Helping sleep apnea sufferers get their 40 winks

A healthcare-focused professional engineer has created an at-home kit that can help diagnose this serious sleep condition.

Getting a good night’s sleep can be a struggle for the approximately 3 per cent of Canadians with obstructive sleep apnea (OSA), but it’s also elusive for the many more who have the condition but don’t know it. The answer to better diagnosing this medical condition and bringing faster relief to sufferers may be an engineering innovation led by healthcare engineer Geoff Fernie, PhD, P.Eng.

With OSA, pauses or “apneas” of up to 30 seconds occur multiple times during sleep. Left untreated, it can decrease concentration and memory, cause depression, stroke and heart attacks, and contribute to car and workplace accidents. The Canadian Sleep Society reports the disorder is present in up to 62 per cent of the elderly, while the American Sleep Apnea Association estimates 80 per cent of cases are undiagnosed. The reason may be the cumbersome testing process: staying overnight at a sleep lab connected to multiple medical sensors. Other factors are the often-long wait time for a publicly funded test, and the approximately $500 fee for a private test.

About seven years ago, Fernie, a senior scientist at Toronto Rehabilitation Institute (TRI), was asked by the Ministry of Health and Long-Term Care to develop an at-home sleep apnea test. Together with Douglas Bradley, MD, director of TRI’s Sleep Research Laboratories, and Hisham Alshaer, MD, PhD, a physician and scientist at TRI, Fernie created BresoDX, a single-user, multiple-use sleep test that is portable, comfortable and easy to use. Advanced software, a microphone and an accelerometer capture two critical data types: breathing sounds, including the precise frequencies of snoring; and head position and movements, which is useful since side sleeping is better for OSA sufferers. The BresoDX can also deduce whether a breathing pause is due to an obstruction or the brain forgetting to tell the person to breathe. As important is the device’s design: a lightweight, mostly plastic headpiece, it sits comfortably over the nose and mouth, has no cables or wires, and is simple to operate.

“There is a massive amount of sophisticated software in this device, it’s quite clever,” says Fernie, TRI’s Creaghan family chair in prevention and healthcare technologies, and a multi-appointed faculty member at the University of Toronto. ”It also has a really comfortable frame, which makes testing a much easier process.”

The BresoDX’s development was supported by the MaRS Discovery District’s EXCITE program, which helps health technology innovators validate their product’s efficacy before bringing it to market. The process involved conducting three clinical trials, which produced data that helped with addressing engineering issues, such as ensuring the device would still operate even if the user pushed the on/off button again, and finding a microphone and SD card that would flawlessly capture data. The data on the SD card is what users send to BresoDX company BresoTec, which produces a sleep study report for the user’s physician. EXCITE provided an evidence package to help facilitate BresoDX’s regulatory approval by Health Canada. This year, the Ministry of Health and Long-Term Care is expected to launch a two-year pilot project in which the BresoDX will be available for free to 6000 Ontarians at up to 25 clinics. The device is also now available for purchase directly from BresoTec at a cost of $250.

Applying his engineering expertise to advance human health became a priority for Fernie in the summer of 1966, while, as a University of Sussex mechanical engineering undergraduate, he volunteered at Chailey Heritage School for children with complex disabilities. He helped fit prosthetics onto “thalidomide kids” who were missing limbs, but they didn’t quite fit or work well, and he realized his purpose as an engineer. After completing his PhD in bioengineering at the University of Strathclyde in Scotland, he moved to Canada and worked with amputees at West Park Healthcare Centre in Toronto, and established an orthotics and prosthetics training program at George Brown College. In his previous role as director of the Centre for Studies in Aging at Sunnybrook and Women’s College Health Sciences Centre, and at TRI, he has developed various innovations—for which he has 22 patents—to prevent injury and disease, such as an artificial spinal disc, non-slip winter footwear and a powered wheelchair with extraordinary manoeuverability. Last year, Fernie was inducted into the Order of Canada for his significant contributions to the field of rehabilitation engineering.

“Solving common problems of the injured and elderly aren’t attractive to a lot of people,” Fernie says. “But too many people are suffering and someone needs to care. As an engineer, I can provide them with useful solutions.”