You eat healthily, try to stay active and take your prescribed medications. But have you considered whether your sleep could be affecting your health?

Many people focus on diet and exercise when managing their health, yet overlook another essential factor: sleep.

Sleep is more than just rest. It plays an important role in regulating blood pressure, blood sugar, metabolism and brain health. Research shows that consistently poor sleep is associated with an increased risk of several chronic health conditions.

1. Could Poor Sleep Be Affecting Your Health ?

You may be surprised by how closely sleep is connected to your overall health.

If you are managing diabetes, high blood pressure or weight problems, paying attention to your sleep may be another important step toward better health.

2. Sleeping 8 Hours But Still Feeling Tired?

Most adults need around 7–9 hours of sleep each night. However, getting enough hours does not always mean getting good-quality sleep.

You might spend eight hours in bed but still wake up feeling exhausted. One possible reason is obstructive sleep apnea (OSA), a condition where breathing repeatedly becomes blocked or restricted during sleep.

These breathing interruptions can disturb your sleep, sometimes without you realizing it. Sleep apnea is also associated with high blood pressure, cardiovascular disease and type 2 diabetes.

3. 5 Signs Your Sleep May Need Attention

Do any of these sound familiar?

• You snore loudly or frequently.
• You experience frequent awakenings during the night.
• You wake up gasping for air or have breathing pauses noticed by someone else.
• You feel mouth dry when you wake up.
• You often feel sleepy, unfocused or exhausted during the day despite sleeping enough.

These symptoms do not necessarily mean you have sleep apnea, but they may indicate that your sleep deserves further attention.

4. What Can You Do To Improve Your Sleep

Maintain a regular sleep schedule: Go to bed and wake up at similar times each day.

• Create a sleep-friendly environment: Keep your bedroom cool, dark and quiet.

• Limit caffeine and screen time: Avoid caffeine late in the day and reduce stimulating activities before bedtime.

• Pay attention to persistent symptoms: Do not ignore ongoing fatigue, snoring or disrupted sleep.

If your sleep problems continue, speak with your GP. Your doctor can help assess possible causes and determine whether further sleep testing is appropriate.

Better Sleep, Better Health

Taking care of your sleep is just as important as eating well, exercising and attending regular health checks. If you are managing high blood pressure, diabetes or weight concerns, your sleep health may be another piece of the puzzle.

The next time you visit your family doctor, don’t forget to talk about your sleep. Understanding how well you sleep could be an important step toward improving your overall health.

This article is for general health education and does not replace professional medical advice.

Continued Reading :

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

REFERENCE:

1. Grandner MA. Sleep, Health, and Society. Sleep Med Clin. 2017;12(1):1–22.

2. St-Onge M-P, et al. Multidimensional Sleep Health: Definitions and Implications for Cardiometabolic Health. AHA. 2025.

3. Gottesman RF, et al. Impact of Sleep Disorders and Disturbed Sleep on Brain Health. Stroke. 2024.

4. Shah AS, et al. Effects of Sleep Deprivation on Physical and Mental Health Outcomes: An Umbrella Review. Am J Lifestyle Med. 2025.

Publications by Belun :

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://pubmed.ncbi.nlm.nih.gov/37380590/), 

4) “Correlation of Pulse Rate Variability(PRV) and Heart Rate Variability(HRV) Metrics During Sleep in Subjects Suspected of OSA” (https://academic.oup.com/sleep/article/46/Supplement_1/A420/7182347)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

6) “Integrating Body Sensor into a Wearable Platform to Enhance the Identification of Central and Mixed Apneas”. (https://academic.oup.com/sleep/article/47/Supplement_1/A222/7654683)

7) “Using a Wearable’s Multi-Night Capability to Mitigate Night-to-Night Variability in a Dental Clinic Cohort”. J Dental Sleep Med. 2026; 13(1). (https://aadsm.org/journal/original_article_1_issue_131.php)

Partnering with Belun :

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

The post Why Your Sleep Matters More Than You Think first appeared on Belun Technology.

The post Why Your Sleep Matters More Than You Think first appeared on Belun Technology.

COMISA (Co-Morbid Insomnia and Sleep Apnea) is a “double-jeopardy” condition frequently seen in sleep clinics but largely unknown to the general public. Once considered entirely separate disorders, obstructive sleep apnea (OSA) and insomnia are now recognized as deeply intertwined. 

Patients with COMISA often experience severe difficulties initiating or maintaining sleep, early morning awakenings, non-restorative sleep, daytime fatigue, and impaired concentration. These compounded symptoms frequently diminish their quality of life far more than either condition would in isolation Figure from Sweetman et al. 2021(1)

Figure from Sweetman et al. 2021(1)

2. Global Prevalence

COMISA is far from a rare clinical curiosity. Systematic reviews and meta-analyses highlight its widespread impact:

• 30–50% of patients with OSA meet the diagnostic criteria for chronic insomnia.
• 30–40% of patients with chronic insomnia have undiagnosed OSA (AHI ≥ 5/h).
• 30–50 million adults globally are estimated to suffer from COMISA.

3. Clinical Implications by COMISA

COMISA is not simply “two diseases in one patient”—it is a distinct clinical phenotype with a bidirectional pathophysiology. Arousals from apneas fragment sleep and perpetuate hyperarousal, while insomnia-driven sleep fragmentation destabilizes upper airway control. This compounding effect leads to significantly worse outcomes(2): 

• Cardiovascular morbidity: Elevated risk of hypertension, atrial fibrillation, and coronary events beyond that conferred by OSA alone. 
• All-cause mortality : A landmark analysis of the Sleep Heart Health Study demonstrated a 47% increased mortality risk in COMISA patients over 15 years compared to controls. 
• Neurocognitive and mental health burden : Higher rates of depression, anxiety, suicidal ideation, and an increased risk of dementia(3)
• Treatment resistance : CPAP adherence significantly is reduced — the insomnia component undermines the very therapy meant to correct the apnea.

