Every person is different. Sometimes you can look at two different people and their signals are so different, you wouldn’t believe we’re measuring the same thing. Coming from a background in physics, Laura is used to everything being neat and ordered, with a clear solution. She says, ‘The fact that we all can be so different still surprises me, and it creates unique challenges in our research. We need to work out how to take account of all of that information and develop tools that can be used across the board.’ The differences from person-to-person isn’t Laura’s only challenge; because it sits so close to the heart, the new oesophageal balloon device also catches heart rhythms. To separate the two processes, she’s had to record heart activity overnight with an ECG and use signal filtering methods to help distinguish between heart and breathing in her analysis.
Peter and Laura are hoping this research will have a big impact. About 20% of adult males have moderate to severe sleep apnoea—some studies say more. It is as common as diabetes or asthma. For some, they wouldn’t know they have it because the symptoms vary so much between people; they may not notice symptoms and may or may not need treatment depending on severity and daytime impacts. Others can suffer very severe consequences, potentially even death caused by accidents (like falling asleep while driving). In these cases, treatment can be life changing—and potentially life saving.
The main treatment for sleep apnoea is called continuous positive airway pressure (CPAP). Basically, to be effectively treated you wear a mask over your nose—or nose and mouth—all night, every night, which is connected to a machine that blows air and holds the airway open with pressure. It’s a very effective treatment, but, as Peter explains, ‘It’s not exactly convenient or sexy, and around half the people recommended to use it don’t use it at all or enough to be well treated.’ It doesn’t matter how great a treatment is if people won’t use it. While modern machines are very small and quiet, and masks can be comfortable with the right choice for your face, many people still won’t or don’t use CPAP effectively long-term. Peter thinks we can do better. The first step is to better understand how and why sleep apnoea occurs in the first place. He also has some ideas for treatments that might not need a mask and machine to force the airway to stay open.