Belun joined the conference, “7th International Sleep Update 2023,” held in New Delhi, India, on Feb 12^th and 13th, organized by the Neurology Sleep Centre, New Delhi. The event composed of a 2-days conference on the topic “Innovative Approach to Sleep Disorders” cum exhibition.

Belun representatives showed the Belun Sleep System, Belun® Ring, and Sleep App for the first time in a public event in India. We had many insightful discussions with industry leaders.

Photo credit: Sumeet Sethi

Continued Reading :

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 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),

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:

DM us if you are a potential partner!

The post Belun in India first appeared on Belun Technology.

Patient screening for initiation of pharmacological treatment

In 2017, the American College of Cardiology / American Heart Association Task Force (1) published Clinical Practice Guidelines for patient evaluation in primary and secondary hypertension. Primary hypertension was defined by: i) a gradual increase in BP, with a slow rate of rise in BP, ii) lifestyle factors that favor higher BP (e.g., weight gain, high-sodium diet, decreased physical activity, excessive consumption of alcohol) and iii) family history of hypertension. On the other hand, secondary hypertension can be attributed to pheochromocytoma, OSA, chronic kidney disease due to post-renal urinary tract obstruction, hyperthyroidism, Cushing’s syndrome, medication and substance use. 

Basic laboratory tests for primary hypertension should include fasting blood glucose, complete blood count, lipid profile, serum creatinine with eGFR, serum sodium, potassium, calcium, thyroid-stimulating hormone, urinalysis, and electrocardiogram. 

Initiation of Pharmacological BP Treatment 

The use of BP-lowering medications is recommended for secondary prevention of recurrent Cardiovascular disease (CVD) events in patients with clinical CVD and an average SBP ≥ 130 mm Hg or an average DBP ≥ 80 mm Hg, and for primary prevention in adults with an estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk of ≥ 10% and average SBP ≥ 130 mm Hg or an average DBP ≥ 80 mm Hg.  

The use of BP-lowering medication is also recommended for primary prevention of CVD in adults with no history of CVD and with an estimated 10-year ASCVD risk < 10% and an SDP ≥ 140 mm Hg or a DBP ≥ 90 mm Hg. The pictorial workflow on the thresholds for treatment and follow-up is demonstrated in figure 1.  

Follow-up after initial BP evaluation

Guidelines for Follow-up after initial BP Evaluation are recommended as follows: 

1. For adults with normal BP, yearly evaluation is suggested.
2. Adults with elevated BP or stage 1 Hypertension with ASCVD risk < 10% should be managed by nonpharmacological treatment and review BP within 3-6 months.
3. Adults with stage 1 hypertension with ASCVD risk of ≥ 10% should be first managed by a combination of nonpharmacological and antihypertensive drug therapy and a repeat BP evaluation in 1 month.
4. Adults with stage 2 hypertension should be evaluated or referred to a primary care provider within 1 month for initial diagnosis, provide nonpharmacological and antihypertensive drug therapy, and repeat evaluation within 1 month.
5. For adults with high BP (e.g., SBP ≥ 180 mm Hg or DBP ≥ 110 mm Hg), evaluation should be immediate with antihypertensive drug treatment.

Appropriate follow-up and monitoring enable assessment of adherence and response to therapy; it also helps to identify adverse events by treatment and possible target organ damage and allows assessment of progress toward treatment goals. 

A systematic approach to out-of-office BP assessment is an important part of follow-up and monitoring of BP to assess response to treatment, elimination of white coat hypertension, and detection of masked hypertension or uncontrolled hypertension.

How precision treatment in OSA can improve coexisting Resistant Hypertension

Although improvement of sleep was documented to have a modest effect on BP reduction, however, precision medicine may shed new light on targeting tailored-made treatment strategies for selecting responders to OSA treatment. Torre et al. conducted an interesting study to identify 84 micro-ribonucleic acid (miRNA) arrays that could predict blood pressure responses to CPAP treatment (2). The study participants were recruited in a relatively large, randomized, controlled trial from 24 Spanish teaching hospitals of patients with Resistant Hypertension (RH) and OSA. After performing miRNA PCR array-based expression analyses, a subset of 3 differentially expressed miRNAs were found to be predictive in the reduction of blood pressure after CPAP treatment. The panel provided a discriminatory predictive model for identifying responders and non-responders to CPAP treatment effective in BP reduction. The identification of responders to CPAP with BP reduction helps clinicians to customize CPAP treatment options for responders and perhaps provides evidence to suggest other OSA treatment options to non-responders (e.g., Mandibular advancement device).