4. Current Diagnostic Challenges

Diagnosing COMISA is inherently complex because the symptoms often mimic one another. An OSA patient’s frequent awakenings may sound clinically similar to insomnia’s sleep maintenance issues. Accurate diagnosis currently requires a multidisciplinary approach:(4)

Clinical Interviews & Sleep Diaries: Insomnia diagnoses rely heavily on clinical evaluations, validated questionnaires, and prospective sleep logs. However, these depend on patient-recalled subjective symptoms, making them highly susceptible to recall bias. (5)

Polysomnography (PSG): While an overnight in-lab sleep study is the gold standard for measuring the Apnea-Hypopnea Index (AHI), a single night cannot capture the full spectrum of insomnia symptoms due to night-to-night variability. Consequently, PSG is not recommended as a primary diagnostic tool for insomnia, creating a major hurdle for identifying COMISA. (6)

Actigraphy: Used for multi-night tracking, actigraphy bridges the gap between subjective diaries and single-night PSG by objectively monitoring sleep-wake patterns.

5. How Belun^® Ring Transforms Diagnosis & Monitoring

We are moving away from relying entirely on cumbersome, in-lab polysomnography toward advanced digital phenotyping. Because one-night PSG is insufficient to capture insomnia, innovations in multi-night monitoring (e.g. advanced wearables)—are critical. Technologies like the Belun^® Ring track both sleep-disordered breathing and sleep duration simultaneously over weeks, rather than hours. This longitudinal data captures the reality of a patient’s sleep in their own bed, eliminating the high costs and “first-night effect” of an unfamiliar lab while providing an objective, multi-night recording to traditional sleep diaries.

6. Fresh off the Press : Newest Study in Nature’s Scientific Reports

We are thrilled to share our newly published feasibility study in Scientific Reports: 

A wearable-based pathway for characterizing COMISA, Insomnia, and OSA.

Deployed in a Hong Kong community hospital, the Belun^® Ring successfully characterized these conditions outside of a traditional sleep center. We discovered that COMISA and insomnia patients exhibited notably longer sleep onset latency and greater wake-after-sleep-onset (WASO) times than those with OSA alone, while OSA-alone and COMISA patients showed higher AHI metrics than those with insomnia-alone (Figure: Young et al., 2026) (7).

This demonstrates that multi-night wearable monitoring effectively complements traditional clinical phenotyping. By serving as an accurate early triage tool, we successfully optimized Hong Kong’s public healthcare pathway, massively reducing patient wait times from 104 weeks down to an impressive 45 weeks.

Sleep medicine is entering an exciting, multidisciplinary era. Let’s start treating the whole patient, not just the apnea or the insomnia.

Reference:

1.         Sweetman A, Lack L, McEvoy RD, Smith S, Eckert DJ, Osman A, et al. Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA). Sleep Med Rev. 2021 Dec 1;60:101519. doi:10.1016/j.smrv.2021.101519

2.         Popovici C, Steiropoulos P, Mihaicuta S, Dumitru S, Dragila S, Bikov A, et al. The Hidden Burden of COMISA: Clinical Implications and Treatment Challenges. Pulm Ther. 2026 Mar;12(1):25–38. doi:10.1007/s41030-025-00331-0

3.         Dementia Risk in Patients with Comorbid Insomnia and Obstructive Sleep Apnea: A Propensity Score–Matched Cohort Study | SLEEP | Oxford Academic [Internet]. [cited 2026 Sep 14]. Available from: https://academic.oup.com/sleep/advance-article-abstract/doi/10.1093/sleep/zsag224/8770613

4.         Ragnoli B, Pochetti P, Raie A, Malerba M. Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management. Int J Environ Res Public Health. 2021 Sep 1;18(17):9248. doi:10.3390/ijerph18179248

5.         Ong JC, Crawford MR, Wallace DM. Sleep Apnea and Insomnia. Chest. 2021 May;159(5):2020–8. doi:10.1016/j.chest.2020.12.002

6.         Wulterkens BM, Den Teuling NGP, Hermans LWA, Asin J, Duis N, Overeem S, et al. Multi-night home assessment of sleep structure in OSA with and without insomnia. Sleep Med. 2024 May;117:152–61. doi:10.1016/j.sleep.2024.03.031

7.         Young BHK, Kwok ICY, Tsai CW, Leung L, Cheung C, Kwok APL. A wearable-based pathway for characterizing COMISA, insomnia, and OSA: a feasibility study in a community hospital. Sci Rep. 2026.

8. Selected Sleep Review Article: COMISA Impacts a Third of People with Insomnia or OSA. A Sleep Researcher Explains Why That Matters

The post COMISA Explained: When Insomnia Meets Sleep Apnea — and How Belun® Ring Detects Both at Once first appeared on Belun Technology.

The post COMISA Explained: When Insomnia Meets Sleep Apnea — and How Belun® Ring Detects Both at Once first appeared on Belun Technology.

A Paradigm Shift in How We Measure Sleep-Disordered Breathing

Introduction

For decades, clinicians treating obstructive sleep apnea (OSA) have relied on metrics that count events—drops in oxygen, pauses in breathing—as proxies for disease severity. Yet as our understanding of OSA’s pathophysiology has deepened and AI empowers diving deeper for data analyses, a fundamental question has emerged: Are we measuring what truly matters?

The journey from the Oxygen Desaturation Index (ODI) to the Apnea-Hypopnea Index (AHI) to the emerging concept of Hypoxic Burden represents more than technical refinement. It reflects a philosophical evolution in sleep medicine—from simply counting respiratory events to quantifying their physiological consequences.

This blog traces that evolution, examining the clinical implications of each metric, identifying which patient populations benefit most from each measure, and exploring how hypoxic burden may revolutionize long-term treatment monitoring. In Part I, we will discuss the rationale for the evolution and overview of the difference in definition of the parameters (i) ODI, (ii) AHI, (iii) Hypoxic Burden. In Part II, we will further discuss which disease entity, demographics of the patients we should take special attention to these parameters for better patient care.

Part I (i): The Oxygen Desaturation Index (ODI) — Where It All Began

Historical Context and Definition

The Oxygen Desaturation Index emerged in the 1980s as pulse oximetry became widely available and affordable. ODI measures the number of times per hour of sleep that blood oxygen saturation falls by a specified threshold—typically ≥3% or ≥4%—from baseline(Rashid et al., 2021)

The practical appeal was immediate: a simple finger probe could measure intermittent hypoxemia, capturing the core physiological danger of sleep apnea. The resulting Oxygen Desaturation Index (ODI) has proven to be a highly relevant clinical metric. For example, the large-scale, community-based Japanese CIRCS study of 4,398 middle-aged residents demonstrated a strong correlation between ODI and the three-year incidence of type 2 diabetes(Muraki et al., 2010). Furthermore, ODI serves as a reliable predictor for adverse cardiovascular outcomes (Cao et al., 2020). 

