the new era self-care and democratization of sleep medicine5db5ef8f-83f1-437e...optical (oximeter,...

Health monitoring in insuranceUnlocking the power of your customers' data

The New Era Self-care and Democratization of Sleep Medicine

A Sleepless SocietyBrightness map indicates light pollution

Insufficient sleep Insomnia Circadian rhythm problems

Social jet lag Obstructive sleep apnea

99% of Europeans and people in the US, live under skies nearly 10% brighter than their natural starry state

Allan Rechtschaffen, 1970

“If sleep does not serve an absolutely vital function, then it is the biggest mistake the evolutionaryprocess has ever made.”

Why we sleep?

Through an explosion of discoveries over the past

twenty years, we have come to realize that

evolution did not make a spectacular blunder in

conceiving of sleep. Sleep dispenses a multitude

of health-ensuring benefits, yours to pick up in

repeat prescription every twenty-four hours, should

you choose. (Many don’t.)“

Matthew Walker; 2017

“

General Organization of the Autonomic Nervous Function

Endocrine (Glands Secrete

Circulating Factors)

Autonomic Nerves (organs)

Environment (sensory)

Endocrine (Glands Secrete

Circulating Factors)

Autonomic Nerves (organs)

Motor and Pain Control

CentralAutonomic

Network

Behavioral State Control (attention, sleep-wake cycle,

motivation…)

Sleep Drive (needs)

Circadian Rhythm (clock)

Age

Individual/Genetic Differences

Determinants of Sleep

Waketime

Function

& HealthStress/Mood

Health/Pain

Motivation

Ambient Conditions

Social Time

Light-dark Cycle

The Sleep-Life Balance is Broken

Technology Brought Fast Changes In Human Life:

Computers

TV and Media

Smartphones

Social media

Industrial revolution

Artificial light

Transportation

Communication

Half of the population of the U.S.A, Europe, and China

suffers from sleep deficit & sleep disorders

Sleep DeficiencyPoor or Insufficient Sleep

Cardiovascular Diseases, Obesity & Metabolic

Syndrome, Cancer, Degenerative Disorders &

Dementia, Infectious Diseases, Mood

Disorders, Work and Traffic Accidents,

Absenteeism, Presenteeism….

Lower Quality of Life

Decreased Performance

Decreased Life Expectancy

Causes:

Leading to increase in:

Resulting in:

Lower Immunity

Increased Inflammation

Increased Stress

Endocrine Dysfunction

Memory Impairment

Increased Reaction Time

Emotional Imbalance

Economic cost of insufficient sleep in 5 OECD countries

Source: Jess Plumridge/RAND Europe

The Impact of Sleep Loss

$63 B - Cost to employers$1,500 vs $300 - Cost to insurance company for person with poor sleep vs good sleep

Use Technology to Repair the Very Damage it Caused

Give Sleepa Chance

Assess

SolveMonitor

SleepRate Solutionat a Glance

Heart Rate Measurement

Electrical (ECG, Chest Strap)

Optical (Oximeter, PPG)

Ballistical

Integration of Signals to Improve Results

Heart Rate

Actigraphy

Breathing

Oxygen Saturation

Ambient factors

Sound (noise & snoring)

Light

Temperature

Weather

Light-Dark

SleepRate Supports a Variety of Sensors

BIO

“ Wearable apps help Olympic athletes train at their best” Special for USA TODAY Sports; July 29, 2016

Assessment

Assessment Algorithm Flow

Raw Data Data Analysis Results

Sleep times and alarms as measured (GTB,WU,Alarm)

IBI

Accelerometer

Ambient sound & snoring

Daytime sleepiness, stress and naps (reported)

Daytime behaviors & habits

Questionnaires and demographics

Perceived sleep times

Sleep disturbances connected to ambient factors

Measured stress, HR and recovery

Perceived sleep measures & discrepancies from objective variables

Sleep Architecture (HRV and/or Actigraphy)