How Belun can facilitate preventive management in Hypertension

Belun® remoVital remote monitoring system is a real-time monitoring system composed of an FDA 510(k)-cleared Belun® Ring and a communication hub. The system measures vital signs, including blood oxygen saturation, pulse rate, and body temperature. The installation is simple, user-friendly, and no pairing for Bluetooth or WiFi is required. The automatic connection with the cellular networks enables the system to run once it is turned on. It allows easy access to patients’ real-time measurements via the web portal. Besides, this real-time alarm customization alerts healthcare professionals if any measured vital sign exceeds the pre-set thresholds. RemoVital provides real-time monitoring of hypertensive patients with a high prevalence of underlying cardiovascular problems, which may require regular monitoring of vital signs.

Belun Sleep System (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, perform sleep stage analysis and give REM and NREM sleep duration using its artificial intelligence platform. Furthermore, autonomic nervous system (ANS) activities, including sympathetic and parasympathetic activities, throughout the monitoring period. Belun Sleep System provides objective sleep impairments data that can monitor the treatment responses of patients with coexisting OSA and hypertension. 

Going forward, Belun Sleep System herein serves to provide a cost-effective, readily available, automated, no-skilled technician-needed solution to cardiologists, sleep physicians, and patients with sleep-related disordered breathing population-wide. Besides, we empower physicians to have a brief overview of their vital signs, sleep problems, and cardiovascular health remotely in hypertensive patients with OSA　before thorough medical examinations. 

See more about how Dr. Chi-Hang Ronald Lee & his team in Singapore brings new management to hypertension patients with Belun® Ring. It demonstrates a new application & potential contributions of Belun Sleep System in screening OSA to hypertension patients with cardiovascular risks.

https://www.linkedin.com/feed/update/urn:li:activity:7051134960425947139

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 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),

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.         Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018 Jun;71(6):1269–324.

2.         Sánchez-de-la-Torre M, Khalyfa A, Sánchez-de-la-Torre A, Martinez-Alonso M, Martinez-García MÁ, Barceló A, et al. Precision Medicine in Patients With Resistant Hypertension and Obstructive Sleep Apnea. Journal of the American College of Cardiology. 2015 Sep;66(9):1023–32.

The post The Management of Sleep in Improving Treatment Responses in Hypertension first appeared on Belun Technology.

Photos by DP Dental

DM us if you are a potential partner!

Continued Reading :

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 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),

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:

The post Belun in Japan first appeared on Belun Technology.

Part 1 :

Advocated workflow for dental management in Sleep medicine

Management of sleep disorders is an expanding area in medical care, and in recent decades, dentists may play an important role in diagnosing and treating sleep disorders. In the previous article, we addressed the advocated guidelines provided by the American Academy of sleep medicine (AASM) and the American Academy of Dental Sleep Medicine (AADSM) for the treatment of Obstructive Sleep Apnea (OSA) and Snoring with Oral Appliance Therapy (OAT) (1), type of interventions for OSA treatment and comparable benefits using Oral Appliances (OAs) versus Continuous Positive Airway Pressure (CPAP). In this review, we will discuss the actual guidelines for short and long-term dental management, potential factors contributing to the success of OAT, and possible side effects in treating OSA.

Management in dental care for patients with suspected Sleep Related Disordered Breathing

Standards of Practice Committee of the AADSM suggested a management flowchart for dentists in 2018 (2). Two major pathways may lead to a dental patient’s evaluation of suspected sleep-related disordered breathing (SRDB). A patient may start a visit to a qualified dentist and be screened, or a physician may refer the diagnosed patient to a qualified dentist. The first visit to a qualified dentist should implement a screening process including nocturnal and daytime symptoms (e.g., snoring, witnessed apnea, gasping, sleepiness), STOP-BANG questionnaires, chief complaints, medical and family histories, current medications, dental history and findings. It is also important to record baselines such as BMI, blood pressure and neck circumference for OAT monitoring. Then in consultation with the patient, the qualified dentist should then refer the suspected case to a physician for evaluation and assessment of SRDB. Another pathway may be a physician who has diagnosed a patient with SRBD, referring the patient to a qualified dentist for dental assessment and initiation of OAT. Patients undergoing OAT should be educated on their SRBD severity, including AHI, RDI and REI from sleep test results. They should also be informed that OAT success may be affected by fragmented sleep, oxygen desaturation and other co-existing sleep problems. (2)

Clinical characteristics contributing to the success and failure of OAT

Evidence showed that OAT works better on anatomic traits by opening the airway, preventing closure and probably acting as a mandibular and tongue retainer. OA may help to reduce sleep arousals, effective in patients with low loop gain of ventilatory control reflex. Additional characteristics contributing to treatment efficiency are summarized in Figure 2 (3).  