Clinical Implications of ODI

The ODI provides a direct window into the hypoxemic consequences of sleep-disordered breathing. This has several important clinical implications:

Cardiovascular Risk Stratification:

Intermittent hypoxemia drives oxidative stress, sympathetic activation, and endothelial dysfunction—key mechanisms linking OSA to hypertension, arrhythmias, and atherosclerosis. Studies have shown that ODI independently associated with incident hypertension(Tkacova et al., 2014) and cardiovascular outcomes (He et al., 2023).

Screening Utility: 

The simplicity of overnight oximetry makes the Oxygen Desaturation Index (ODI) a valuable tool for home-based preoperative screening, allowing clinicians to develop appropriate perioperative management plans. For instance, an ODI greater than 10 events per hour demonstrates a sensitivity of 93% and a specificity of 75% in detecting moderate-to-severe OSA (Chung et al., 2012). Moreover, when standard polysomnography is unavailable, ODI serves as an effective alternative for identifying moderate-to-severe OSA in snoring children within resource-limited settings (Polytarchou et al., 2023)

Monitoring Oxygen-Sensitive Conditions: 

While comorbid chronic obstructive pulmonary disease (COPD) elevates the risks of mortality and hospitalization, treatment with CPAP resulted in a non-significant increase in these risks compared to remaining untreated (Marin et al., 2010). Furthermore, the Oxygen Desaturation Index (ODI) has been shown to correlate positively with pulmonary function metrics (FEV₁, FEV₁/FVC, and FEV%) and inversely with airflow limitation. Consequently, ODI serves as a strong predictive tool, particularly for patients with milder COPD and suspected OSA (Tamai et al., 2016).

Limitations That Prompted Evolution

Despite its utility, ODI’s limitations became increasingly apparent. The metric ignores respiratory events that do not produce measurable desaturation—common in younger patients with robust ventilatory reserves. It also fails to capture the arousal-related sleep fragmentation that drives daytime symptoms. Furthermore, nocturnal pulse oximeter cannot distinguish between central apnea from obstructive events, limiting its diagnostic specificity (Rashid et al., 2021). 

In Part II, we will discuss why ii) Apnea-Hypopnea Index (AHI) has been evolved and what are the limitations of AHI that are still unable to resolve. 

REFERENCES

Cao, W., Luo, J., Xiao, Y., 2020. <p>A Review of Current Tools Used for Evaluating the Severity of Obstructive Sleep Apnea</p>. Nat. Sci. Sleep 12, 1023–1031. https://doi.org/10.2147/NSS.S275252

Chung, F., Liao, P., Elsaid, H., Islam, S., Shapiro, C.M., Sun, Y., 2012. Oxygen Desaturation Index from Nocturnal Oximetry: A Sensitive and Specific Tool to Detect Sleep-Disordered Breathing in Surgical Patients. Anesth. Analg. 114, 993–1000. https://doi.org/10.1213/ANE.0b013e318248f4f5

He, S., Cistulli, P.A., de Chazal, P., 2023. A Review of Novel Oximetry Parameters for the Prediction of Cardiovascular Disease in Obstructive Sleep Apnoea. Diagnostics 13, 3323. https://doi.org/10.3390/diagnostics13213323

Muraki, I., Tanigawa, T., Yamagishi, K., Sakurai, S., Ohira, T., Imano, H., Kitamura, A., Kiyama, M., Sato, S., Shimamoto, T., Konishi, M., Iso, H., for the CIRCS Investigators, 2010. Nocturnal intermittent hypoxia and the development of type 2 diabetes: the Circulatory Risk in Communities Study (CIRCS). Diabetologia 53, 481–488. https://doi.org/10.1007/s00125-009-1616-0

Polytarchou, A., Ohler, A., Moudaki, A., Koltsida, G., Kanaka-Gantenbein, C., Kheirandish-Gozal, L., Gozal, D., Kaditis, A.G., 2023. Nocturnal oximetry parameters as predictors of sleep apnea severity in resource-limited settings. J. Sleep Res. 32, e13638. https://doi.org/10.1111/jsr.13638

Rashid, N.H., Zaghi, S., Scapuccin, M., Camacho, M., Certal, V., Capasso, R., 2021. The Value of Oxygen Desaturation Index for Diagnosing Obstructive Sleep Apnea: A Systematic Review. The Laryngoscope 131, 440–447. https://doi.org/10.1002/lary.28663

Tamai, K., Matsuoka, H., Suzuki, Y., Yoshimatsu, H., Masuya, D., Nakashima, N., Okada, N., Oda, N., Inoue, S., Koma, Y., Otsuka, A., 2016. Nocturnal Oxygen Desaturation Index is Inversely Correlated with Airflow Limitation in Patients with Chronic Obstructive Pulmonary Disease. COPD J. Chronic Obstr. Pulm. Dis. 13, 235–240. https://doi.org/10.3109/15412555.2015.1074995

Tkacova, R., McNicholas, W.T., Javorsky, M., Fietze, I., Sliwinski, P., Parati, G., Grote, L., Hedner, J., 2014. Nocturnal intermittent hypoxia predicts prevalent hypertension in the European Sleep Apnoea Database cohort study. Eur. Respir. J. 44, 931–941. https://doi.org/10.1183/09031936.00225113

Publications by Belun :

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://pubmed.ncbi.nlm.nih.gov/37380590/), 

4) “Correlation of Pulse Rate Variability(PRV) and Heart Rate Variability(HRV) Metrics During Sleep in Subjects Suspected of OSA” (https://academic.oup.com/sleep/article/46/Supplement_1/A420/7182347)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

6) “Integrating Body Sensor into a Wearable Platform to Enhance the Identification of Central and Mixed Apneas”. (https://academic.oup.com/sleep/article/47/Supplement_1/A222/7654683) 

7) “Using a Wearable’s Multi-Night Capability to Mitigate Night-to-Night Variability in a Dental Clinic Cohort”. J Dental Sleep Med. 2026; 13(1). (https://aadsm.org/journal/original_article_1_issue_131.php)

The post The Diagnostic Evolution in Obstructive Sleep Apnea : From ODI to AHI to Hypoxic Burden [Part I (i) : Oxygen Desaturation Index (ODI)] first appeared on Belun Technology.

