamar is available to advise doctors on all reimbursement-related issues. Please email us at reimbursement@itamar-medical.com for further assistance.

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