[HN Gopher] Launch HN: Helio Sleep (YC S21) - One-stop portal fo...
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Launch HN: Helio Sleep (YC S21) - One-stop portal for sleep apnea
Hello HN! We're Helio Sleep (https://www.heliosleep.com). We help
treat sleep apnea at home using sleep tests, best-in-class
treatment devices, and board-certified physicians. We prescribe and
deliver medical equipment, so that patients can get care affordably
and easily from their homes. An estimated 30M Americans suffer
from sleep apnea. Getting diagnosis, treatment devices, and ongoing
support can be difficult, and is getting harder, because fewer
physicians are practicing sleep medicine. There is a serious
"conversion funnel" problem. 50% of patients give up before making
it to a sleep specialist; of those that get to a sleep specialist,
50% don't get a sleep study; and of those that do get care, more
than a third fail to continue within 6 months. As a result, 24M
Americans are currently untreated, leaving them tired and also at
risk for serious health problems such as diabetes, heart disease,
and high blood pressure. Clearly, a lot more support is needed.
That's our intention with Helio Sleep. We coordinate the care
journey by connecting patients directly with sleep specialists,
following up to make sure they have access to treatment, and
coaching them to help them stay with it. We encountered this
problem repeatedly with family and friends who were having
difficulties getting diagnosed and treated for sleep problems.
Because of our backgrounds in digital health, we knew we could
assemble a process to do something about it. We had previously
worked at digital health companies including Medallion, Truepill,
Counsyl, and Q Bio, building tools for patient education,
telemedicine networks, pharmacy fulfillment, and automated
reporting. We knew a lot about the difficulties of delivering and
supporting prescription medical devices for at-home care. One of
the biggest challenges for such a solution is the complexity of the
healthcare system. There are regulatory barriers to operating a
provider network and a licensed durable medical equipment supplier.
We also need to coordinate with payers and manufacturers. We're
building tools to coordinate all of these steps and provide a
seamless experience. Sleep apnea lies at the intersection of
medical and dental treatment in the US, so due to US billing
structures, patients typically aren't presented with all treatment
options. There is a need for a sleep apnea 'portal' where
everything relevant is addressed, and nothing major falls through
the cracks. At Helio Sleep, patients can self-refer or be referred
through their medical or dental provider. They are evaluated for
sleep apnea through a protocol-driven provider consult and a home
sleep test. They then select from a range of evidence-driven
therapies to treat their sleep apnea, and also their snoring if
that's needed. To help patients adhere to their treatments, we
follow up with them, closely monitoring efficacy and adjusting care
as required. We went live at the end of February, offering
consultations with licensed providers, home sleep tests interpreted
by board-certified sleep physicians, and treatment devices
including oral appliances and sleep positioners from industry-
leading manufacturers, and we look forward to adding other
treatment options including CPAP. We make money in an old-fashioned
way by charging for diagnostic and treatment devices and for
provider consults. We currently accept cash payment, and we'll be
adding insurance coverage. Getting medical care in the US is
expensive, and we're committed to finding ways to extend access to
as many people as possible. We're excited to share what we're
working on and look forward to your thoughts! If you have or
suspect you have sleep apnea, we'd be really interested to hear
about any experiences that you've had in getting care. If you're
curious about your risk, one of the most widely used sleep apneas
screeners is the STOP-BANG questionnaire. You can find a version of
it here: https://www.heliosleep.com/quiz. And if you're a
healthcare professional, we'd be interested to hear about your
experience with delivering care for patients. If anyone would
prefer to reach out directly, we can be reached by email at
support@heliosleep.com. We look forward to your comments!
