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.

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.

Belun Technology will partner with Nexter Living (SCG’s subsidiary), a healthcare extension from the conglomerate. A new Brand, “DoCare” is created to cater to the elderly market with the concept of “Making Eldercare Affordable and Convenient for Everyone”. ³

Thailand is among the fastest aging countries in the world; of its 67 million population, 12 million Thais are elderly, according to the latest national statistics report from WHO.² Since 2016, Nexter Living has innovated the smart living series to tackle the aging population.

Source : DoCare’s Facebook

According to the Lancet’s report, 36% of the Thai population has AHI (apnoea-hypopnoea index) >= 5, posing new challenges to the country’s healthcare system with its 20% aging population issue. Research shows sleep health is critical for the overall immune system & treatment effectiveness of chronic diseases. Nexter Living partners with Belun® Ring because of its medical accuracy backed up by the US FDA 510(k) clearance. Belun’s CEO, Lydia Leung, shared: “Belun® Ring is a user and environmentally friendly PPG-based wearable with medical accuracy. Belun will offer a superb convenient option that encourages suspected patients to take action and kick start their treatment journey.”

Nexter Living will promote the Belun Sleep Platform to the local hospital, hotels, wellness centers, elderly homes & new property projects promoting preventive care living. Thailand has been a hub for global medical tourism, and the expanding expatriate communities will also be the target.

Solutions from SCG for the elderly Source: SCG’s website

Chronic Disease Management via AI Preventive Healthcare

Belun’s vision is to help people better manage their chronic diseases through artificial intelligence and big data analytics to alleviate medical expenditures due to the aging population. Its solution allows caregivers and patients to follow their treatment effectiveness, select personalized solutions, and enhance treatment compliance. Lydia further shared: “Long-term monitoring using medical-grade wearables can help people to identify abnormalities earlier to achieve preventive healthcare.” 

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) and 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).

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:

References

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

2. https://www.who.int/southeastasia/news/feature-stories/detail/thailands-leadership-and-innovation-towards-healthy-ageing#:~:text=Thailand%20is%20among%20the%20fastest,for%2010%25%20of%20the%20population

3. https://www.scg.com/innovation/%E0%B8%9B%E0%B8%A3%E0%B8%B1%E0%B8%9A%E0%B8%95%E0%B8%B1%E0%B8%A7%E0%B8%AD%E0%B8%A2%E0%B9%88%E0%B8%B2%E0%B8%87%E0%B9%84%E0%B8%A3-%E0%B9%83%E0%B8%99%E0%B8%A7%E0%B8%B1%E0%B8%99%E0%B8%97%E0%B8%B5%E0%B9%88/

The post Belun Technology announces Nexter Living as its Official Distributor in Thailand   first appeared on Belun Technology.

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

The post Belun Ring was adopted in the multidisciplinary management of OSA & Insomnia in Hong Kong public hospital first appeared on Belun Technology.

Medical-grade sleep stages generate positive feedback from medical professionals

Belun Ring, would help physicians & sleep specialists understand the patients’ sleep stages better, differentiate OSA, insomnia, and COMSA (OSA x Insomnia), and thus empower the medical professionals for a more personalized treatment plan. A recap of media highlights about Belun Sleep System achieving FDA clearance is listed below.

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:

References

1. https://rtmagazine.com/products-treatment/diagnostics-testing/diagnostics/beluns-home-sleep-apnea-testing-device-fda-cleared/
2. https://rtsleepworld.com/2023/03/07/belun-sleep-ring-now-fda-cleared/
3. https://sleepreviewmag.com/practice-management/laws-regulations/fda/fda-clears-belun-ring/

The post Belun Sleep System has received positive responses for its medical-grade sleep stages first appeared on Belun Technology.

Taiwan as a Pill-Popping country

More than one in five people in Taiwan has insomnia, likely caused by stress due to economic woes. With 21.8 percent of its population having chronic trouble falling asleep or staying asleep & in 2022, the country consumed 10.5 billion sleeping pills, making it the “Island of Insomnia”

Keep people healthy with our preventive healthcare data

Belun’s CEO, Dr. Lydia Leung, shared: “We hope to collaborate with more partners to solve the problem of the Island’s sleep disorder. Being part of the CBT-I (cognitive behavior treatment – insomnia) of Hong Kong’s public hospital program, Belun Ring, acting as the digital sleep diary, would help clinical psychologists to understand the patients’ sleep stages (also FDA 510(k) cleared) better, differentiate OSA, insomnia and COMISA (OSA x Insomnia), and thus devising a more personalized treatment journey.” Research shows sleep health is critical for the overall immune system & treatment effectiveness of chronic diseases. Currently, the Company is also supporting research on post-stroke patients at a local hospital in Taipei.