In the long term, patients who have higher respiratory arousal showed better improvement in sleepiness. Patients preferred OA as a first-time treatment or have complete symptom resolution may have higher adherence in the long run. From the perspective of OA fabrication and titration, the use of Bi-Bloc OA enabling relatively free mandibular movement or custom-made OA with regular dental follow-up showed better adherence. Regular follow-ups also help to minimize early side effects and treatment discontinuation. Support from bed partners by improving bed partners’ sleep quality is another important factor in OAT success (4).

Side effects and Contraindications of OAT

Side effects, such as dental pain, muscular pain, excessive salivation or dryness, may result in non-adherence (4). While bite change, dental and occlusal changes, mesial tipping of mandibular molars and distal tipping of maxillary molars, increased mandibular arch length, and downward rotation of mandible were reported. These changes are usually irreversible (5–11). Although side effects may seem substantial, patients should not discontinue the OAT unless there is a better treatment option provided since the preventive benefits of life-threatening outcomes of OSA outweigh the side effects of OAT.

It is also worth noting that edentulous patients with inadequate teeth, patients with severe periodontitis or a history of temporomandibular joint may not be suitable for OAT (12).

Calibration of OA and long-term management

In the previous decades for OAT, evidence on treatment effect and adherence with OA had been limited. In particular, adherence to OAT has recently been limited to self-reported data, with the inherent risks of overreporting (4). While extensive publications have been reported on the efficacy of short-term and long-term treatment of CPAP, the effectiveness and long-term adherence of OAT remain to be investigated. According to guidelines in 2015 (1), home sleep tests should be implemented for follow-up visits for treatment efficacy or even annual follow-ups to evaluate the long-term effects of OAT. Patients are expected to return to a qualified dentist within the first 30 days to assess the comfort and efficacy of the OAT. In addition, the qualified dentist will need to determine an appropriate endpoint for the OA advancement process. Consideration of evidence supporting 50% improvement in baseline AHI may be considered as partial treatment success (11). The AASM and American Medical Association (AMA) have published policies that a physician must order a home sleep apnea test to determine the appliance’s efficacy (13,14). Therefore the interpretation of sleep results should be in consultation with the qualified dentist, patient and physician. Additionally, final calibration of the OA, the qualified dentist should refer the patient back to the physician for assessment of OAT outcomes(2).

For long-term follow-up and management, patients are expected to follow up every 6 months for the first year and at least annually thereafter. The annual examination should include verification of OA efficacy and occlusal stability, check of the structural integrity of OA, symptoms evaluation, patient comfort and adherence rate,and possible short and long-term side effects (2). In case of damage, bacterial or fungal growth, replacement should be made, and additional calibration should be conducted (2).

How Belun can help

According to AASM and AMA published policies, a physician must order a home sleep apnea test to determine the efficacy of OAT. For long-term management, patients are expected to assess their sleep architecture at baseline, 1 month, 6 months, and yearly follow-ups to ensure good adherence and long-term prevention of life-threatening complications associated with OSA. For example, Belun Sleep Platform (BSP), using an FDA-cleared wearable Ring, offers an automated Home sleep test for patients with OSA.

Belun Sleep System (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, perform sleep stage analysis and give REM and NREM sleep duration using its artificial intelligence platform. Furthermore, autonomic nervous system (ANS) activities, including sympathetic and parasympathetic activities, throughout the monitoring period. From the assessment provided by Belun Sleep System, objective sleep impairments data. Although polysomnography is currently the gold standard for measuring sleep quality, the test is costly, not easily available, and requires skilled sleep technicians for assessment. Going forward, Belun Sleep System herein serves to provide a cost-effective, readily available, automated, no-skilled technician-needed solution to dentists, sleep physicians, and patients with sleep-related disordered breathing population-wide.

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 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),

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.         Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015 [Internet]. [cited 2022 Sep 5]. Available from: https://jcsm.aasm.org/doi/epdf/10.5664/jcsm.4858

2.         Levine M, Bennett K, Cantwell M, Postol K, Schwartz D. Dental Sleep Medicine Standards for Screening, Treating, and Managing Adults with Sleep-Related Breathing Disorders. J Dent Sleep Med. 2018 Jul 10;5(3):61–8.

