![]() ![]() Although efficacious irrespective of underlying mechanisms, sub-optimal patient acceptance and use of CPAP remain problematic and warrant personalized treatments that better target underlying causal mechanisms. This approach, in combination with the advent of continuous positive airway pressure (CPAP) to reverse airway collapse during sleep ( Sullivan et al., 1981), led to rapid advances in the modern field of sleep medicine. Most people with sleep disorders remain undiagnosed and untreated, and thus vulnerable to the major adverse health and safety consequences associated with untreated sleep disorders.Ĭurrent sleep apnea diagnostic approaches rely on traditional labor-intensive overnight sleep tests and subjective manual scoring approaches developed around the constraints of paper-based methods from the 1960’s. However, globally, nearly 2 billion people are estimated to have one or both of the two most common clinical sleep disorders–sleep apnea ( Benjafield et al., 2019) and insomnia ( Roth et al., 2011). Sleep, along with diet and exercise, is essential for optimal health and wellbeing. This review outlines the current state-of-the-art in sleep and circadian monitoring and diagnostics and covers several new and emerging approaches to better define sleep disruption and its consequences. ![]() The “endpoint” of these new and emerging assessments will be better targeted therapies that directly address underlying sleep disorder pathophysiology via an individualized, precision medicine approach. Modern sleep tracking technology can also further facilitate the transition of sleep diagnostics from the laboratory to the home, where environmental factors such as noise and light could usefully inform clinical decision-making. Bringing these novel approaches into the clinic and the home settings should be a priority for the field. Recent technological advances may also soon facilitate simple assessment of circadian rhythm physiology at home to enable sleep disorder diagnostics even for “non-circadian rhythm” sleep disorders, such as chronic insomnia and sleep apnea, which in many cases also include a circadian disruption component. These include more fine-grained and continuous EEG signal feature detection and novel oxygenation metrics to better encapsulate hypoxia duration, frequency, and magnitude readily possible via more advanced data acquisition and scoring algorithm approaches. Newer emerging approaches that aim to overcome the practical and technical constraints of current sleep metrics have considerable potential to better explain sleep disorder pathophysiology and thus to more precisely align diagnostic, treatment and management approaches to underlying pathology. Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, AustraliaĬurrent approaches to quantify and diagnose sleep disorders and circadian rhythm disruption are imprecise, laborious, and often do not relate well to key clinical and health outcomes.Bastien Lechat † Hannah Scott † Ganesh Naik Kristy Hansen Duc Phuc Nguyen Andrew Vakulin Peter Catcheside Danny J. ![]()
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