The company is expanding towards Preventive Healthcare from the original sleep health. Since the launch of the 1st generation Belun Ring in 2018, it’s now widely used in research on long-term diseases, including stroke, hypertension, insomnia, dementia, cardiovascular-related risk, etc.

Chronic Disease Management via AI Preventive Healthcare

Belun’s vision is to help people better manage their chronic diseases through artificial intelligence and big data analytics to alleviate medical expenditures due to the aging population. Our solution allows caregivers and patients to follow their treatment effectiveness, select personalized solutions, and enhance treatment compliance. Lydia further shared: “Long-term monitoring using medical-grade wearables can help people to identify abnormalities earlier to achieve preventive healthcare.” 

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:

References

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

The post Taiwan FDA-cleared Belun Ring will help solve the crisis of the “Island of Insomnia” first appeared on Belun Technology.

Social and economic impacts of chronic insomnia

While a substantial population worldwide may experience sleep disturbances, chronic insomnia exerts significant economic burdens on society, which comprises direct and indirect expenditures. In the US, Insomnia is one of the commonest sleep disorders that causes a significant burden to the US healthcare system and vulnerable patient groups. Direct costs may include higher economic burdens in using emergency and healthcare services and greater expenditures for prescribed medications in these patients with chronic insomnia. Likewise, indirect costs may lead to work absenteeism (11), loss of productivity, and insomnia-induced fatal injuries (7).  The estimated direct costs range from $2-16 billion and indirect costs from $75-100 billion annually, respectively (12).

DSM-V diagnostic criteria of chronic insomnia

The American Academy of Sleep Medicine(AASM) defines insomnia as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite the sufficient opportunity for sleep and that causes a substantial form of daytime impairment. According to DSM-V Diagnostic criteria for chronic insomnia, patients may experience sleep disturbance that may cause clinically significant distress or daytime impairment of at least one of the following symptoms (9):

• Fatigue or low energy
• Daytime sleepiness
• Impaired attention, concentration, or memory
• Mood disturbance
• Behavioral difficulties
• Impaired occupation or academic function
• Impaired interpersonal or social function
• Negative effect on caregiver or family functioning

The aforementioned sleep difficulties occur at least three times a week for at least three months, although the sufficient opportunity for sleep has been provided.

Cognitive behavioral therapy for Insomnia (CBT-I) is the first-line treatment for chronic insomnia

Evaluation of a patient with chronic insomnia should include a complete medical and psychiatric history, medication/ substance use, and a detailed assessment of sleep-related behaviors and symptoms. Cognitive behavioral therapy for insomnia (CBT-I) is recognized as one of the most effective first-line treatments for insomnia, which includes setting realistic goals for sleep, limiting time spent in bed, restructuring maladaptive benefits of sleeplessness, maintaining good sleep hygiene, and practicing relaxation skills. CBT-I is traditionally offered over six to eight meetings (9). The efficacy of CBT-I is proven to be as effective as sedative-hypnotics in acute conditions (4-8 weeks) and sedative-hypnotics on a long-term basis (normally has a long-lasting effect for more than 3 months after treatment) (13).

Given the high efficacy of CBT-I for patients with chronic insomnia, CBT-I has evolved in various alternative formats. CBT-I can be delivered in a group format. Several studies conducted in group format demonstrated significant improvement in sleep initiation, although the outcomes were less desirable compared to individual treatment (14–16). Possible reasons accounting for the difference might be due to the significant overlapping comorbidities of more anxiety-prone patients with insomnia.

Likewise, CBT-I can be delivered via telehealth (e.g. video conferencing), which facilitates CBT-I therapists to provide their CBT-I treatment and CBT-I training online nationwide. Moreover, the COVID-19 pandemic has indirectly expanded the development of CBT-I online and made it more readily available for patients who are reluctant to seek medical care.