3.         Lavigne GJ, Herrero Babiloni A, Beetz G, Dal Fabbro C, Sutherland K, Huynh N, et al. Critical Issues in Dental and Medical Management of Obstructive Sleep Apnea. J Dent Res. 2020 Jan 1;99(1):26–35.

4.         Tallamraju H, Newton JT, Fleming PS, Johal A. Factors influencing adherence to oral appliance therapy in adults with obstructive sleep apnea: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine. 17(7):1485–98.

5.         Aarab G, Lobbezoo F, Heymans MW, Hamburger HL, Naeije M. Long-Term Follow-Up of a Randomized Controlled Trial of Oral Appliance Therapy in Obstructive Sleep Apnea. RES. 2011;82(2):162–8.

6.         Doff MHJ, Hoekema A, Pruim GJ, Huddleston Slater JJR, Stegenga B. Long-term oral-appliance therapy in obstructive sleep apnea: a cephalometric study of craniofacial changes. J Dent. 2010 Dec;38(12):1010–8.

7.         Fransson AMC, Kowalczyk A, Isacsson G. A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea/snoring who use a mandibular protruding device. Eur J Orthod. 2017 Oct 1;39(5):502–8.

8.         Chen H, Lowe AA, de Almeida FR, Fleetham JA, Wang B. Three-dimensional computer-assisted study model analysis of long-term oral-appliance wear. Part 2. Side effects of oral appliances in obstructive sleep apnea patients. Am J Orthod Dentofacial Orthop. 2008 Sep;134(3):408–17.

9.         Rose EC, Staats R, Virchow C, Jonas IE. Occlusal and skeletal effects of an oral appliance in the treatment of obstructive sleep apnea. Chest. 2002 Sep;122(3):871–7.

10.       Pliska BT, Nam H, Chen H, Lowe AA, Almeida FR. Obstructive sleep apnea and mandibular advancement splints: occlusal effects and progression of changes associated with a decade of treatment. J Clin Sleep Med. 2014 Dec 15;10(12):1285–91.

11.       Hamoda MM, Kohzuka Y, Almeida FR. Oral Appliances for the Management of OSA: An Updated Review of the Literature. Chest. 2018 Feb 1;153(2):544–53.

12.       Ng JH, Yow M. Oral Appliances in the Management of Obstructive Sleep Apnea – Sleep Medicine Clinics [Internet]. [cited 2022 Sep 5]. Available from: https://www.sleep.theclinics.com/article/S1556-407X(18)30092-4/fulltext

13.       Rosen IM, Kirsch DB, Chervin RD, Carden KA, Ramar K, Aurora RN, et al. Clinical Use of a Home Sleep Apnea Test: An American Academy of Sleep Medicine Position Statement. J Clin Sleep Med. 2017 Oct 15;13(10):1205–7.

14.       H-35.963 Appropriate Use of Objective Tests for Obstructive Sle | AMA [Internet]. [cited 2022 Sep 10]. Available from: https://policysearch.ama-assn.org/policyfinder/detail/sleep%20apnea?uri=%2FAMADoc%2FHOD.xml-H-35.963.xml

The post The Emerging Importance of Dental Sleep Medicine (Part 2) first appeared on Belun Technology.

In 2015, the US cost of diagnosing and treating Obstructive Sleep apnea (OSA)  was approximately US$12.4 billion (1,2). The Obstructive Sleep Apnoea Health Economics report by the British Lung Foundation suggests an estimated 1.5 million adults in the UK have sleep apnea, although only around 330,000 are currently diagnosed and treated (3). 

In the past decades, although 5.2% of dental patients were identified as high risk of OSA, none received a referral for further OSA evaluation (4). Furthermore, 54% of dentists never consulted a physician about a suspected OSA patient (5). In light of the growing prevalence and serious health outcomes associated with OSA, the American Academy of sleep medicine (AASM) and the American Academy of Dental Sleep Medicine (AADSM) published guidelines in 2015 for the treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy (6), dentists are advocated as the frontiers in medical examinations for patients with potential sleep problems. Qualified dentists should have a minimum of 25 hours of recognized continuing education in dental sleep medicine (e.g., American Dental Association Continuing Education Recognition Program [ADA CERP] or Academy of General Dentistry Program Approval for Continuing Education [AGD PACE] ) provided by a dental sleep medicine focused non-profit organization or accredited dental school in the last two years. The major recommendations are as follows:

• Sleep physicians prescribe oral appliances, rather than no therapy, for adult patients who request treatment for primary snoring (without OSA)
• When oral appliance therapy (OAT) is prescribed by a sleep physician for an adult patient with OSA, a qualified dentist should use a custom, titratable appliance over non-custom oral devices
• Sleep physicians should consider prescriptions of an oral appliance (OA), rather than no treatment, for adults with OSA who are reluctant to use CPAP or prefer alternative therapy.
• Qualified dentists should provide oversight rather than no follow-up of OAT in adults with OSA to survey for dental-related side effects or occlusal changes and reduce their incidence.
• Sleep physicians should conduct follow-up sleep tests to improve or confirm treatment efficacy rather than follow-ups without sleep tests for patients fitted with OAs.
• Sleep physicians and qualified dentists should instruct adult patients with OAT for scheduled visits as opposed to no follow-up.

During the COVID-19 pandemic, OAT is even advocated as the first-line therapy for OSA (7) as it does not generate aerosols, is easily disinfected, and does not need replaceable parts, unlike Continuous positive airway pressure (CPAP), which experienced a shortage of supplies during the COVID lockdown. Patients who prefer OAT may be more likely to adhere to the treatment since it does not increase the significant risk of COVID-19 exposure (7).

Types of interventions to treat OSA

While not all patients may be suitable for OA use, several available treatment options are available for patients with OSA. For example, it could be pharmacological to use domperidone and pseudoephedrine to reduce snoring; however, the effectiveness of therapy was not substantially validated with limited evidence (8). Surgery has been advocated to address structural issues, but NICE guidelines state that there is a lack of evidence of the clinical effectiveness of surgery for OSA; thus, it is not routinely used (9). Given the non-invasive, cost-effective, reversible nature of OAs, they are recommended as useful devices to treat mild to moderate OSA. OAs were mainly categorized into the following types: custom titratable; custom, non-titratable; non-custom, titratable; and non-custom, non-titratable. The guidelines in 2015 recommended the use of custom, titratable appliances as the best type of OA for OSA treatment.

Comparable Benefits using OAs vs CPAP

CPAP and OAs can reduce upper airway collapse during sleep, with CPAP having great efficacy in moderate to severe OSA. CPAP reduces the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), or respiratory event index (REI) more than OAs in adult patients with moderate OSA (6). However, there are no significant differences in quality of life and cognitive and functional outcomes (10). Interestingly, it is worth noting that adherence to CPAP is generally lower than OA. Moreover, greater efficacy of CPAP may not necessarily translate into better treatment outcomes. In various randomized control trials comparing CPAP to OA across various severity of OSA patients, the use of CPAP and OA showed comparable results in improving symptoms of sleepiness (11,12), quality of life (13), and drive performance (14), cardiovascular outcomes and short-term effects on blood pressure (15) and even mortality rate in patients with severe OSA (16,17). The possible reason for the similar treatment effect between CPAP and OA was due to the longer adherence to OA compared to CPAP by patients. The adverse side effects, such as pressure sores, mask dislodgement, claustrophobia, air leakage, and nasal congestion had made CPAP intolerable to many patients (18). About 20-50% of OSA patients are reluctant to comply with CPAP (19), and adherence with CPAP is reportedly over 1h/night lower than OA (14). Moreover, OAT was also reported to be effective in two-thirds of patients after 3 years of treatment (20). Combination therapy of CPAP and OA was thus advocated to reduce the upper airway resistance and allow a more comfortable and lower pressure to sustain patency of the airway (21). The benefits of OAT are summarized in the figure below.

How Belun can facilitate OAT

According to AASM and American Medical Association published policies, a physician must order a home sleep apnea test to determine the efficacy of OAT. For long-term management, patients are expected to assess their sleep architecture at baseline, 1 month, 6 months, and yearly follow-ups to ensure good adherence and long-term prevention of life-threatening complications associated with OSA. For example, Belun Sleep System (BSP), using an FDA-cleared wearable Ring, offers an automated Home sleep test for patients with OSA.

