Sleep Review interviews Svanbjorn Thoroddsen andVyto Kab of SleepTech Solutions; Takaaki Saito,business development manager of Konica Minolta Photo Imaging USA; and Brian Long, sleep productmanager for VIASYS Healthcare.

Vyto Kab and Svanbjorn Thoroddsen

Medcare has placed a sizeable bet on the sleep industry’s future success. Using recently acquired diagnostic and treatment service provider SleepTech as a base, the Reykjavik, Iceland-based manufacturer and marketer of sleep equipment is entering the North American market with what Medcare CEO Svanbjorn Thoroddsen calls a new sort of company that aims “to partner, not to compete.” Sleep Review spoke with Thoroddsen and comanaging director of SleepTech, Vyto Kab, who will also head the new company, SleepTech Solutions, about what the industry can expect from their brand-new enterprise.

Q Why did Medcare decide to acquire SleepTech and form SleepTech Solutions?

Thoroddsen: For the past 18 months at least, Medcare has been focusing on transitioning from being a product company providing equipment and software for sleep diagnosis into an overall comprehensive solutions company. By acquiring SleepTech, which is a highly skilled, competent, and profitable company providing turnkey management services to hospital-owned sleep centers, we believe we are taking a very big step in that strategic transformation.

Kab: This new entity, SleepTech Solutions, will be the first comprehensive sleep solutions company focused on the needs of sleep center professionals and operators in the field of sleep medicine.

Q How will the formation of SleepTech Solutions change the industry?

Thoroddsen: The sleep industry is changing rapidly from almost a cottage industry just a few years ago into an industry that is more efficient. It is also attracting more physicians, technicians, and capital. This means it is transforming very much into a bigger business, and we think by acquiring SleepTech and by coming out with these comprehensive solutions, we will be well positioned to fulfill the needs of that industry and to help any industry player grow fast and meet the needs out there; we indeed know there is more need for sleep diagnostic services.

Q You have said that you are “aiming to partner and not compete.” What exactly do you mean by that?

Kab: Probably the definitive thing is that we are not going to open company-owned sleep centers all over the country. We will help big players attack the market in two ways: first by giving them the solutions and connectivity they will need to expand their own network, and second, by helping them handle a much larger patient load more efficiently. Our current network in the tri-state [Connecticut, New Jersey, and New York] area will end up being a proving ground for these services and solutions that we’ll roll out to players in the North American market.

Q Mr Kab, you and your wife Patricia have already contributed to the sleep industry with your work on the NFL study linking SDB and young athletes with large body masses. How will Medcare and SleepTech together continue to propel the sleep industry forward?

Kab: One of the things that made this an attractive deal for us to do with Medcare was that the two companies shared a passion for research and development. Medcare will continue to devote substantial dollars to R&D and to the development of its equipment. SleepTech has stretched the understanding of sleep issues in our landmark NFL study and in a poster paper that will be presented at the Associated Professional Sleep Societies annual meeting this June on interscorer reliability. We also have another landmark study under way that we are conducting on retired NFL players to show the relationship between sleep and cardiovascular disease. We will continue to be leaders in R&D just as we’re going to be leaders with this new solutions concept. We know we’re breaking ground in our industry.

Takaaki Saito

Most sleep professionals will agree that pulse oximetry during polysomnography is essential for use in scoring respiratory disturbance events. Sleep Review spoke with Takaaki Saito, business development manager, Instrument Systems Division, Konica Minolta Photo Imaging USA Inc, Mahwah, NJ, about some of the benefits of using pulse oximetry during polysomnography to detect sleep apnea.

Q What is the importance of pulse oximetry to polysomnography?

A Pulse oximetry gives essential information on a patient’s baseline arterial oxygen and will reveal irregular, or interrupted, breathing patterns. That type of information is very useful in diagnosing a person who has sleep apnea. Oxygenated hemoglobin absorbs more infrared light and less red light. Deoxygenated hemoglobin is the reverse: less infrared light and more red light. Pulse oximeters can measure the R/IR ratio generated by the pulse. The pulse oximeter will record a patient’s pulse and SpO2.