The post The Diagnostic Evolution in Obstructive Sleep Apnea : From ODI to AHI to Hypoxic Burden [Part I (i) : Oxygen Desaturation Index (ODI)] first appeared on Belun Technology.

Poor sleep may affect your blood pressure, blood sugar, weight and heart health. Here’s why getting quality sleep matters.

Could Poor Sleep Be Affecting Your Health ?

You may be surprised by how closely sleep is connected to your overall health.

If you are managing diabetes, high blood pressure or weight problems, paying attention to your sleep may be another important step toward better health.

Sleeping 8 Hours but still Feeling Tired ?

Most adults need around 7–9 hours of sleep each night. However, getting enough hours does not always mean getting good-quality sleep.

You might spend eight hours in bed but still wake up feeling exhausted. One possible reason is obstructive sleep apnea (OSA), a condition where breathing repeatedly becomes blocked or restricted during sleep.

These breathing interruptions can disturb your sleep, sometimes without you realizing it. Sleep apnea is also associated with high blood pressure, cardiovascular disease and type 2 diabetes.

Five Signs Your Sleep May Need Your Attention

Do any of these sound familiar?

These symptoms do not necessarily mean you have sleep apnea, but they may indicate that your sleep deserves further attention.

What Do You Do To Improve Your Sleep

Small changes can make a meaningful difference.

If your sleep problems continue, speak with your GP. Your doctor can help assess possible causes and determine whether further sleep testing is appropriate.

Better Sleep, Better Health

Taking care of your sleep is just as important as eating well, exercising and attending regular health checks. If you are managing high blood pressure, diabetes or weight concerns, your sleep health may be another piece of the puzzle.

This article is for general health education and does not replace professional medical advice.

Continued Reading :

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

REFERENCE:

1. Grandner MA. Sleep Med Clin. 2017;12:1–22.

2. St-Onge M-P, et al. AHA Scientific Statement. 2025.

3. Gottesman RF, et al. Stroke. 2024.

4. Shah AS, et al. Am J Lifestyle Med. 2025.

Publications by Belun :

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://pubmed.ncbi.nlm.nih.gov/37380590/), 

4) “Correlation of Pulse Rate Variability(PRV) and Heart Rate Variability(HRV) Metrics During Sleep in Subjects Suspected of OSA” (https://academic.oup.com/sleep/article/46/Supplement_1/A420/7182347)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

6) “Integrating Body Sensor into a Wearable Platform to Enhance the Identification of Central and Mixed Apneas”. (https://academic.oup.com/sleep/article/47/Supplement_1/A222/7654683)

7) “Using a Wearable’s Multi-Night Capability to Mitigate Night-to-Night Variability in a Dental Clinic Cohort”. J Dental Sleep Med. 2026; 13(1). (https://aadsm.org/journal/original_article_1_issue_131.php)

Partnering with Belun :

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

The post Why Your Sleep Matters More Than You Think first appeared on Belun Technology.

The post Why Your Sleep Matters More Than You Think first appeared on Belun Technology.

Obstructive sleep apnea (OSA) affects an estimated 30 million Americans.¹ OSA is commonly diagnosed and graded using the apnea-hypopnea index (AHI). In practice, however, the AHI reported for the same sleep study may differ depending on which hypopnea criterion is used during scoring. This is why clinicians, laboratories, and payers may refer to AHI-3 and/or AHI-4 when discussing the same patient’s study results. Differences between these two values can affect diagnostic thresholds, severity classification, and insurance reimbursement guidelines.

What is the Apnea-Hypopnea Index?

The Apnea-Hypopnea Index (AHI) is the average number of apneas (complete cessation of airflow) and hypopneas (partial reduction in airflow) per hour of sleep.² The AHI determines disease severity according to AASM guidelines:

• Normal: AHI < 5 events/hour
• Mild OSA: AHI 5-14 events/hour
• Moderate OSA: AHI 15-29 events/hour
• Severe OSA: AHI ≥ 30 events/hour ²

Importantly, AHI-3 and AHI-4 do not represent two different sleep studies; rather, they are two versions of the apnea-hypopnea index, with the same definition of apnea, differing only in the scoring method for hypopnea.

The Two Hypopnea Scoring Rulesetations

AHI-3

The American Academy of Sleep Medicine (AASM) recommended rule, established in the 2012 scoring manual update, defines a hypopnea as:

A ≥30% reduction in airflow lasting ≥10 seconds, associated with either a ≥3% oxygen desaturation OR an arousal from sleep.²

AHI-4

The AHI-4, AASM acceptable rule, historically aligned with Centers for Medicare & Medicaid Services (CMS) requirements, defines a hypopnea as:

A ≥30% reduction in airflow lasting ≥10 seconds, associated with a ≥4% oxygen desaturation.²

This more stringent criterion focuses on events with clear physiological consequences, specifically significant drops in blood oxygen levels. The rationale behind this threshold centers on capturing events with demonstrable cardiovascular and metabolic implications.³

Clinical Implications of the Two Scoring Methods

The choice between AHI-3 and AHI-4 scoring can dramatically affect diagnostic outcomes, particularly across different age groups. According to Abbasi-Moradi et al. in Sleep Medicine (2024) ,⁴ changing from the 4% criterion to the updated 3% recommended rule increases OSA diagnosis rates by approximately 27.6% to 38.8% across different age groups(Table 1). ⁴ This surge in positive diagnoses is particularly prominent among patients under age 40 with mild OSA symptoms — a finding that underscores the importance of screening younger patients who may exhibit relatively healthier oxygen desaturation patterns than older OSA patients yet demonstrate alarming arousal patterns (Figure. 1).

