Sleep medicine is undergoing a profound transformation. What was once centered around episodic, in-lab evaluations is evolving into a more continuous, personalized model of care.
With the rapid rise of home sleep testing (HST) and increasingly sophisticated wearables, the integration of remote patient monitoring (RPM) into sleep medicine has moved from a promising concept to a clinical reality.
For clinical teams designing chronic care and follow-up programs, RPM offers an unprecedented opportunity to deliver longitudinal, data-driven care that benefits patients and streamlines clinical workflows.
Its integration into sleep medicine is not only feasible now—it’s essential.
The Power of Longitudinal Data
Traditional in-lab polysomnography has long been the gold standard in sleep diagnostics, offering high-resolution insight into a patient’s sleep health. However, it provides only a single-night snapshot, which may fail to capture night-to-night variability or reflect typical sleep patterns.
In contrast, HST over multiple nights or even months has shown significant potential in improving diagnostic accuracy and treatment personalization. Empower Sleep, for instance, has developed a model allowing for multi-month HST, enabling clinicians to distinguish between different sleep phenotypes and track changes over time with greater precision.1 This type of longitudinal data fosters more dynamic and personalized adjustments to treatment and more nuanced patient management.
Innovations in Wearable Technology Supporting RPM
Recent technological advances have substantially enhanced the ability of RPM to monitor sleep health from home with clinical-grade accuracy. Devices such as ring-based pulse oximeters have received FDA clearance and are capable of collecting continuous oxygen saturation and respiratory data over extended periods. In clinical trials, these devices achieved usage rates exceeding 85 percent over more than 25 nights—a strong indication of both usability and patient compliance.2
In addition, researchers at the University of Cambridge have developed “smart pajamas” embedded with textile sensors that monitor a range of physiological metrics, including respiration and sleep states. These garments have demonstrated 98.6 percent accuracy in identifying sleep phases and disruptions, offering a comfortable, noninvasive alternative to traditional wired setups.3
Collaborative innovations are also reshaping the landscape. For example, partnerships like the one between BodiMetrics and EnsoData have resulted in platforms that integrate wearable devices with AI-powered sleep scoring tools, providing clinicians with instant access to diagnostically rich sleep data from the patient’s home environment.4 Similarly, the upgraded Nox Connect platform, previewed at SLEEP 2025, offers AI-enhanced scoring and cloud-based access to longitudinal HST data, thereby streamlining clinical workflows and reducing barriers to continuity of care.5
Clinical Applications of RPM in Chronic Sleep Care
The integration of RPM into chronic care frameworks has opened up new avenues for managing sleep disorders with a continuous, rather than episodic, model of care. Obstructive sleep apnea (OSA) remains one of the most prevalent targets for such monitoring.
By combining wearable HST devices with CPAP compliance data, clinicians can track oxygen desaturation, respiratory disturbances, and positional variables in real time, enabling early detection of therapeutic failures and poor compliance. Moreover, RPM services are now supported by a range of reimbursable billing codes—including those for device setup, data transmission, and time spent on patient monitoring—making them increasingly viable from a financial standpoint.6
RPM has also shown promise in managing insomnia and behavioral sleep disorders. Through actigraphy and integrated sleep diary applications, clinicians can follow sleep-wake patterns over time, tailoring interventions such as CBT-I more effectively and evaluating response to treatment longitudinally. This approach captures nuances like adaptation effects and potential relapse, providing a more holistic view of the patient’s progress.
Pediatric applications of RPM are emerging as well. Wearables like ring sensors and smart sleepwear offer a less intrusive means of monitoring pediatric sleep, increasing compliance and enabling better screening and management of conditions like central apnea and OSA in children.
Additionally, sleep monitoring data are increasingly valuable in managing comorbid conditions. A recent eight-week feasibility study involving older adults with mild cognitive impairment and dementia achieved data completeness rates of 79 percent to 97 percent when combining at-home EEG and actigraphy, supporting the feasibility of long-term RPM in vulnerable populations.7 This integration allows sleep data to inform broader care plans involving cardiovascular, metabolic, and neurological health.