Author : maxgreenfeld
Score : 104 points
Date : 2022-03-22 15:43 UTC (7 hours ago)
(HTM) web link (www.heliosleep.com)
(TXT) w3m dump (www.heliosleep.com)
| stuffuru wrote:
| do you score RERAs (respiratory effort related arousals) in your
| home sleep test?
| jvans wrote:
| this is not possible with home sleep tests. They will often
| claim to do this by using pulse transit time as a correlate for
| eeg arousal but that does not imply high sensitivity. People
| should be getting their sleep tests in lab as much as possible,
| home sleep tests are trash
| flanbiscuit wrote:
| I have severe apnea, I use a CPAP nightly.
|
| When I got tested for it I did the full sleep study in a hospital
| with all kinds of wires and things attached to me. How does a
| "NightOwl Home Sleep Apnea Test" compare to the test I had? Is
| the NightOwl good enough? Or is it there to tell you that you
| might/might-not need to do more intense sleep study?
|
| I'm curious about the oral appliance. I've seen people post about
| it on /r/SleepApnea. Curious if anyone here has had success with
| it.
| stuffuru wrote:
| I'm one of those people who have had success with MADs in
| r/SleepApnea. Unfortunately I couldn't use it long term due to
| preexisting issues with my bite, and had to get surgeries
| instead.
| sjg007 wrote:
| In a few years the apple watch will be able to detect sleep
| apnea and probably be certified by insurance to qualify you for
| CPAP etc...
|
| I have a CPAP and hate it, I need to switch to a dental
| appliance but these are $$$ ... CPAPs are also annoyingly $$$
| and I think all of the telemetry and crap is just nonsense. 99%
| of them auto-adjust their pressures.
| progmetaldev wrote:
| I had a take home sleep study a few months ago, and the study
| showed that I stopped breathing 89 times an hour. I am now on a
| long waitlist for a ResMed CPAP machine, because the specialist
| wrote "prescribe as written." I honestly can't wait to finally
| get the CPAP, as I am constantly tired, which has caused high
| blood pressure and exacerbates anxiety that I mostly had under
| control through medication (which is why I originally sent to
| get a sleep study).
| dsr_ wrote:
| Call your doctor's office, tell them that all CPAPs are
| currently facing major supply shortages. Get them to reissue
| the Rx for "*pap machine capable of range [x-y]mmH20". It
| should be ready by the end of the day.
|
| Then go buy anything you can. If you're a mouthbreather at
| night, get a full face mask and a humidifier.
| sithadmin wrote:
| 'At home' diagnostic devices for sleep apnea are pretty good at
| identifying apneic events via various approaches to respiratory
| and cardiovascular monitoring. What they're not able to do is
| discern between obstructive and central apneas. In practice,
| this probably doesn't matter a lot for most, and direct
| providers that rely on at home testing generally lead with
| prescribing an APAP (auto-adjusting CPAP) with good results
| instead first of doing another sleep study like a traditional
| doctor might require.
|
| Once you use an APAP, you actually are able to discern between
| apnea types with some degree of confidence if you dump the
| diagnostic data and use a tool like OSCAR to analyze it.
| kareemm wrote:
| Why does it matter if you know whether you're experiencing
| central or obstructive apneas? Does the treatment differ?
| jenkstom wrote:
| Talk about a racket. I have OSA pretty badly and can't do
| anything about it. These shrink-fit oral appliances would extend
| my lifespan by years, but I can't afford the thousands of dollars
| for a sleep study to get diagnosed to get a stupid prescription.
| Anybody who says the US has the greatest healthcare in the world
| obviously hasn't had to actually use it or has money falling out
| of their ears.
| rockdiesel wrote:
| Have you looked at Lofta?
|
| https://lofta.com/products/sleep-apnea-test
|
| Disclaimer: I've not used them. No experience with them. I've
| just seen their name mentioned as an affordable sleep test.
|
| EDIT: Just realized the company of this submission has
| similarly priced sleep apnea test. I should have probably
| clicked through before commenting.
| numinoid wrote:
| Lofta does sell CPAP machines whereas Helio doesn't. I just
| did my sleep test and follow up through them and the process
| was quick and painless.
| jjkaczor wrote:
| Ouch. In Canada the sleep study itself and subsequent
| prescription is covered by our healthcare system - however
| payment for CPAP/BIPAP machines for treatment will depend on
| the specific province. When I was first diagnosed in Alberta,
| there was no coverage - and I didn't have any as I am self-
| employed and my tiny corp doesn't have enough employees to
| qualify for a plan. A year later, I moved to Ontario - where
| our provincial health-care plan covers up-to 75% of the initial
| cost for a machine.