Table 1: According to F. AbbasiMoradi et al. 2024, Age-stratified percentage change in OSA severity classification after switching from AHI-4 to AHI-3

Delta Difference% in diagnosis from 4%AHI to 3%AHI

Figure 1: According to F. AbbasiMoradi et al. 2024, graphical representation of the increase in diagnosis of subjects under the updated AASM recommendation rule (AHI-3) from AHI-4 criteria:

Derived from table 2, Abbasi-Moradi et al. 2024

Diagnostic Sensitivity

The AHI-3 rule demonstrates higher sensitivity in detecting:

• Sleep apnea in younger patients with shallower oxygen desaturation pattern⁴
• Case report where upper airway resistance causes arousals without significant desaturation⁵
• REM-related sleep apnea, where events may cause arousals without deep desaturations (especially in women and young patients)^6–10

Population-Specific Considerations

As mentioned before, the following populations show particular vulnerability to underdiagnosis when using AHI-4:

• Women: Often present with more arousals, less severe OSA during NREM, and greater respiratory events during REM.^10,11
• Younger adults: May have greater respiratory reserve, limiting desaturation.¹²
• Patients with comorbid COPD: Complex interactions between respiratory conditions,¹³ often resulting in more arousals and difficulty falling asleep.

Practical Challenges and Controversies

Sleep laboratories face practical challenges in navigating these dual standards. Recommended approaches include:

1. Dual reporting: Providing both AHI-3 and AHI-4 values on every case
2. AASM-standard reporting: Using recommended criteria with supplementary data for insurance policy

Future Technological Directions

Emerging technologies may influence future diagnostic paradigms:

• Hypoxic burden calculations: Quantifying total oxygen deficit rather than event counting¹⁴ (Stay tuned for future blog posts where we will dive into why measuring the hypoxic burden is so critical.)
• Multi-night testing: Capturing night-to-night variability in AHI

What Belun Offers?

Belun Ring provides multi-night Level 3 Sleep test, providing both AHI-3 and AHI-4 scoring and also hypoxic burden, providing more comprehensive phenotyping of patients’ sleep disorders and enabling long-term monitoring of treatment effects.

Key Takeaways: Guidelines for Applying AHI-3 vs. AHI-4 Criteria

AHI-3 is recommended for:

• Initial clinical diagnosis: Particularly for highly symptomatic patients presenting with a sub-threshold AHI.
• Atypical presentations: Specifically, younger patients with a low-to-moderate BMI who exhibit marked daytime fatigue despite minimal oxygen desaturation.
• Targeted demographics: Women with suspected REM-predominant OSA.

AHI-4 is recommended for:

• Cardiovascular risk assessment: When the clinical focus requires identifying events with a more evident hypoxic burden.
• Administrative compliance: Fulfilling documentation requirements for Medicare, payer preauthorization, or PAP therapy reimbursement.
• Longitudinal analysis: Facilitating historical comparisons with older sleep studies, prior clinical reports, or legacy databases.

Conclusion

The distinction between AHI-3 and AHI-4 scoring rules represents more than a technical detail—it fundamentally affects which demographic differences in patients receive diagnoses and access to treatment. AHI3 offers greater sensitivity and better reflects the full spectrum of obstructive sleep apnea pathophysiology, AHI4 creates coverage challenges for these subsets of patients, in particular to younger and female patients with less steep oxygen desaturation patterns and more arousals. Until standardization occurs, the sleep medicine community must remain vigilant in ensuring that scoring methodology differences do not create barriers to necessary care for patients with obstructive sleep apnea.

REFERENCE:

1.             Benjafield, A. V. et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir. Med. 7, 687–698 (2019).

2.             Berry, R. B. et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events: deliberations of the Sleep Apnea definitions Task Force of the American Academy of Sleep Medicine. J. Clin. Sleep Med. 08, 597–619 (2012).

3.             Punjabi, N. M., Newman, A. B., Young, T. B., Resnick, H. E. & Sanders, M. H. Sleep-disordered breathing and cardiovascular disease: an outcome-based definition of hypopneas. Am. J. Respir. Crit. Care Med. 177, 1150–1155 (2008).

4.             AbbasiMoradi, F., Mogavero, M. P., Palomino, M., Ferri, R. & DelRosso, L. M. Age related disparities in sleep apnea diagnosis using a wearable device: Implications of 4% vs. 3% hypopnea scoring criteria. Sleep Med. 118, 88–92 (2024).

5.             Guilleminault, C., Stoohs, R., Clerk, A., Cetel, M. & Maistros, P. A cause of excessive daytime sleepiness. The upper airway resistance syndrome. Chest 104, 781–787 (1993).

6.             Mokhlesi, B. & Punjabi, N. M. “REM-related” Obstructive Sleep Apnea: An Epiphenomenon or a Clinically Important Entity? Sleep 35, 5–7 (2012).

7.             Resta, O. et al. Gender difference in sleep profile of severely obese patients with obstructive sleep apnea (OSA). Respir. Med. 99, 91–96 (2005).

8.             Koo, B. B., Patel, S. R., Strohl, K. & Hoffstein, V. Rapid eye movement-related sleep-disordered breathing: influence of age and gender. Chest 134, 1156–1161 (2008).

9.             Goh, D. Y., Galster, P. & Marcus, C. L. Sleep architecture and respiratory disturbances in children with obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 162, 682–686 (2000).

10.          O’Connor, C., Thornley, K. S. & Hanly, P. J. Gender Differences in the Polysomnographic Features of Obstructive Sleep Apnea. Am. J. Respir. Crit. Care Med. 161, 1465–1472 (2000).

11.          Ye, L., Pien, G. W. & Weaver, T. E. Gender differences in the clinical manifestation of obstructive sleep apnea. Sleep Med. 10, 1075–1084 (2009).

12.          Heinzer, R. et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir. Med. 3, 310–318 (2015).

13.          Owens, R. L. & Malhotra, A. Sleep-disordered breathing and COPD: the overlap syndrome. Respir. Care 55, 1333–1344; discussion 1344-1346 (2010).

14.          Azarbarzin, A. et al. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study. Eur. Heart J. 40, 1149–1157 (2019).

Publications by Belun :

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://pubmed.ncbi.nlm.nih.gov/37380590/), 

4) “Correlation of Pulse Rate Variability(PRV) and Heart Rate Variability(HRV) Metrics During Sleep in Subjects Suspected of OSA” (https://academic.oup.com/sleep/article/46/Supplement_1/A420/7182347)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

6) “Integrating Body Sensor into a Wearable Platform to Enhance the Identification of Central and Mixed Apneas”. (https://academic.oup.com/sleep/article/47/Supplement_1/A222/7654683)

7) “Using a Wearable’s Multi-Night Capability to Mitigate Night-to-Night Variability in a Dental Clinic Cohort”. J Dental Sleep Med. 2026; 13(1). (https://aadsm.org/journal/original_article_1_issue_131.php)

Partnering with Belun :

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

The post AHI-3 vs AHI-4 in Sleep Apnea Diagnosis: Understanding the Scoring Rules first appeared on Belun Technology.