Belun Sleep System (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, perform sleep stage analysis and give REM and NREM sleep duration using its artificial intelligence platform. Furthermore, autonomic nervous system (ANS) activities, including sympathetic and parasympathetic activities, throughout the monitoring period. From the assessment provided by Belun Sleep System, objective sleep impairments data. Although polysomnography is currently the gold standard for measuring sleep quality, the test is costly, not easily available, and requires skilled sleep technicians for assessment. Going forward, Belun Sleep System herein serves to provide a cost-effective, readily available, automated, no-skilled technician-needed solution to dentists, sleep physicians, and patients with sleep-related disordered breathing population-wide.

Continued Reading :

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 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),

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.          Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. The Lancet Respiratory Medicine. 2019 Aug 1;7(8):687–98.

2.         Watson NF. Health Care Savings: The Economic Value of Diagnostic and Therapeutic Care for Obstructive Sleep Apnea. J Clin Sleep Med. 2016 Aug 15;12(8):1075–7.

3.         Steier J, Martin A, Harris J, Jarrold I, Pugh D, Williams A. Predicted relative prevalence estimates for obstructive sleep apnoea and the associated healthcare provision across the UK. Thorax. 2014 Apr 1;69(4):390–2.

4.         Guess NW, Fischbach H, Ni AA, Firestone AR. Referral rate for obstructive sleep apnea in a pre-doctoral dental clinic using the STOP-Bang Questionnaire. Journal of Dental Education. 2022;86(4):456–62.

5.         Knowledge, opinions, and clinical experience of general practice dentists toward obstructive sleep apnea and oral appliances – PubMed [Internet]. [cited 2022 Sep 7]. Available from: https://pubmed.ncbi.nlm.nih.gov/15211392/

6.         Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015 [Internet]. [cited 2022 Sep 5]. Available from: https://jcsm.aasm.org/doi/epdf/10.5664/jcsm.4858

7.         Schwartz D, Addy N, Levine M, Smith H. Oral appliance therapy should be prescribed as a first-line therapy for OSA during the COVID-19 pandemic. J Dent Sleep Med [Internet]. 2020 Jul 10 [cited 2022 Sep 5];7(3). Available from: https://www.aadsm.org/docs/jdsm.7.10.2020.sa1.pdf

8.         Larrain A, Kapur VK, Gooley TA, Pope CE. Pharmacological treatment of obstructive sleep apnea with a combination of pseudoephedrine and domperidone. J Clin Sleep Med. 2010 Apr 15;6(2):117–23.

9.         Tanna N, Smith BD, Zapanta PE, Karanetz I, Andrews BT, Urata MM, et al. Surgical Management of Obstructive Sleep Apnea. Plast Reconstr Surg. 2016 Apr;137(4):1263–72.

10.       Schwartz M, Acosta L, Hung YL, Padilla M, Enciso R. Effects of CPAP and mandibular advancement device treatment in obstructive sleep apnea patients: a systematic review and meta-analysis. Sleep Breath. 2018 Sep;22(3):555–68.

11.       Sharples LD, Clutterbuck-James AL, Glover MJ, Bennett MS, Chadwick R, Pittman MA, et al. Meta-analysis of randomised controlled trials of oral mandibular advancement devices and continuous positive airway pressure for obstructive sleep apnoea-hypopnoea. Sleep Med Rev. 2016 Jun;27:108–24.

12.       Iftikhar IH, Bittencourt L, Youngstedt SD, Ayas N, Cistulli P, Schwab R, et al. Comparative efficacy of CPAP, MADs, exercise-training, and dietary weight loss for sleep apnea: a network meta-analysis. Sleep Med. 2017 Feb;30:7–14.

13.       Gupta MA, Simpson FC, Lyons DCA. The effect of treating obstructive sleep apnea with positive airway pressure on depression and other subjective symptoms: A systematic review and meta-analysis. Sleep Med Rev. 2016 Aug;28:55–68.

14.       Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial – PubMed [Internet]. [cited 2022 Sep 9]. Available from: https://pubmed.ncbi.nlm.nih.gov/23413266/

15.       CPAP vs Mandibular Advancement Devices and Blood Pressure in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis | Cardiology | JAMA | JAMA Network [Internet]. [cited 2022 Sep 9]. Available from: https://jamanetwork.com/journals/jama/fullarticle/2473494

16.       Anandam A, Patil M, Akinnusi M, Jaoude P, El-Solh AA. Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: an observational study. Respirology. 2013 Nov;18(8):1184–90.

17.       Hamoda MM, Kohzuka Y, Almeida FR. Oral Appliances for the Management of OSA: An Updated Review of the Literature. Chest. 2018 Feb 1;153(2):544–53.

