Devices to detect apnoea

[Part 2: Questions; Duncan J]

 

 

Apnoea occurs in SUDEP and, in some cases, is likely to be the primary event, with a cardiac arrest being a secondary event consequent to the cessation of breathing. It is well-known that cessation of breathing, apnoea, occurs in many generalized and complex partial seizures, with associated lack of oxygen supply to the brain and heart. Apnoea may result from airway obstruction, reduced respiratory drive or a combination of these. If recognized in time, however, death from apnoea can be averted by prompt basic resuscitation.

 

Whilst monitoring of breathing is well-established in intensive care units, chronic monitoring in low intensity clinical, domiciliary and residential settings is not satisfactory. Existing devices that monitor respiration are based either on sensing airflow, movement, or concentrations of oxygen and carbon dioxide in the blood. The first approach uses detectors that are secured just under the patient’s nose and sense the movement of air into and out of the airways to detect breathing. These can be successfully used within a hospital, but difficulty keeping the device in place makes them impractical for day to day use.

 

Other breathing detectors sense movements associated with breathing. They can be either attached to a mattress and with an audible or visible alarm triggered after a delay following cessation of movement; or a sensor pad on the chest which triggers when breathing is interrupted. The main problems with this approach are the false alarms that may occur, the size of the devices and need for mains power which restricts the places in which they may be used.

 

Pulse oximetry uses infrared light that shines through skin with good blood flow such as the finger, toe, or ear lobe, and can measure the oxygen level in the blood. The equipment is bulky, needs a mains power supply and the probes often get displaced from the skin. Further, the detectable changes in blood oxygen and carbon dioxide levels occur after a delay following disruption of breathing and so, inevitably, lag behind the causative event.

 

There is an urgent need for a device that can reliably detect breathing and its cessation, and which is small and discrete enough for long-term use in domestic and residential settings, as well as in low-intensity clinical care areas.

 

Electronic engineers at Imperial College and neurologists at UCL in London have pioneered a miniaturized, wearable apnoea detection device and respiration monitor that is suitable for long-term use in low-intensity clinical, domiciliary or residential care and may alert carers to the cessation of breathing. The device is applied to the skin of the neck with adhesive and detects the noise of air flow in the trachea, and hence registering when a breath occurs. The device is light enough to be worn comfortably and unobtrusively and is designed to detect episodes of apnoea. 

 

This device has been shown to reliably detect apnoea in the context of sleep apnoea (Rodriguez-Villegas et al., 2014) and a forthcoming trial will determine its ability to reliably identify episodes of apnoea associated with epileptic seizures, and hence raise the alarm when breathing is affected, this being a warning sign of a severe seizure that carries risk of SUDEP.

 

 

John Duncan

Professor of Neurology

Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology

National Hospital for Neurology and Neurosurgery, London, UK

Dec 2014

 

 

How to cite:

Duncan J. Devices to detect apnoea. In: Hanna J, Panelli R, Jeffs T, Chapman D, editors. Continuing the global conversation [online]. SUDEP Action, SUDEP Aware & Epilepsy Australia; 2014 [retrieved day/month/year]. Available from: www.sudepglobalconversation.com.

 

 

References

 

 

 

 

Rodriguez-Villegas E, Chen G, Radcliffe, J, Duncan J. A pilot study of a wearable apnoea detection device. BMJ Open 2014;4(10):e005299.

Please reload

January 16, 2006 is the day that changed our family forever. It was the day we lost our vibrant, caring and precious, nineteen year old, only daughter Kate, and the loving sister of our three sons...

On the morning of May 29th 2013, I went into Joseph’s room ... I knew something was very wrong, then I realized my beautiful baby boy was gone. We deserved to know SUDEP existed...

Had I known that death was a possibility, how would I have handled things with Abbey? ... Would I have wanted her to live her life any more inhibited than she did already?...

Please reload

continuing the global conversation

Sudden Unexpected Death in Epilepsy

Past Conversations   -   Glossary  -  Bibliography  -  Contact Us  -  Donate

 

©2020

 

 

 

 

 

The editors have endeavoured to publish reliable data and information but cannot assume responsibility for the validity of the materials or the consequences of their use.

 

All rights reserved.  No part of the publication may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without permission of the editors.