The post AHI-3 vs AHI-4 in Sleep Apnea Diagnosis: Understanding the Scoring Rules first appeared on Belun Technology.

Apple recently introduced a feature for the Apple Watch that alerts users to potential obstructive sleep apnea (OSA), helping to raise awareness of sleep health, particularly among individuals without noticeable symptoms. However, there are important considerations for consumers using consumer-grade wearables or software as medical devices (SaMD) to detect sleep apnea: 

1) Limited Accuracy for clinical diagnosis

Consumer-grade wearables, including the Apple Watch, often exhibit moderate accuracy suited for general health monitoring rather than clinical diagnosis. For example, the Apple Watch can only detect severe OSA, potentially missing individuals with mild or moderate OSA and providing false reassurance. Even detected cases of severe OSA may not always be accurate, leading to potential misdiagnosis. 

2) Restricted Metrics and Misinterpretations

These devices typically measure basic health metrics with limited data points and precision. They often inaccurately derive critical sleep parameters based on standards from the American Academy of Sleep Medicine (AASM). For smartphone acoustic apps, users should note that sleep measurements can be compromised by the presence of bed partners or pets sharing the same room.  This can result in misinterpretations and confusion when physicians attempt to explain inconsistencies in wearables or software-derived reports to patients. 

Many wearable devices and sleep apps track basic health data but may not be very accurate. They often estimate important sleep details using methods that don’t always follow trusted medical standards, which can lead to errors.

For smartphone apps that use sound (acoustics) to measure sleep, keep in mind that the presence of a bed partner, pets, or even background noises in the room can interfere with the results. This can lead to confusion, especially when doctors try to explain why the app’s reports don’t match your actual sleep patterns.

3) Limited Validations and Limitations

Caution is necessary when relying on consumer-grade wearables or even FDA-cleared SaMD for sleep assessment. Most are validated only in healthy populations, not in real-world clinical settings. While some devices or apps might be FDA-cleared, they are typically limited to assessing the risk assessment of OSA, not providing a definitive diagnosis.

4) Data Privacy Concerns

Health data collected by wearables may be vulnerable to breaches or misuse due to commercial considerations. Many consumer-grade devices and apps do not adhere to strict data protection protocols required in clinical practice, raising concerns about privacy. 

5) Restricted to General Health and Fitness Usage

Consumer-grade wearables or SaMD should be regarded primarily as tools for general health monitoring and fitness tracking. Individuals experiencing sleep issues are strongly advised to undergo a proper sleep test for an accurate medical diagnosis.

Ultimately, while consumer wearables can increase awareness of sleep health, they are not a substitute for professional medical diagnosis and care.

What Belun is capable of ?

The Belun® Ring stands as the only FDA-cleared wearable for sleep stage classification within OSA diagnosis, achieving a high accuracy rate of 89% for moderate OSA and above. The Belun® Ring demonstrates impressive performance in sleep stage classification, achieving accuracy rates of 88% for Wake, 82% for REM sleep, and 90% for NREM sleep.⁽¹⁾ The device shows excellent sensitivity (91%) and specificity (88%) in detecting moderate to severe OSA.⁽¹⁾

Extensively validated across diverse patient populations^(1–4), the Belun® Ring has proven reliable for clinical and research applications in sleep medicine and is used by over a hundred organizations locally in Hong Kong and globally. This includes universities, academic research units, hospital authorities, clinics, dental offices, and elderly centers. Internationally, the Belun Sleep System has expanded to Asia (Singapore, Thailand, Malaysia, Taiwan, Indonesia, Australia), the U.S., and Latin America (Mexico) for both clinical and research purposes.

Partnering with Belun :

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

1) Strumpf Z, Gu W, Tsai CW, Chen PL, Yeh E, Leung L, et al. 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. Sleep Health. 2023 Aug;9(4):430–40. (https://journals.lww.com/jhypertension/Abstract/2023/06000/The_Belun_sleep_platform_to_diagnose_obstructive.16.aspx), 

2) Gu W, Leung L, Kwok KC, Wu IC, Folz RJ, Chiang AA. Belun Ring Platform: a novel home sleep apnea testing system for assessment of obstructive sleep apnea. J Clin Sleep Med. 2020 Sep 15;16(9):1611–7.(https://jcsm.aasm.org/doi/10.5664/jcsm.8592),

3) Ou YH, Ong J, Thant AT, Koo CY, Leung L, Sia CH, et al. : The Belun Sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk. J Hypertens. 2023 Jun;41(6):1011–7. (https://pubmed.ncbi.nlm.nih.gov/37071415/)

4) Yeh E, Wong E, Tsai CW, Gu W, Chen PL, Leung L, et al. Detection of obstructive sleep apnea using Belun® Sleep Platform wearable with neural network based algorithm and its combined use with STOP-Bang questionnaire. PLoS ONE. 2021;16(10):e0258040. (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258040)

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

The post Interpreting Obstructive Sleep Apnea (OSA) Diagnoses with Consumer Wearables or Software: A Cautionary Perspective first appeared on Belun Technology.

The post Interpreting Obstructive Sleep Apnea (OSA) Diagnoses with Consumer Wearables or Software: A Cautionary Perspective first appeared on Belun Technology.

Singapore Health Sciences Authority Approves Use of Belun Sleep System for evaluating Sleep-Related Breathing Disorders

Belun Technology, with its mission to provide innovative sleep health solutions, is pleased to announce that the Singapore Health Sciences Authority (HSA) has officially approved the Belun Sleep System for evaluating sleep-related breathing disorders. This landmark regulation allows individuals across Singapore to conduct sleep apnea tests from the comfort of their homes, a significant advancement in improving accessibility to sleep health diagnostics & also echoes their long-term strategy of preventive healthcare launched under the Healthier SG program. 

A Breakthrough in Sleep Health Access: Belun Sleep System Receives HSA Approval

With HSA’s approval, patients experiencing symptoms of sleep apnea — such as loud snoring, daytime fatigue, and disrupted sleep — can now access convenient and accurate diagnostic tools from the comfort of their own homes.