18.       Tallamraju H, Newton JT, Fleming PS, Johal A. Factors influencing adherence to oral appliance therapy in adults with obstructive sleep apnea: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine. 17(7):1485–98.

19.       Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, Richards KC, Weaver TE. A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev. 2011 Dec;15(6):343–56.

20.       Attali V, Chaumereuil C, Arnulf I, Golmard JL, Tordjman F, Morin L, et al. Predictors of long-term effectiveness to mandibular repositioning device treatment in obstructive sleep apnea patients after 1000 days. Sleep Med. 2016 Dec;27–28:107–14.

21.       Levine M, Bennett K, Cantwell M, Postol K, Schwartz D. Dental Sleep Medicine Standards for Screening, Treating, and Managing Adults with Sleep-Related Breathing Disorders. J Dent Sleep Med. 2018 Jul 10;5(3):61–8.

The post The Emerging Importance of Dental Sleep Medicine (Part 1) first appeared on Belun Technology.

Among a population of 1.46 billion, health-conscious Indians are keen to explore ways to stay fit. Belun hopes to spread the sleep health concept to stressful executives with wellness remaining top-of-mind but always time-deprived. We look forward to collaborating with the mindfulness guru at the yoga retreat or even a sleep master class. DM us if you are a potential partner!

Photo by Vansh, TENx2 & The Wellness. Co. 

Partnering with Belun :

Up to now, over 32 organizations, including HK hospital authority, medical groups, clinic groups, dentists, and elderly centers selected to use the 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 in the form below:

The post Belun in India 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.

2.         Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002 Apr;6(2):97–111.

3.         Ohayon MM. OBSERVATION OF THE NATURAL EVOLUTION OF INSOMNIA IN THE AMERICAN GENERAL POPULATION COHORT. Sleep Med Clin. 2009 Mar;4(1):87–92.

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.

5.         Kyle SD, Morgan K, Espie CA. Insomnia and health-related quality of life. Sleep Med Rev. 2010 Feb;14(1):69–82.

6.         Shahly V, Berglund PA, Coulouvrat C, Fitzgerald T, Hajak G, Roth T, et al. The associations of insomnia with costly workplace accidents and errors: results from the America Insomnia Survey. Arch Gen Psychiatry. 2012 Oct;69(10):1054–63.

7.         Laugsand LE, Strand LB, Vatten LJ, Janszky I, Bjørngaard JH. Insomnia symptoms and risk for unintentional fatal injuries–the HUNT Study. Sleep. 2014 Nov 1;37(11):1777–86.

8.         Hertenstein E, Feige B, Gmeiner T, Kienzler C, Spiegelhalder K, Johann A, et al. Insomnia as a predictor of mental disorders: A systematic review and meta-analysis. Sleep Medicine Reviews. 2019 Feb 1;43:96–105.

9.         Winkelman JW. Insomnia Disorder. New England Journal of Medicine. 2015 Oct 8;373(15):1437–44.

10.       Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004 Apr;8(2):119–32.

11.       Leigh JP. Employee and job attributes as predictors of absenteeism in a national sample of workers: the importance of health and dangerous working conditions. Soc Sci Med. 1991;33(2):127–37.

12.       Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 Feb 15;13(2):307–49.

13.       Muench A, Vargas I, Grandner MA, Ellis JG, Posner D, Bastien CH, et al. We know CBT-I works, now what? Fac Rev. 2022 Feb 1;11:4.

14.       Bastien CH, Morin CM, Ouellet MC, Blais FC, Bouchard S. Cognitive-behavioral therapy for insomnia: comparison of individual therapy, group therapy, and telephone consultations. J Consult Clin Psychol. 2004 Aug;72(4):653–9.

15.       Verbeek IH, Konings GM, Aldenkamp AP, Declerck AC, Klip EC. Cognitive behavioral treatment in clinically referred chronic insomniacs: group versus individual treatment. Behav Sleep Med. 2006;4(3):135–51.

16.       Yamadera W, Sato M, Harada D, Iwashita M, Aoki R, Obuchi K, et al. Comparisons of short-term efficacy between individual and group cognitive behavioral therapy for primary insomnia. Sleep Biol Rhythms. 2013 Jul;11(3):176–84.

17.       Ritterband LM, Thorndike FP, Gonder-Frederick LA, Magee JC, Bailey ET, Saylor DK, et al. Efficacy of an Internet-based behavioral intervention for adults with insomnia. Arch Gen Psychiatry. 2009 Jul;66(7):692–8.