Another approach to CBT-I was based on CBT-I apps that offer a convenient alternative to ‘self-help’ to patients. Without seeking help from a CBT-I therapist, patients can undergo treatment in comfortable settings by watching videos by key opinion leaders, patient testimonials, and so on. These CBT-I apps are data-driven and allow automated assessment and real-time monitoring for insomnia symptom progression with prompt reminders/ feedback. With the help of CBT-I apps, this alternative format of CBT-I reported substantial improvement in sleep continuity, sleep latency, and total wake time (17).

How Belun can facilitate CBT-I treatment

While traditional daily sleep diaries are often used to record sleep complaints over time, these include bedtime and time arising from bed, time to fall asleep, number and duration of awakening during night, time of final awakening in the morning, and daytime naps (18). Belun Sleep Platform (BSP) offers an automated and convenient digital sleep diary for patients.

Belun Sleep Platform (BSP) has the capability of monitoring and analyzing SpO2, heart rate variability (HRV), photoplethysmography (PPG) waveform, and accelerometer-derived actigraphy data. It can calculate an estimated apnea-hyponea index (bAHI). It can also differentiate wakefulness from sleep and perform sleep stage analysis and give REM sleep duration and NREM sleep duration using its artificial intelligence platform. Furthermore, autonomic nervous system (ANS) activities include sympathetic and parasympathetic activities throughout the monitoring period. From the assessment provided by Belun Sleep Platform, objective sleep impairments data (e.g., prolonged sleep latencies, reduced sleep time, elevation in heart rate, and reduced heart rate variability) can be provided to clinicians with more accurate diagnosis and monitoring of the efficacy of CBT-I or combined pharmacotherapy before and after treatment in the era of precision medicine. Although polysomnography is currently the gold standard for measuring sleep quality, the test is costly, not easily available, requires skilled sleep technicians for assessment, and most importantly, it is not a pre-requisite assessment for insomnia (18). Going forward, Belun Sleep Platform provides a cost-effective, readily available, automated, no-skilled technician-needed solution to clinicians and patients with insomnia population-wide.

Partnering with Belun :

Up to now, over 32 organizations, including HK hospital authority hospitals, medical groups, clinic groups, dentists, and elderly centers selected to use the Belun Sleep Platform, Belun® Ring and Sleep App, 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) and 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). If you would like to know more about how to adopt Belun’s solution in your organization or home use, pls feel free to contact us to schedule a meeting by filling out the form below:

References

1.         Perlis ML, Vargas I, Ellis JG, Grandner MA, Morales KH, Gencarelli A, et al. The Natural History of Insomnia: the incidence of acute insomnia and subsequent progression to chronic insomnia or recovery in good sleeper subjects. Sleep. 2019 Dec 18;43(6):zsz299.

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4.         Roth T, Coulouvrat C, Hajak G, Lakoma MD, Sampson NA, Shahly V, et al. Prevalence and perceived health associated with insomnia based on DSM-IV-TR; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision; and Research Diagnostic Criteria/International Classification of Sleep Disorders, Second Edition criteria: results from the America Insomnia Survey. Biol Psychiatry. 2011 Mar 15;69(6):592–600.

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The post Chronic insomnia and epidemiology first appeared on Belun Technology.

Physiological parameters:

• Belun® Ring: SpO₂, pulse rate (beat-to-beat), pulse rate variability, autonomic nervous system response (every 5-minute) and actigraphy

• Belun® Sleep Platform: machine learning algorithm for obstructive sleep apnea (bAHI), sleep stages (wake, NREM, REM), sleep efficiency

Applications / Studies for:

• Digital sleep diary for insomnia / mental rehab patients

Sample ordering

Belun® Ring is currently used by clinical psychologist and CBT-I studies. If you would like to order the sample for reviewing the performance of the Belun Ring for your organization, you can visit our online sample purchase platform here [LINK]

Partnering with Belun

Up to now, over 32 organizations partners including HK hospital authority hospitals, medial groups, clinic groups, dentists and elderly centres selected to use Belun Sleep health platform, Belun Ring and Sleep App 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) and 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). If you would like to know more about how to adopt Belun’s solution in your organization or home use, pls feel free to contact us to schedule a meeting by filling the form below:

The post Digital sleep diary for insomnia patients under CBT first appeared on Belun Technology.