Clinical Considerations to Implement RPM Successfully
As promising as RPM may be, successful implementation requires thoughtful integration into clinical practice. First and foremost, platforms must interface seamlessly with existing electronic health records and be compatible with FDA-cleared devices to ensure data reliability and ease of use. Systems like Nox Connect have been designed with this integration in mind, enabling clinicians to access AI-analyzed sleep data in a user-friendly format.5
Reimbursement is another critical factor. Since the COVID-19 pandemic, the Centers for Medicare & Medicaid and private payers have expanded coverage for RPM services, including for sleep apnea and related disorders.8 Sleep-specific RPM billing codes introduced in recent years now reimburse for setup, monitoring, and clinical decision-making time.9 Keeping abreast of these evolving billing practices is essential for maximizing the financial sustainability of RPM programs.
Equally important is the patient experience. Comfort, simplicity, and education are central to long-term adherence. Devices must be easy to use and non-disruptive to sleep. Clinicians must also invest in educating patients on the importance of consistent use and ensuring that support is available for technical issues. This type of patient engagement is essential to achieving reliable, longitudinal data capture.
Finally, sleep teams must be equipped to interpret the influx of data generated by RPM systems. AI-driven analytics can help by flagging anomalies and trends, but human oversight remains essential for clinical decision-making. Sleep physicians and technologists must be trained to assess long-term data patterns and respond to actionable alerts in a timely and effective manner.
Looking Ahead: The Shift Toward Continuous Care
Remote patient monitoring is redefining the practice of sleep medicine. It allows for a shift from reactive, episodic care to a continuous, preventive model. This transition means patients are no longer evaluated only when symptomatic but are instead monitored over time, enabling early intervention and more precise treatment titration.
As RPM becomes more integrated into chronic disease management, sleep data will increasingly inform multidisciplinary care plans involving cardiology, endocrinology, and neurology. The growing body of longitudinal data will also support more personalized approaches to sleep medicine, allowing clinicians to tailor interventions based on distinct patient phenotypes.
The evolution of sleep care will not be without challenges—data privacy, alert fatigue, and disparities in digital access must be addressed. Nonetheless, the trajectory is clear: remote monitoring is the foundation upon which the future of sleep medicine will be built.
Source: SleepWorld Magazine Jul/Aug 2025 Issue
Haramandeep Singh, MD, is a board-certified sleep physician and chief executive officer of iSleep Physicians, which offers sleep interpretation and telemedicine in all 50 states for both pediatric and adult patients.
References
- Carlson AH. The impact of longitudinal sleep testing on patient care. Sleep Review. April 22, 2024
- Bruk D. New wearable device may help treat common sleep problem: ‘Gold standard.’ New York Post. Published May 18, 2025. https://nypost.com/2025/05/18/health/new-wearable-device-may-help-treat-common-sleep-problem/.
- Beard M. ‘Smart pajamas’ can monitor sleep apnea and other disorders at home — and send the results to your smartphone. New York Post. Published Feb 21, 2025. Available from: https://nypost.com/2025/02/21/health/smart-pajamas-can-monitor-sleep-disorders-at-home/.
- BodiMetrics and EnsoData announce strategic partnership to expand access to sleep apnea diagnostics. EnsoData. www.ensodata.com/press/bodimetrics-ensodata-partnership. Published June 18, 2024. Accessed July 1, 2025.
- Nox Medical introduces Nox Connect, a cloud-based platform designed to streamline sleep lab operations and enhance patient care. Nox Medical. https://noxmedical.com/about/news-press/article/nox-medical-introduces-nox-connect-a-cloud-based-platform-designed-to-streamline-sleep-lab-operations-and-enhance-patient-care. Published April 19, 2024. Accessed July 1, 2025.
- Remote patient monitoring. Centers for Medicare & Medicaid Services. https://www.cms.gov/medicare/coverage/telehealth/remote-patient-monitoring. Updated May 5, 2025. Accessed July 1, 2025.
- Gabb V, Blackman J, Morrison H, et al. Longitudinal remote sleep and cognitive research in older adults with mild cognitive impairment and dementia: prospective feasibility cohort study. JMIR Aging. 2025;8:e72824. doi: 10.2196/72824.
- Woidtke R. Remote patient monitoring (RPM) and remote therapeutic monitoring (RTM): where are we today? California Sleep Society. Published Dec. 7, 2022. https://californiasleepsociety.org/news/rpm_rtm. Accessed July 3, 2025.
- Roy S. What updates to remote patient monitoring reimbursement mean for sleep medicine. Sleep Review. Jan. 26, 2023.
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