|
| It was a life-saver - as I have a high-level of sleep apnea
| (90+ incidents per hour) - a regular CPAP does not cut it, I
| was prescribed a BIPAP.
|
| It has changed my life - I am incredibly lucky that I got
| treatment.
| sbmsr wrote:
| Glad to see another company tackling this. I started a company
| (https://www.getairmed.com/) to help address this exact problem
| back in 2019.
|
| I am a firm believer sleep apnea is under diagnosed and
| widespread. While I agree with the sentiment that CPAP isn't the
| panacea here, my CPAP machine changed my life for the better.
| Whether its a mouth appliance, CPAP, or a didgeridoo
| (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/), I look
| forward to a world where more people can live better lives
| through healthy sleep.
|
| Best of luck!
| maxgreenfeld wrote:
| Thanks, love what you've built at AirMed. Price transparency is
| so important and often difficult to find.
| heleninboodler wrote:
| FYI, your target user is probably an old fart such as myself that
| really, really thought your name was hellosleep based on reading
| this intro.
| readdit wrote:
| Arguably a much better name.
| dang wrote:
| I had the same impression so often while editing this text that
| I emailed the founders and suggested they try to get the
| domain. It would be such a great name for this startup!
| heleninboodler wrote:
| Not going to lie, I checked to see if it was available (it
| was). Hope it still is if they decide to grab it.
| maxgreenfeld wrote:
| We will definitely consider it!
| onion2k wrote:
| _your target user is probably an old fart..._
|
| FWIW sleep apnea isn't _that_ much more prevalent in older
| people. The risk of developing it approximately doubles between
| 30 and 60, but that could be partially explained by people
| being more willing to seek help with their sleep as they get
| older. A lot of younger people with sleep problems just ignore
| them and remain dangerously tired all the time...
| JoshTriplett wrote:
| Many of the vendors of medical devices in this area have
| extensive automated telemetry that isn't under the control of the
| patient, often even preventing the patient from accessing that
| data, or gatekeeping that access through healthcare providers. As
| you move forward into more advanced treatment options, do you
| plan to address this and keep the patient in control?
| maxgreenfeld wrote:
| Absolutely - there is no good reason a patient should be
| blocked from their data. It is rather surprising that it is
| common for resellers to block patient facing views of their
| data that manufacturers have engineered into their products.
| jedberg wrote:
| > It is rather surprising that it is common for resellers to
| block patient facing view
|
| Is it though?
|
| To be clear I'm all for letting patients get access to their
| own data and think it should be required, but I totally
| understand why companies would limit their liability by
| locking consumers out of their own data.
|
| Patients are notoriously bad at interpreting their own data
| and test results. That last thing you want are patients
| changing their own treatment because the misinterpret their
| own data and then blame the device.
| fallingknife wrote:
| Last thing I want is this completely insane liability
| system we have that somehow puts the responsibility for a
| person misinterpreting data on the data provider.
| haswell wrote:
| If I want, I can get access to all sorts of things from my
| medical provider that I'm not qualified to interpret.
|
| Just by connecting Apple Health to my health care system, I
| can see every lab result, most of which I'm not qualified
| to interpret.
|
| My brother had a CT scan, and upon request, got a DVD with
| the scan data and a viewer for that data.
|
| If my healthcare provider prevented me from seeing this
| info, I'd find another provider.
|
| Getting back to the core question: is it surprising?
|
| I don't think it'd be surprising in the consumer or
| enterprise spaces where lock-in is a feature. But I don't
| think that automatically extends to healthcare, where such
| restrictions are extremely problematic, and threaten my
| ability to get care from my provider of choice.
|
| (And to clarify, I don't think this is good or acceptable
| for consumer/enterprise products either, but the
| implications there are different, where I might just choose
| another vendor - a choice I might not have for medical
| devices).
