Trends Shaping the Sleep Medicine Industry From SLEEP 2023

By Ingvar Hjalmarsson

Sleep medicine is always evolving and after a jam-packed week at the annual SLEEP conference in Indianapolis, we are now more excited than ever about the future of the sleep field. Many fascinating new trends, thought-provoking ideas, and changes in diagnostic sleep technology surfaced during the annual event and we are excited about the crossroads where the sleep industry is currently positioned.

Sleep as a Strategic Intervention for Chronic Disease Management

With the broad applications of sleep in healthcare, we can move in almost any direction at the moment. However, I see a clear path forward for our field, illuminated by recent technological advances, research, and innovations. Our way forward is that sleep needs to be seen as a strategic intervention for chronic disease management. The journey to curbing the burdensome costs of chronic diseases, such as diabetes, congestive heart failure, and hypertension — starts with sleep health.  For years, sleep industry professionals have understood the profound ramifications of untreated sleep disorders  — now is the time to focus on educating all stakeholders in the healthcare system about the importance of sleep health.

Artificial Intelligence is Here to Stay

There’s no doubt that artificial intelligence is having a limelight moment both in sleep medicine and beyond. Throughout the conference halls of SLEEP 2023, the buzz around artificial intelligence and deep learning was palpable. Opinions vary, but most professionals within the sleep industry seem to agree that AI is here to stay, and sleep labs throughout the world are already welcoming the technology into their workflows in the form of sleep study autoscoring.

I’m proud to report that those using the AI-driven sleep software that comes complimentary with all Nox Medical diagnostic testing equipment, Noxturnal, say the results are clear: there is increased efficiency, higher patient throughput, and significant time savings in the sleep lab. And this is only the tip of the artificial intelligence iceberg. We are only beginning to discover the many applications of AI in the sleep lab.

In the poster hall, Nox’s VP of Artificial Intelligence and Data Science, Jon Skirnir Agustsson, was on hand to present and answer questions about two AI-focused research abstracts:

• Deep Learning-based Sleep and Arousal Detection in Polysomnography Data, which showcased the Nox Research team’s work on developing an automatic PSG sleep stage and arousal scorer that expedites sleep analysis while maintaining high accuracy.
• Predicting Sleep Arousals in Home Sleep Apnea Tests Using Artificial Intelligence, which looked at a deep learning model developed by Nox Research to predict arousals during home sleep apnea tests using only respiratory inductance plethysmography (RIP) and activity signal groups.

More Than Ever, Efficiency is Top of Mind in the Sleep Lab

An efficient workflow has always been a high priority in sleep labs, but now more than ever it is top of mind due to the labor shortage that some sleep labs are currently experiencing. This problem seemed to expand exponentially when labs shut down due to the COVID-19 pandemic. When these sleep diagnostic facilities did eventually open their doors, many sleep technologists had moved on from the profession and others had decided to retire. Now sleep lab managers have an eye out for ways to optimize manpower in the sleep lab.

Is the United States Ready for At-home PSG Testing? We Think So.

Sleep specialists want more data and are turning to at-home PSG testing as the potential future of sleep diagnostics. With the current limited access to accurate sleep testing, many patient populations may struggle to travel to a sleep lab for overnight testing. At-home PSG testing makes it possible to reach more patients, said medical director at Somnocor in Canada, Dr. Judith Leech, MD, during an industry product theater presentation.

A large crowd gathered to learn about at-home PSG testing during the industry product theater as Leech described her journey with ambulatory PSG. She presented her lab’s experience with over 200 PSG-home tests as a case study of the success of performing full diagnostic studies on patients in the comfort of their own homes.

“There are potential advantages for home sleep studies for patients,” Leech told the audience.  Patients are more likely to sleep better at home and in their own beds. Patients with responsibilities at home, including single parents and people who prefer to sleep at odd hours, could also benefit from at-home PSG testing. Also, the number of studies conducted is not limited to the number of beds available in the sleep laboratory, she continued. The list of benefits is long.

Dr. Nisha Aurora, MD, an associate professor of medicine at NYU Grossman School of Medicine in the Division of Pulmonary, Critical Care, and Sleep Medicine, then took the stage to review her work using home-based PSG in research settings and shared favorable opinions of ambulatory PSG.

“Especially in the last 15 years, there’s been an acceleration of the interest in the development of approaches that completely bypass in-laboratory sleep studies,” said Aurora.

While there is still no universal billing code in the United States for at-home PSG, clinicians are still interested and excited about the potential of investing in this technology as the wave of the future. Some in the United States are already making the leap to at-home PSG, finding creative solutions to payment, including offering patients a self-pay option. We are hopeful that level II testing will be the next big thing in sleep medicine and at Nox Medical, we already offer a full PSG system, the Nox A1s, that is suitable for in-lab and at-home testing. Stay tuned to see what comes next for level II sleep testing.

And finally, as always, thank you to the Associated Professional Sleep Societies (APSS) and to the AASM and Sleep Research Society for hosting a wonderful event. See you next year in Houston for SLEEP 2024!

Ingvar Hjalmarsson is Chief Strategy Officer & EVP Strategic Business Development at Nox Health