18.       Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical Guideline for Evaluating and Management of Chronic Insomnia in Adults. J Clin Sleep Med. 2008 Oct 15;4(5):487–504.

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

Cognitive behavioral therapy for insomnia (CBT-I) is a short, structured, evidence-based approach to cure insomnia. CBT-I explores the connection between how we think, what we do, and how we sleep. It is a multi-component treatment because it combines several different approaches, involving cognitive intervention, behavioral intervention, and psychoeducational intervention. During treatment, a trained CBT-I provider helps identify thoughts, feelings, and behaviors contributing to insomnia symptoms. The provider will examine the shared beliefs and emotions to see if they’re accurate and review the behaviors to see if they promote sleep. The process aims to clarify or reframe misconceptions and challenges in a way that is more conducive to restful sleep. Treatment often takes 6-8 sessions, although the length may vary depending on a person’s needs. 

CBT-I is a collaborative process, and the skills learned in sessions require practice. Homework is a common component of treatment.

Assignments in-between sessions may involve:

• Keeping a sleep diary.
• Practicing questioning automatic thoughts or beliefs when they arise.
• Improving sleep hygiene practices.

Access the patients’ sleep architecture
Belun® Ring can become a patient’s digital sleep diary. It records what happened every night. Does the patient have insomnia because they cannot fall asleep quickly, do not sleep well, or have difficulty falling asleep again after waking up? Adopting the ring empowers the doctor with quality data (Belun’s sleep data is medical grade) to determine the cause of insomnia more accurately, instead of relying solely on the patient’s description out of sheer memory or guessing. The ring is a digital tool providing scientific data to support diagnosis, thus improving clinical decision-making.

About Sleep2022 : 

https://www.sleepmeeting.org/wp-content/uploads/2022/03/SLEEP-2022-Preliminary-Program.pdf

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 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 SLEEP 2022 Highlight 2 : Digital CBT-I and integrated with the EHR for treatment of chronic insomnia disorder first appeared on Belun Technology.

Cardiovascular disease (CVD) susceptibility is influenced by physiology, genetics, and exposure. Physiology includes (1) Autonomic nervous system (ANS) responses: CV responses to respiratory events, arrhythmia, ischemia, and cardiac output; and (2) Sleep State dynamics. Genetics includes inflammation and angiogenesis, while exposures include smoking, diet, physical activity, etc.

Precision medicine has been a hot topic. During the talk, Susan Redline shared her vision of how “gender differences” can be a step towards precision sleep medicine. How additional parameters, including ANS response during respiratory events, hypoxic burden, and delta heart rate, can more accurately predict CVD risks. Dr. Redline concluded the keynote by calling for action in improving metrics that robustly identify individuals at risk for OSA-related CVD, including endotypes, physiological response markers, e.g., ANS, hypoxic burdens, delta heart rate, genetics, gender, etc. Last is the need and value of multi-disciplinary teamwork in physiology, epidemiology, genetics, and implementation science. Empowered by the FDA-cleared wearable (Belun® Ring) and its proprietary machine learning algorithms, the Belun Sleep Platform is capable of computing both the AHI of the users and the ANS response throughout the night, reflecting users’ ANS response to respiratory events. In addition, hypoxic burdens and delta heart rate will be new features in the product roadmap, which concur with Dr. Redline’s outlook.

About Sleep2022 : 

https://www.sleepmeeting.org/wp-content/uploads/2022/03/SLEEP-2022-Preliminary-Program.pdf

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 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 out the form below:

The post SLEEP 2022 Highlight: Inspiring Keynote from Dr. Susan Redline – the complexities of sleep-disordered breathing and increased cardiovascular risk first appeared on Belun Technology.

On the other hand, Belun will join many interesting tutorials and plenary sessions in #sleep2022 related to Sleep technology:
5 Jun | SUN – C02: Trends in Sleep Medicine
5 Jun | SUN – C07: The Ones and Zeros of Digitizing your Practice: Roadmap to Choosing Digital Health Solutions
6 Jun | MON – O11: Sleep Considerations in Hypertension, Arrhythmias, and More
7 Jun | TUE – D07: Smart Sleep: A Guide to Choosing Artificial Intelligence (AI) Solutions for Clinical Practice

Belun Presentive Healthcare Solution:

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 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),

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:

The post Belun in SLEEP 2022 TUTORIAL first appeared on Belun Technology.