| tedyoung wrote:
| Came here to say this. And not just preventing patient access
| to the data, but locking the ability to change settings in a
| reasonable manner, without having to con$ult with a "doctor"
| (really an admin at the doctor's office) for each tiny increase
| in air pressure. It's one of the reasons I gave up on the whole
| CPAP thing.
| k12sosse wrote:
| Same, until I realized it's just a key sequence to get in to
| the machines.
|
| For me it's hold two buttons down to reveal the settings.
| Navigate to the setting, change the setting. Done. Fisher-
| Paykel.
|
| I think they lock this behind this setting because they don't
| want amateurs blowing out their lungs.
| cupofpython wrote:
| ~liability~
| floatinglotus wrote:
| I'm in favor of people being able to get the data from their
| machines, but letting users manipulate the prescribed CPAP
| settings related to pressure and flow? Someone is going to
| get killed.
| renewiltord wrote:
| Damn. Neat! I'm going to try this right after this meeting. That
| is really cheap for an FDA approved test.
| [deleted]
| anonu wrote:
| Great initiative. Solving OSA is a multi-$bn industry. And
| there's no silver bullet yet...
|
| I've had 4 sleep studies in the past - professional ones where
| they wire up your entire body for monitoring. They all produced
| wildly varying results. So I'm quite skeptical of at-home sleep
| studies. Maybe you can employ some sort of ML to record snoring
| and make a determination as to OSA?
|
| Suggestions for your site: you need a little bit more supporting
| text, especially with the products.
|
| On a separate topic - one of the coolest things I've seen which I
| think really does "solve" snoring - and persistently is
| https://www.inspiresleep.com/ - but my feeling is people will
| avoid invasive surgeries to embed nerve-stimulating devices in
| their bodies. If we could design such a product without surgery -
| that would be a game changer.
| weego wrote:
| OSA is solved. I had a home sleep study, sent it back off and
| had an APAP machine delivered all within 10 days. Mouthpieces
| and alternatives are halfway houses on the way to a solution,
| not solutions themselves.
| c_t wrote:
| There are millions of people undiagnosed, burdening
| healthcare systems and leading to preventable deaths or poor
| health outcomes.
|
| OSA hardware is a chore to use, and many simply give up on
| using it.
|
| I guess it depends on your definition of solved, but by most
| standards it is not close.
| jpthurman wrote:
| It's good to see someone filling this void. I was diagnosed with
| sleep apnea when I was leaving the military and have struggled to
| get it addressed in the transition to civilian life, changing
| insurance, doctors etc and have basically given up. Having a
| resource to be able to coordinate the process to finding a
| solution is really important. The CPAP never worked for me but I
| know there are other configurations that I never got to.
| sloshnmosh wrote:
| Have you gone to the VA?
|
| I know our local Vetrans hospital has a small sleep study room
| for diagnosis and will supply CPAP to those in need.
| maxgreenfeld wrote:
| We've heard great things from patients about the VA program
| for sleep apnea, and we're looking to incorporate best
| practices from their published studies into our care
| protocols.
| go_prodev wrote:
| I'm currently the owner of a sleep apnea mouth guard (MAD)
| similar to your pictured one.
|
| Fortunately it was free thanks to UK's NHS, because I cannot use
| due to discomfort and teeth movement, causing disrupted sleep.
|
| What's your experience been like, and are you doing anything to
| combat users giving up on treatments due to discomfort? Curious
| also why you aren't offering CPAP machines.
| miketery wrote:
| Congrats on the launch, and great space to be in.
|
| How are you different then something like Lofta?
|
| I tried signing up to use Lofta recently, but dropped off once
| they wanted me to sign some documents and I felt like it was no
| longer a simple test, but I was in a relationship with this
| provider, so I dropped off. Do you know if this due to
| regulations? (Edit: I recall now, I didn't want to chat to a
| doctor).
|
| I'd love if this was as easy as sleep tracking with an Apple
| watch and SleepWatch app (got me to reduce my drinking
| considerably).