“Receiving HSA approval is a major milestone in the field of sleep health in Singapore. This advancement not only enhances patient comfort and convenience but also allows healthcare providers to diagnose sleep apnea faster and more efficiently. The ability to perform these tests at home can lead to earlier diagnosis and treatment, improving the overall quality of life for those suffering from sleep disorders. It aligns with Singapore’s emphasis on managing chronic conditions and promoting overall well-being.”  said Lydia Leung, CEO of Belun Technology.

Alignment with the current Singapore Government’s program

The approval of the Belun Sleep System aligns seamlessly with Singapore’s ongoing healthcare initiatives aimed at addressing chronic conditions such as diabetes, heart disease, and hypertension through early detection and management.

1. Chronic Disease Management: Proper sleep is essential in managing chronic diseases. The Belun Sleep System empowers healthcare providers to enhance treatment outcomes by identifying and addressing sleep-related issues that can exacerbate these conditions.
2. Health Screenings: Integrating sleep health assessments into routine health screenings, especially for individuals at risk of conditions like OSA, would facilitate discussions of sleep issues related to overall health during routine health assessments. Sleep data from Belun Sleep System would also facilitate these discussions.
3. Lifestyle Counseling: Lifestyle counseling may be included in personalized health plans to discuss lifestyle factors such as stress management, which can impact sleep. Belun Sleep analytics would empower long-term monitoring for lifestyle changes, and the increase in user engagement would also promote a gradual shift with more long-term impact.

Simplifying the Path to Diagnosis

Sleep apnea, a serious but underdiagnosed condition, can lead to complications like heart disease, stroke, and high blood pressure. Traditional diagnostic methods typically involve in-clinic sleep studies, which can be time-consuming and inconvenient.

The Belun Ring, leveraging Photoplethysmography (PPG) technology, addresses these challenges by allowing patients to:

• Perform simple at-home sleep tests.
• Monitor critical parameters such as oxygen levels, pulse rate, heart rate variability, and actigraphy.
• Receive accurate, clinically validated data for professional diagnosis and treatment recommendations.

The Benefits of Home Sleep Testing (HST)

The advent of HST represents a significant shift in how sleep apnea is diagnosed, making it easier for patients to access critical care without the constraints of traditional in-clinic testing. This innovative approach caters to the growing need for accessible, cost-effective, and reliable diagnostic tools

Here are the key benefits of HST:

• Convenience: Patients can conduct sleep studies in the comfort and privacy of their homes, eliminating the need for overnight clinic stays and minimizing disruptions to daily routines.
• Cost-Effective: Home sleep testing offers a more affordable alternative compared to traditional in-clinic sleep studies, making it accessible to a broader population.
• Timely Results: The streamlined nature of home testing enables quicker results, allowing healthcare providers to diagnose and initiate treatment earlier, which can significantly improve patient outcomes.
• Clinically Accurate: Equipped with advanced technology, HST devices such as the Belun Ring deliver clinically validated data, providing healthcare professionals with the precision needed for accurate diagnoses and effective treatment planning.

With this approval, Belun Technology is poised to redefine sleep health management in Singapore, making diagnostic tools more accessible and empowering individuals to take charge of their sleep health. This milestone reflects a leap forward in healthcare innovation and underscores the importance of sleep in overall wellness and chronic disease prevention.

Partnering with Belun :

Up to now, over a hundred organizations, including HK hospital authority hospitals, medical groups, clinic groups, dentists, and elderly centers, have 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” (https://academic.oup.com/sleep/article/46/Supplement_1/A420/7182347)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

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

The post Congratulations to Belun as evaluation tool for sleep-related breathing disorder in Singapore first appeared on Belun Technology.

The post Congratulations to Belun as evaluation tool for sleep-related breathing disorder in Singapore first appeared on Belun Technology.

Obstructive Sleep Apnea (OSA) is a prevalent and serious sleep disorder that affects millions of Americans. Mandibular Advancement Devices (MADs) are an effective treatment option, especially for those who cannot tolerate Continuous Positive Airway Pressure (CPAP) therapy. However, the titration process—where the device is adjusted to find the optimal advancement that effectively reduces the Apnea-Hypopnea Index (AHI)—can be time-consuming and challenging.

The Challenge: Slow Titration Process

Traditionally, the titration of MADs has relied on periodic sleep studies or follow-up appointments, often spaced weeks or months apart. During this time, patients may continue to experience poor sleep quality, daytime fatigue, and associated health risks due to insufficient control of their OSA. The intermittent nature of monitoring makes it difficult for dentists to quickly determine if adjustments are effectively lowering the AHI, leading to a prolonged titration period and delayed therapeutic outcomes.

The Solution: Daily AHI Monitoring

Integrating AHI monitoring into the treatment process can revolutionize the titration of MADs, offering a faster and more precise approach. By utilizing Belun Ring, the advanced home sleep monitoring device, which can track AHI on a nightly basis, dentists can obtain real-time data on the effectiveness of the current MAD settings.

Key Benefits of AHI Monitoring:

1. Real-Time Feedback: Dentists can access AHI data, allowing them to make timely adjustments to the MAD. This continuous feedback loop accelerates the titration process by quickly identifying the optimal device settings.
2. Increased Patient Engagement: Patients become active participants in their treatment by monitoring their own AHI. This engagement can improve adherence to therapy and encourage patients to report back on their comfortability and any residual symptoms.
3. Reduced Time to Optimal Therapy: By identifying the correct titration settings sooner, patients can achieve therapeutic AHI levels more quickly, reducing the duration of ineffective treatment periods. This leads to faster symptom relief and improved overall health outcomes.
4. Customized Treatment Plans: Daily* monitoring allows for highly individualized treatment. Dentists can fine-tune the MAD to each patient’s specific needs, improving the overall treatment outcomes.
5. Improved Clinical Efficiency: For the dental practice, daily* AHI monitoring reduces the need for frequent in-person follow-up visits solely for MAD adjustments. This efficiency allows for better resource allocation and more focused patient care.
6. Mobile app BelunPro X*: To collect the daily AHI data, Healthcare professionals make the decision if the optional mobile app will be used to get the data remotely. BelunPro X is available at both Apple App Store or Google Play.