Correlates with daytime habits

Insomnia

DSPS

DSPS & Insomnia

ASPS

Insufficient sleep

Poor sleep related habits

Normal sleep

Referral to expert

Global Sleep Fix

Global Sleep Fix participation map

Global Sleep Fix

50.0%

23.2%

7.5%

6.5%

12.5%0.2%

AssessmentOutcome

Insomnia Insomnia and Circadian Circadian Insufficient Sleep Habits Only Normal Sleep

7904 completed assessment

50

51

52

53

54

55

56

57

Alcohol No Alcohol

Subjective Sleep Satisfaction

0

2

4

6

8

10

12

14

Alcohol No Alcohol

min

ute

s

Subjective WASO

error bars are standard errors

**

**

** p<0.0001

Alcohol and Sleep Parameters

Pain and Sleep

• Pain – 586 Users • No Pain – 4437 Users

For which conditions have you been diagnosed or treated? • Arthritis or pain: Yes / No

40

50

60

70

80

90

100

Active Insomnia Insomnia - Not Active Short Sleep Duration Poor Sleep Habits

% o

f U

se

rs

Pain No Pain

Therapy

Historical Wisdom

The day and night [together] are twenty-four hours long. It is sufficient to

sleep for a third of this, i.e. eight hours, which should be at the end of the

night, so that there will be eight hours from when one goes to sleep to

sunrise. One should get up before sunrise.

One should not sleep on one's front or on one's back, but on one's side; at the

beginning of the night one should sleep on one's left side, and at the end of

the night on one's right side. One should not sleep close to having eaten, but

one should first wait three or four hours. One should not sleep during the day.

Maimonides, The Book of Knowledge, Regimen of Health, 1170-1180

Increases sleep drive

Stabilizes circadian rhythm

Synchronizes sleep drive with

circadian rhythm

Reduces conditioned arousals

Lowers sleep related anxiety

Targets sleep damaging behaviors

Provides adequate individual guidance to reduce

conditioned arousals and negative emotions

Provides sleep education

Supports adherence with challenging behavioral

changes

Provides biofeedback or relaxation guidance

Provides detection of disturbing ambient noise

Therapy Phase corrects detected abnormalities Improves Sleep

How Does CBT+ Work

Aetna Validation Study (RCT)

Subjective-ObjectiveDiscrepancies (mean and SEM)

* for p<0.05 two-tailed paired t-test

CONFIDENTIAL AND PROPRIETARY

619 subjects with insomnia symptoms

Each subject’s sleep parameters were compared:

last goal in therapy versus assessment

Insomnia Improvement

0

10

20

30

40

50

60

Assessment Last Goal

min

ute

s

Subjective Sleep Onset

0

5

10

15

20

25

30

35

40

Assessment Last Goal

min

ute

s

Subjective WASO

76

78

80

82

84

86

88

90

Assessment Last Goal

%

Subjective Sleep Efficiency

40

42

44

46

48

50

52

Assessment Last Goal

Subjective Sleep Satisfaction

0

2

4

6

8

10

12

Assessment Last Goal

SSS Rank

**

**

**

**

**

error bars are standard errors

** p<0.0001

Insomnia Improvement

Users’ engagement

0%

10%

20%

30%

40%

50%

60%

70%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

# nights in therapy

With Device Without Device

% o

f u

se

rsw

ith

co

mp

lete

d a

ss

es

sm

en

t

Assess

Solve

Prevent

Monitor

Sleep Deficiency is SolvableRedeem your natural rights to sleep and undo the damage:

Cardiovascular Diseases, Obesity & Metabolic

Syndrome, Cancer, Degenerative Disorders &

Dementia, Infectious Diseases, Mood

Disorders, Work and Traffic Accidents,

Absenteeism, Presenteeism….

Better Quality of Life

Better Performance

Increased Life Expectancy

Normalize:

Reduce risk of:

Get:

Immunity

Inflammation

Stress

Endocrine function

Memory

Reaction time

Emotional Imbalance

> 70,000 - # of users > 3,000 - # of therapy customers > 400,000 - # of nights recorded

As users’ s data accumulates Therapy improves and Prevention becomes possible

anda@sleeprate.com

> 70,000 - # of users > 3,000 - # of therapy customers > 400,000 - # of nights recorded

Sleep Well

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