| maxgreenfeld wrote:
| We're looking to support the full range of treatment options
| including CPAP alternatives. Our goal is to offer convenient
| care, and we'll be adding asynchronous options to streamline
| the process whenever possible.
| adora wrote:
| I used Lofta. They were much more interested in selling me
| their CPAP machines than explaining the results to me. (I was
| so borderline, CPAP would not be the first treatment anyone
| would recommend.)
| spelunker wrote:
| I know CPAPs get a bad rep because they're difficult to adjust
| to, but I use my CPAP nightly and after an adjustment period it
| has transformed my sleep. I suppose ultimately treating sleep
| apnea is the important part, so if dental devices help, that's
| great too.
| toqy wrote:
| I could never get used to mine, I didn't even know there were
| alternatives so I might give it a go.
| maxgreenfeld wrote:
| CPAP works great for many patients and we intend to fully
| support.
| pdonis wrote:
| If you can do something about the idiotic Philips recall and
| the lack of replacement units, that would be great. I've been
| waiting for my replacement unit for months. I'm using a
| mouthpiece in the meantime (btw, $199 for a mouthpiece as
| shown on your site seems way high), which is helping, but I
| would still like to have the replacement CPAP.
| jjkaczor wrote:
| The biggest success-factor for me in using it was - the type of
| mask.
|
| A full mouth/nose mask (ala "fighter-pilot-mode") was useless,
| incredibly constricting and confining - I ended-up always
| removing it after a couple hours of fitful sleep.
|
| Moving to a "nasal pillow" mask made all the difference - I
| slept the entire night through the first night - and ever
| since. While some people need a "chin strap" to keep their
| mouth closed, I found that I did that automatically.
| heleninboodler wrote:
| If you simply provide a decent web experience for ordering
| supplies I'll be your customer forever. The places where I can
| find supplies have prices and UX that only the medical industry
| could love.
| rootedbox wrote:
| I have sleep apnea and snoring. this is what I've learned over
| the years 1. outside of cpap.. there really aren't any Devices
| that work. Mouth guards nasal openers.. etc.. do not do anything.
| 2. cpap is a pain in the butt.. and has a low compliance long
| term. 3. Snoring and most apnea(can be a brain issue) are jaw /
| tongue / tonsil issues. 4. If you want too fix apnea / snoring
| surgery of some sort is required. 5. Though it will make you feel
| better and sleep better fixing a deviated septum will also make
| you snore louder.
| chris_st wrote:
| Recently found out that BPAP/VPAP [0] is a thing. It locks onto
| your breathing and has one pressure for in-breaths, another for
| out-breaths. Friend with one says it's great. My apnea is not
| bad enough to require such intervention.
|
| And, I'm very sorry to say that surgery is NOT a guarantee of a
| solution. Had another friend with very bad apnea, who got the
| surgery which removes everything that can be removed, and after
| that he had... apnea. Bad enough to need a CPAP machine. Sigh.
|
| [0] https://en.wikipedia.org/wiki/Positive_airway_pressure#Bi-
| le...
| foobarian wrote:
| I've seen many articles and comments about apnea and its serious
| consequences. The thing is, I have no idea if I have it. As far
| as I know I sleep fine, so I don't bother looking deeper, but I
| have this nagging FOMO doubt that I could maybe magically
| drastically improve my sleep. Wish there was some simple test
| that could rule out even starting down this rabbit hole.
| heleninboodler wrote:
| I had it for years and had no idea, but had occasional
| nightmares about choking, so my wife suggested I get checked
| out. Eventually I got checked out and diagnosed, but didn't
| take it particularly seriously until I picked up a logging
| pulse oximiter which would show me my blood oxygen level
| overnight, and even give me a little vibration to wake me up if
| I stopped breathing long enough for it to drop below 80%. I
| don't wear it frequently, but when I do, it buzzes and wakes me
| up all night long if I'm not wearing the CPAP. If I do wear the
| CPAP, it's fine. [aside: I'm not sure what brand it is, but it
| and its software looks exactly like the one at getwellue.com,
| so I'm assuming those are at least the same OEM. The only thing
| I hate about it is that it uses a usb-micro connector for the
| charger, and the cable is so short I had to time travel back to
| 2003 to find a longer one.]