Conclusions

AHI monitoring is a game-changer in the management of OSA with MADs. Data empowers dentists to accelerate the titration process, ensuring that patients receive the most effective treatment in the shortest possible time. This approach not only enhances treatment outcomes but also improves the overall efficiency of OSA management in dental practices across the U.S.

Adopting Belun Sleep System in the titration process of MAD treatment could mark a significant advancement in the standard of care for OSA patients, offering a faster path to better sleep and health.

Partnering with Belun :

Up to now, over a hundred organizations, including HK hospital authority hospitals, medical groups, clinic groups, dentists, and elderly centers, have 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” (https://academic.oup.com/sleep/article/46/Supplement_1/A420/7182347)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

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

The post Accelerating MAD Treatment for OSA Patients through AHI Monitoring  first appeared on Belun Technology.

The post Accelerating MAD Treatment for OSA Patients through AHI Monitoring  first appeared on Belun Technology.

The Belun Sleep System, an AI-enabled system for diagnosing Obstructive Sleep Apnea (OSA) with sleep stages classification, has received approval from the Ministry of Health and Family Welfare India as a diagnostic tool. This clearance allows more convenient and accessible diagnostic solutions for millions of Indians who suffer from sleep disorders.

Advancing Sleep Health for Millions

For individuals aged 30 to 69 years, it is estimated that about 936 million people worldwide¹ suffer from some form of OSA. In India specifically, studies show that the prevalence of OSA in adults ranges between 4.4% to 13.7% depending on gender and region. This means a substantial portion of the Indian population in this age group could have OSA, with Indian men being particularly at higher risk, where the condition could affect up to 19.7%² of males in certain studies​. 

“This is a breakthrough in India’s approach to diagnosing sleep disorders,” said Lydia Leung, CEO of Belun Technology. “With Belun Sleep System available to the Indian public, we aim to help facilitate early detection and treatment of sleep apnea, resulting in quicker, more accurate diagnoses and better treatment outcomes for the millions of Indians living with untreated sleep disorders.”

Convenient and Accessible Diagnosis

Obstructive Sleep apnea (OSA), a serious condition that affects breathing during sleep, is becoming increasingly common in India due to rising rates of obesity, stress, and lifestyle changes. Traditionally, diagnosis required overnight stays in specialized sleep clinics, which could be costly and difficult for patients to access. With the approval of Belun, patients can now undergo a sleep apnea diagnosis from the comfort of their own homes.

The newly-approved Belun Sleep System, with the use of artificial intelligence (AI) and optical technologies similar to PAT to collect physiological parameters such as pulse rate, heart rate variability, oximetry, and actigraphy, allowing healthcare professionals to remotely monitor Apnea Hyponea Index (AHI), oxygen saturation levels (SpO2), pulse rate and autonomic nervous system (ANS), without requiring patients to visit a sleep clinic. The system provides a simpler, more affordable way for patients to receive a diagnosis, particularly in areas where access to medical services may be limited.

Key Benefits of Belun Sleep System :

• Comfort: Tests can be performed in the patient’s own home, allowing for a more natural sleep environment.
• Affordability: Home testing reduces the cost burden of traditional sleep studies, making it more accessible to a larger population.
• Timely Diagnosis: Faster diagnostic results enable earlier treatment for sleep apnea, reducing the risk of associated conditions like heart disease, diabetes, and hypertension.
• Reach in Rural Areas: The Belun device empowers healthcare providers to serve patients in underserved areas, expanding the reach of sleep health diagnostics.

Expanding Healthcare Innovation in India

The approval of the Belun Sleep System in India aligns with the country’s broader healthcare goals of improving access to diagnostic services through innovative technologies. As part of this initiative, Belun Technology, a data technology provider of sleep health solutions, is committed to working with local healthcare professionals to integrate these tools into regular practice.

“India’s healthcare system is undergoing rapid transformation, and we are proud to be part of this journey,” added Lydia Leung. “By enabling patients to perform these tests at home, we aim to promote preventive healthcare and ensure that advanced medical technologies are accessible to all.”

Next Steps

With the clearance of local regulation, Belun is poised to support the roll-out of the Belun Sleep System across India. The company will collaborate with healthcare providers to offer training and educational resources on the use of these diagnostic tools, launch awareness campaigns to engage the industry and inform the public about the importance of early detection and treatment of sleep apnea.

To cope with the massive Indian market, Belun has teamed up with partners to customize end-to-end solutions for local communities.

Sources :

1/ A.V, Benjafield et al, Lancet Respiratory Medicine, 2019; 2. Susanna Ng et al, PLOS One, 2015

2/ RedMed India

Partnering with Belun :

Up to now, over a hundred organizations, including HK hospital authority hospitals, medical groups, clinic groups, dentists, and elderly centers, have 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” (https://academic.oup.com/sleep/article/46/Supplement_1/A420/7182347)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

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

The post Indian Health Authorities Approved Belun Sleep System as Diagnostic Tools for Obstructive Sleep Apnea first appeared on Belun Technology.

The post Indian Health Authorities Approved Belun Sleep System as Diagnostic Tools for Obstructive Sleep Apnea first appeared on Belun Technology.

At Belun, we are passionate about revolutionizing healthcare through technology. Our wearable AI-driven devices allow patients to effortlessly conduct sleep studies in the comfort of their homes. The data collected by our innovative ring is meticulously analyzed to produce detailed clinical reports, paving the way for proactive and preventive healthcare solutions.

“Sleep occupies a third of our time and is the most critical period when our body recovers; it is also a precious moment to detect health abnormalities. We are thrilled to be working with IHH to further Belun’s vision to provide evidence-based support to medical professionals to personalise treatment as well as health insights and alerts through wearable medtech and AI”, said our CEO, Dr. Lydia Leung.

For more information, please refer to here.

Partnering with Belun :

Up to now, over a hundred organizations, including HK hospital authority hospitals, medical groups, clinic groups, dentists, and elderly centers, have 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” (https://www.sciencedirect.com/science/article/pii/S2352721823000906)

5) “The Belun sleep platform to diagnose obstructive sleep apnea in patients with hypertension and high cardiovascular risk” (https://pubmed.ncbi.nlm.nih.gov/37071415/)

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

The post New round of investment for Belun Global Expansion & New Development first appeared on Belun Technology.

The post New round of investment for Belun Global Expansion & New Development first appeared on Belun Technology.