Belun Ring was adopted in the multidisciplinary management of OSA & Insomnia in Hong Kong public hospital

The FDA 510(k) cleared Belun Sleep System (OSA diagnosis and sleep stages) was adopted by Clinical psychologists in Hong Kong to test the effectiveness in triaging patients with sleep disorders for more strategic treatment planning. The result was shared in a poster presentation during the 2023 Hong Kong Hospital Authority Convention held on 16-17 May 2023.

Current unmet needs in objective assessment of sleep architecture in patients with insomnia and Co-Morbid Insomnia and Sleep Apnea (COMISA)

In fact, a high prevalence (39%-58%) of insomnia symptoms have been reported with OSA, and between 29% and 67% of patients with insomnia have an apnea-hypopnea index (AHI) of greater than 5.¹ The bidirectional consequences of either untreated OSA or insomnia further limits the treatment response of one another ^2,3. Higher management costs are expected for this group of patients with COMISA, which have worse outcomes (e.g., cardiometabolic abnormalities) than in patients with either OSA-alone or Insomnia-alone ^4,5. Moreover, clinicians often find it difficult to diagnose whether the pattern is of secondary insomnia or co-morbid insomnia based on recalled symptoms⁶. While the diagnosis of insomnia is mainly based on the international classification of sleep disorders on symptom-based assessment, polysomnography(PSG) was not a recommended diagnostic tool for insomnia due to its scarcity, high-cost and inaccuracy caused by the phenomena of “first night effect” by one day only PSG recordings. Therefore, no objective sleep assessment is currently available to diagnose insomnia and COMISA.

How Belun Ring Speeds up the Classification of insomnia patients

Now with Belun, the easy-to-wear Belun Ring (“magic ring” as described in the paper) was used as a digital sleep diary, and objective sleep data collected via multi-night analyses made the diagnosis of insomnia possible rather than solely by subjective estimates of symptoms. The sleep efficiency data and architecture would speed up the classification of insomnia patients and healthcare professionals to efficiently differentiate OSA, insomnia, and COMISA.

Cutting down the patient wait time by 2.3X time

This triaging model sped up (from 104 weeks to 45 weeks, as stated in the paper) the sleep assessment for sleep-disordered patients and also identified insomnia x OSA group, whose cardiovascular risk is highest and needs more attention, often treating OSA alone could only have a sub-optimal improvement in sleep. The novel triaging model helps to precisely identify patients with COMISA and provide additional care (e.g. Cognitive behavioral therapy for insomnia (CBT-I)) apart from conventional OSA treatment alone.

Continued Reading :

See our previous story about CBT-I to understand how Belun’s applications would help clinical psychologists.

Partnering with Belun :

Up to now, over a hundred organizations, including HK hospital authority hospitals, medical groups, clinic groups, dentists, and elderly centers selected to use the Belun Sleep System, Belun Ring, and Belun® remoVital monitoring system. Many doctors read our medical journal papers, including: 

1) “Belun® Ring Platform: a novel home sleep apnea testing system for assessment of obstructive sleep apnea” (https://jcsm.aasm.org/doi/10.5664/jcsm.8592),

2) “Detection of obstructive sleep apnea using Belun Sleep Platform wearable with neural network based algorithm and its combined use with STOP-Bang questionnaire” (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258040),

3)Belun® Ring (Belun Sleep System BLS-100): Deep Learning-Facilitated Wearable Enables OSA Detection, Apnea Severity Categorization, and Sleep Stage Classification in Patients Suspected of OSA  (https://journals.lww.com/jhypertension/Abstract/2023/06000/The_Belun_sleep_platform_to_diagnose_obstructive.16.aspx), 

4) Correlation of Pulse Rate Variability(PRV) and Heart Rate Variability(HRV) Metrics During Sleep in Subjects Suspected of OSA (Accepted in SLEEP conference 2023, Abstract ID: 954).

If you would like to know more about how to adopt Belun’s solution in your organization or home use, please feel free to contact us to schedule a meeting by filling out the form below:

Sources :

1. Comorbid Insomnia and Obstructive Sleep Apnea: Challenges for Clinical Practice and Research | Journal of Clinical Sleep Medicine. Accessed October 20, 2022. https://jcsm.aasm.org/doi/full/10.5664/jcsm.27772
2. Benetó A, Gomez-Siurana E, Rubio-Sanchez P. Comorbidity between sleep apnea and insomnia. Sleep Med Rev. 2009;13(4):287-293. doi:10.1016/j.smrv.2008.09.006
3. Wallace DM, Sawyer AM, Shafazand S. Comorbid insomnia symptoms predict lower 6-month adherence to CPAP in US veterans with obstructive sleep apnea. Sleep Breath. 2018;22(1):5-15. doi:10.1007/s11325-017-1605-3
4. Prevalence of insomnia symptoms in patients with sleep-disordered breathing – PubMed. Accessed October 20, 2022. https://pubmed.ncbi.nlm.nih.gov/11742923/
5. Quality of life in obstructive sleep apnea is related to female gender and comorbid insomnia – PubMed. Accessed October 20, 2022. https://pubmed.ncbi.nlm.nih.gov/29352360/
6. Bjorvatn B, Jernelöv S, Pallesen S. Insomnia – A Heterogenic Disorder Often Comorbid With Psychological and Somatic Disorders and Diseases: A Narrative Review With Focus on Diagnostic and Treatment Challenges. Front Psychol. 2021;12:639198. doi:10.3389/fpsyg.2021.639198