|
| The blood oxygen level dropping so low so frequently is what
| finally motivated me to take it seriously. Your heart goes into
| overdrive when that happens, and it's not good for you long
| term to be going at 90bpm all night. It increases your blood
| pressure too. I actually _feel_ fine if I don 't use the CPAP,
| but having concrete data showing it's probably taking its toll
| is very useful.
| sithadmin wrote:
| The most simple test is to use a continuously logging pulse
| oximeter (not an intermittent-sample type like found on some
| smart watches; also worth nothing continuous-logging sports
| watches at the high end of the market are usually very
| unreliable at O2 sat monitoring insuring sleep). Look for drops
| in O2 saturation dipping into the low 90s/high 80s
| intermittently. If you see them, you probably have an apnea
| issue.
|
| That said, the over the counter devices that can do this
| reliably generally cost half as much (or more) as an at home
| sleep test.
| bckr wrote:
| sound like the OP has some thoughts.
|
| But I am using the app SnoreLab which records me at night and
| scores what percent of the night I'm snoring and how loud (and
| lets me listen to it back).
|
| The lowest tech way is to just record audio of yourself
| sleeping. If you snore, you've got it. If you stop breathing /
| choke / do a "snort snort snort"--you've really got it.
|
| I urge you to set aside a few nights and get this figured out!
| It could be the most important decision you make for your
| health in your entire life.
| Tagbert wrote:
| Is snoring really an indicator of sleep apnea? I'm sure that
| those with apnea likely do snore, but I'm not convinced that
| everyone who snores has sleep apnea. That would indicate that
| almost everyone has apnea.
| bckr wrote:
| https://www.mayoclinic.org/diseases-
| conditions/snoring/sympt...
|
| "Snoring is often associated with Obstructive Sleep
| Apnea... Not everyone who snores has OSA".
|
| Snoring is really, really bad. A cute little "snooze" could
| be okay, but anything more than that should be considered a
| potential life-shortener and potential-limiter.
|
| And yes, I am saying that almost everyone is in danger of
| apnea. I think this is one of the many ignored epidemics of
| our time, similar and related to obesity.
| foobarian wrote:
| That's it, I'm getting a PulsOx sensor and breaking out
| my Raspi and getting to the bottom of this! :-)
| bckr wrote:
| Nice!!
| heleninboodler wrote:
| If you find one that lets you extract the data directly,
| please post. The one I got just has this proprietary app
| that communicates with it via bluetooth, and I'd much
| rather have it in a proper time-series format and
| automate the data-pull.
|
| Also, if you do end up getting a CPAP, those things have
| a fascinating amount of time-series data stored on their
| SD cards. If I recall mine logs about 20 independent
| datapoints, which is a surprising number for something
| that's just blowing air into your nose. :D But for
| example, it can detect when you're snoring and it logs a
| boolean for that all night long.
| tyingq wrote:
| Dry mouth and headache upon waking are common, though not a
| definitive test. Have someone watch you sleep and watch for
| periods of not breathing followed by strained gasping for air.
| Still not a substitute for a sleep study. The peer comment
| suggesting a logging pulse oximeter sounds interesting.
| atotic wrote:
| It is impossible to rule out apnea without a sleep study. My
| kid had apnea, and I'd lay in bed with him for hours, and I
| never noticed anything beyond sleeping with his mouth open, or
| slight stirring. Sleep study revealed that he was consistently
| waking up 6 times an hour.
|
| His apnea got cured with EASE surgery. It dramatically changed
| his personality. Sleep apnea is often misdiagnosed as ADHD in
| kids.
| adrian_b wrote:
| There are some clinics where sleep problems are treated and
| where you can go to sleep while being monitored by various
| medical devices. If there are any sleep problems, they should
| be identified in this way.
|
| Sleep apnea is a serious condition. I believe that if you would
| have it you would wake up suffocating, unless you would die in
| your sleep.
