SchlafCheck

Problems falling asleep and staying asleep can not only lead to reduced performance in everyday life, but also have health implications, such as an increased risk of cardiovascular disease. It is therefore very important for those affected to find a solution to their sleep problems as soon as possible. However, when they contact their primary care practices, a quick initial diagnostic assessment is often not possible. There is a lack of technological solutions that can be used by practice staff and those affected to objectively assess subjective sleep problems. This means that the only option is to refer patients to sleep specialists and have them examined in a sleep laboratory, which involves long waiting times and may delay the diagnosis of serious illnesses.

The main objective of the “SchlafCheck” project was to identify barriers and solutions for sleep medicine care in general practices in order to be able to detect harmful sleep problems earlier in the future. In this context, the use of a device for monitoring sleep disorders at home under the supervision of primary care physicians was evaluated. Among other things, the device was designed to record brain activity in the form of an electroencephalogram (EEG). The EEG is one of the main components of polysomnography in sleep laboratories. Even though additional vital data is recorded there, an EEG taken in the patient's bedroom at home could already provide the family doctor with important information about the quality of their patient's sleep. This could be used to derive early indications for the next treatment steps, which could be recommendations on sleep hygiene or nutrition, or a referral to a specialist facility.

The project included a pilot study with 20 patients each with difficulties falling asleep and staying asleep, supervised by five primary care practices of varying sizes – three in rural areas and two in the city center of Oldenburg. In addition, interviews were conducted with the physicians to identify specific care needs in everyday practice.

Contributions from Fraunhofer IDMT and the University of Oldenburg

Fraunhofer IDMT was responsible for the technical and practical implementation of sleep monitoring in the project. Staff at the participating practices were trained to use a mobile sensor system and distribute it to test subjects.
This was a commercially available sleep monitoring system. In addition, a questionnaire on sleep history (Insomnia Severity Index) and a sleep diary were used. The experts from Fraunhofer IDMT were also responsible for analyzing and processing the sensor data following the pilot studies.

The University of Oldenburg was involved in the project by developing the study methodology and the sleep history questionnaire, as well as conducting structured interviews and workshops with the physicians. Through its teaching and research practice network, the General Medicine Division in the Department of Health Services Research established contact with rural and urban general practices, which were recruited for the project.