Guest Column | September 8, 2020

A Better Solution To Healthcare's Sleep Imperative

By Dr. Melissa Lim, Somnology


Bringing together the best of technology and personalized medicine to improve clinical outcomes.

U.S. sleep disorders impact an estimated 70 million individuals in the United States — roughly the combined populations of California and Texas — and contribute to short- and long-term health issues, ranging from minor accidents to chronic conditions such as depression, hypertension, and dementia.

The connection between sleep and optimal health cannot be denied, and today’s healthcare providers, employers, and consumers are seeking solutions to change current dynamics that contribute to poor population health and drive up overall healthcare costs. Notably, a 2016 Frost & Sullivan study estimated the annual economic burden of undiagnosed sleep apnea among U.S. adults was $149.6 billion, including $86.9 billion in lost productivity, $26.2 billion in motor vehicle accidents, and $6.5 billion in workplace accidents.

Yet not only are most sleep disorders unrecognized and under-reported, but current approaches to improving the outlook on a good night’s rest remain largely ineffective in terms of real impact. Consequently, a holistic solution that finds the middle ground between existing, but ineffective options, such as wearables, and expensive sleep studies must become a priority for healthcare stakeholders. The best models bring together next-generation technological frameworks with the right expertise in an accessible way to promote patient-centered responses.

The Limitations Of Current Sleep Treatment Models

While a small, but growing, percentage of Americans regularly use wearable sleep tracking applications, these offerings provide limited insight into sleep patterns and cannot diagnose deeper clinical issues like sleep apnea. Often, the result is information overload that is lacking in actionable knowledge that leads to effective treatment.

The comprehensive polysomnogram, or laboratory sleep study — in which individuals’ brain waves, breathing patterns, and movements are monitored by a technician while they sleep in an isolated room — is the medical gold standard for making sleep diagnoses. But for most Americans, sleep assessments are inaccessible: there are currently only 7,500 board-certified sleep physicians in the U.S and 2700 accredited sleep centers in the United States and Canada, and a polysomnogram can cost as much as $5,000 (pre-deductible) and requires a time commitment of more than a 10-hours away from home.

For those fortunate to have access to a sleep study, the process is lengthy and complex. The time delay from referral to treatment can take up to 180 days – during which a patient’s symptoms may grow worse, perhaps increasing the risk of accidents, heart attack, stroke, or another adverse event.

The reality is that Americans are getting less sleep than they were 10, 20, or even 30 years ago. Recent figures from 2016 reveal that in many parts of the country, upwards of 40 percent of adults aren’t regularly sleeping at least 7 hours per night—the minimum starting point for optimal rest, according to the Centers for Disease Control and Prevention.

Without a carefully executed treatment plan, this underreported epidemic produces a multitude of negative consequences. According to a recent poll from the American Sleep Association, 38 percent of those with sleep disorders reported unintentionally falling asleep during the day, and about 5 percent reported falling asleep while driving at least once in the past month. These symptoms have consequences: Drowsy driving is responsible for 1,550 fatalities and 40,000 nonfatal injuries annually in the United States.

Making Measurable Improvements

Changing this reality requires a holistic approach that includes improving consumer education, raising awareness, and developing solutions that can help most Americans—many who do not need to participate in a polysomnography to improve sleep.

Healthcare professionals need to learn more about the dynamic nature of sleep itself: increasing our knowledge base about which individuals are at higher risk for sleep disorders and why, and the extent to which an individual’s risk is correlated with their profession and work environment (e.g., transportation, healthcare).

We also need to utilize more accessible solutions, such as sleep assessment technologies that enable individuals to self-monitor and share data with sleep experts consistently, who can then provide personalized responses and one-on-one follow up care. This approach may be superior, and less costly, compared to a one-time sleep study that produces insights based on a single night’s sleep.

The industry is already starting to see how integrated sleep care can improve health and save costs. For the past 12 months, Somnology, Inc. has provided veterans with an integrated sleep care platform called “SLaaS,” or sleep lab-as-a-service, which includes ongoing assessment, home monitoring of an individual’s sleeping patterns, data analysis, and telehealth consultations. This approach has helped individuals understand and manage their sleep disorders. This is just one example, but it illustrates the power of a more accessible and multi-faceted approach to improving sleep.

Positively impacting health outcomes starts with understanding the precursors to poor health—like lack of sleep. Unfortunately, many individuals suffering from a sleep disorder, and their physicians, do not make the connection between sleep and performance, nor do we as a society recognize flawed cultural norms, such as a 60-hour workweek and attaching ourselves to digital devices, which may perpetuate our sleep problems. Instead, we should be sounding the alarm and waking up the healthcare industry to a growing sleep imperative and the opportunity for optimal health and performance through better sleep.

About The Author

Dr. Melissa Lim is Chief Medical Officer and Co-Founder of Somnology.