|
| My mother had sleep apnea as a consequence of severe surgery
| followed by a few weeks in intensive care.
|
| Fortunately, in her case that was a temporary condition. After
| a few terrible weeks during which I was almost unable to sleep
| because I feared that I will not wake up in time during her
| next apnea crisis to help her, the apnea crises disappeared
| suddenly, from one night to the other, exactly when I was about
| to buy a CPAP apparatus.
| honksillet wrote:
| STOP-BANG sleep apnea screening scale
|
| https://www.mdcalc.com/stop-bang-score-obstructive-sleep-apn...
| fhackenberger wrote:
| I can recommend read the book 'Breath' by James Nestor before
| buying an expensive device. It shows that most breathing problems
| are related to the fact that people have changed from nose to
| mouth breathing, which works against how our bodies are designed.
| Melatonic wrote:
| I have this book but have not read it yet - my problem is that
| I often physically cannot breathe through my nose either due to
| mild allergies or damage from sinus infections or maybe a
| mildly deviated septum.
|
| Daytime though I try to breathe through my nose when possible
| and also breathe as deeply as possible - it really is a waste
| that most people only use a small part of their lungs
| aarongray wrote:
| You're absolutely right. 'Close Your Mouth' by Patrick McKeown
| was revolutionary for me. Buteyko breathing is the real deal,
| unfortunately it is largely unknown in the modern American
| medical community.
| amelius wrote:
| This makes me wonder if sleep bruxism and sleep apnea are
| mutually exclusive.
| silicon_wally wrote:
| What makes you wonder that?
| onion2k wrote:
| My partner (who has sleep apnea and a device to stop her
| sleeping on her back) started lightly taping her mouth shut at
| night with micropore tape after reading that book. She reckons
| it helps her sleep significantly better..
| Melatonic wrote:
| Does the micropore tape allow you to still breathe through
| the mouth if you have to?
| floatinglotus wrote:
| The tape doesn't block the air, it's just a strip of tape
| to help keep your mouth closed. You can still breathe a
| tiny bit through the sides of your mouth, and if you open
| your mouth hard enough the tape comes right off. It is
| indeed helpful for OSA, best used with the oral sleep
| appliance.
| throwaway032022 wrote:
| After waiting a couple months for the appointment, I went to an
| in-lab sleep study at a hospital and got the results back after
| two weeks. Now I have to wait a couple more months to speak with
| a sleep specialist (they are all that busy in my area with no
| sooner availability) presumably in the hopes of getting a *PAP Rx
| or discussing other treatment options. Once I get an Rx for the
| machine then I'm sure I will have to wait several more months to
| get one due to the supply shortage. I feel like the medical
| system has failed me as I suffer for months and months - with
| basically only one viable treament option (*PAP). While I applaud
| the effort, it seems like the real disruption would be in
| addressing the bottlenecks of machine production and Rx
| gatekeeping.
| maxgreenfeld wrote:
| I'm sorry to hear that it's taking so long to get treatment!
| Through virtual consults and at-home testing along with CPAP
| alternatives, we're looking to help improve access.
| thenerdhead wrote:
| Very cool and best of luck.
|
| At first I thought your name was "Hello Sleep" which brought back
| faint memories of https://en.wikipedia.org/wiki/Hello_(company) &
| https://www.kickstarter.com/projects/hello/sense-know-more-s...
|
| I am curious on the problem statement though. Is it really
| difficult to get a diagnosis? I've read a number of sleep books
| and it was suggestive that you can generally get diagnosed fairly
| easily with proper equipment and options by general practitioners
| and specialists worldwide.
|
| I'm a bit concerned personally with the diagnosis industry moving
| straight to consumer. I think it's cool and all, but is diagnosis
| through tech potentially bad for changing human behavior? The
| reason I bring this up is because similar companies exist for
| ADHD and other human conditions that I'm curious if this really
| solves people's problems, or just introduces a problem that they
| then pay for because they aren't making the right change in their
| life.