Q How can a portable pulse oximeter be used for a potential sleep apnea patient?

A If a doctor believes a patient is suffering from sleep disorders, the doctor can give the patient a pulse oximeter to wear overnight while the patient is sleeping. Konica Minolta’s Pulsox can be worn like a watch and the probe attaches to a finger. The next day, the patient can return the pulse oximeter to the doctor, who will download the data. That data will help the doctor determine whether the patient has a potential sleep apnea problem. If the patient appears to have sleep apnea, the next step might be to enroll the patient in a sleep lab. While in the lab, sleep tests will be conducted by polysomnography where pulse oximetry is one of the main parameters.

Q What are the pros and cons of using portable pulse oximeter?

A One of the pros of using a portable pulse oximeter is that it is a simple-to-use and economical screening device to determine patients who might have sleep apnea. It would provide supportive data to doctors of those patients who are true candidates for a sleep lab. Konica Minolta’s wristwatch-type Pulsox gives maximum comfort so that the person who wears the device can experience normal sleep habits at home or at other places of sleep study.

On the con side, a portable pulse oximeter tends to have battery operation, while the desktop-type pulse oximeter runs with AC power. Portable pulse oximeters require battery replacement. Konica Minolta Pulsox is operated by two economical AAA batteries, which last for 48 hours.

Brian Long

To increase patient compliance, sleep technicians must have the necessary tools to prescribe more accurate continuous positive airway pressure (CPAP) levels, says Brian Long, sleep product manager for VIASYS Healthcare, Yorba Linda, Calif. Long spoke with Sleep Review about how the company’s sleep diagnostic system helps alleviate problems of under- and over-titration and about the company’s new nasal interface.

Q Have there been any recent advances in aiding sleep professionals to prescribe accurate positive airway pressure levels?

A The flow volume loop and Konno Mead loop options available in VIASYS’ SomnoStar Pro sleep application help technicians look at obstruction that the patient may be having and/or upper-airway resistance as well as the patient’s work of breathing at specific CPAP pressures. We see that there are four factors that really affect CPAP compliance: under-titration, over-titration, mask comfort, and patient follow-up. With the flow volume loop and Konno Mead loop application—which are directly integrated into the SomnoStar Pro—we have the ability to help with under-titration and over-titration.

Q What sort of feedback have you gotten from sleep professionals who have used the diagnostic system?

A They are finding that they have more advanced tools than ever before to help prescribe the most accurate pressure to increase patient compliance and comfort. The flow volume loop and Konno Mead loop data is collected by a technology called RIP, or respiratory inductance plethysmography, which involves putting only two belts on a patient and nothing on the patient’s face or nose. So, the feedback we have been getting has been positive because the patient’s time during the study is more comfortable.

Q How is VIASYS’ new CPAP mask different from any other mask on the market?

A The LYRA nasal CPAP interface is probably the smallest mask available today. It features simple-strap headgear, which makes it easy for the patient to take on and off. Also, in the packaging, we’re including four different sizes, so if the patient doesn’t have the right size with the first one they try, they don’t have to call a durable medical equipment (DME) company to come out and replace that. They can simply try another size and replace it right then. This also benefits DME providers because they don’t have to carry a lot of different mask sizes or constantly revisit patients.

Q Where do you see the sleep marketplace going?

A The sleep marketplace is definitely one of the highest growth potential markets in medicine right now. People are becoming more educated in understanding the importance of sleep and the dangers of sleep apnea. Primary care physicians are also becoming more knowledgeable and are referring patients to have sleep studies.

We will always look to increase patient comfort and make CPAP devices and masks that are smaller, quieter, and less obtrusive. We want to reduce the number of parts and make sure that they are simple, easy to clean, and easy for the patient to interact with. Aiding the patient is most important of all.