|
| In other words, if we make it easier to diagnose, will people
| more likely believe something is wrong with them and be
| subscribed to a lifetime of products instead of making the
| foundational change to improve these problems? Are you in the
| business of putting yourself out of business like a good doctor
| in other words?
|
| For example books like "Breath" by James Nestor suggest that
| we're having trouble sleeping because we're breathing wrong in
| the first place. What about permanent solutions like surgeries?
| maxgreenfeld wrote:
| Unfortunately, getting a diagnosis can be difficult. The
| current wait time for in-lab sleep studies is 3-6 months. We
| want to increase access to care for the 80% of sleep apnea
| sufferers who are currently undiagnosed.
|
| There are a range of treatment options out there including
| weight loss, CPAP, oral appliances, and surgery, and selecting
| the right option can depend on a number of factors including a
| patient's lifestyle and the severity of their sleep apnea.
| We're looking to coordinate access for this full spectrum.
| ramchip wrote:
| Congrats! Is this for US residents only?
| maxgreenfeld wrote:
| Thanks! Yes, we only operate in the US at this time.
| BillSaysThis wrote:
| I was diagnosed with sleep apnea after a sleep study in late
| December but I still don't have a CPAP machine due to supply
| chain issues. In fact the nurse from the clinic said they
| literally cannot get any machines. How do you expect to handle
| that?
| maxgreenfeld wrote:
| Given the global shortage, it can be difficult to get machines
| right now. We're adding CPAP in a few months, and we're also
| offering CPAP alternatives to help people get care.
| candiddevmike wrote:
| It's good that you offer self referrals, I think too many people
| avoid getting treatment due to the amount of time and energy it
| takes navigating the system. My journey to getting sleep apnea
| diagnosed started with discussing sleep quality issues with my
| primary care provider and a couple very expensive blood tests to
| rule out other things. Then I finally met with a sleep
| pulmonologist, who then put me on a multi month long wait list to
| get the sleep study equipment, and then another month after I
| finally had the results/justification to get my CPAP.
|
| The CPAP worked OK, but I couldn't stand wearing the thing. I
| opted for surgery (UPPP, probably the most painful thing I've
| experienced), which has "cured" me (ironically I'm back on the
| multi month wait to verify my sleep apnea is gone via another
| sleep study). Do you recommend surgical or weight loss options to
| your customers? Could be a conflict of interest if you're set on
| recurring supply refill revenue...
| csallen wrote:
| I've considered UPPP surgery. Can you describe the pain? How
| long did it last? Was it worth it?
| k12sosse wrote:
| It was miserable pain, wouldn't do it again. After surgery
| (months) I managed to stretch the insides and snored again.
| Also randomly choking while drinking water with no uvula.
|
| Mine was about 20 years ago. Avoid UPPP for snoring.
|
| My snoring was so bad that I would often wake up with my
| uvula dangling on my tongue, before the surgery.
| candiddevmike wrote:
| The pain was pretty bad, but I also avoided opiates and just
| used tylenol/ibuprofen. It feels like the worst sore throat
| you've ever had. The worst part was when it was dry--you had
| to constantly keep drinking water to keep it from getting
| dried out, which hurt really bad, especially if it was
| already dry (like when you wake up from sleeping). I'd say it
| lasted around 2 weeks, I was back at work a week or so after
| the surgery though.
|
| There is a risk of having a tonsil hemorrhage with adult
| tonsillectomies (which I got with my UPPP, I think most do?).
| There is a vein/artery that runs right behind your tonsils
| and causes them to bleed really bad. Your surgeon will
| cauterize it, but a week or two after surgery your scabs
| start coming off, and if they come off too quickly you'll
| start bleeding. This bleeding won't stop on its own, you need
| to get to the hospital ASAP. This didn't happen to me
| thankfully but it was weighing on me pretty heavily from an
| anxiety standpoint.
|
| I would absolutely do it again. My sleep apnea is gone, I
| have incredible sleep quality and am no longer a zombie. I
| was a good candidate for the surgery though--I had a really
| big uvula and medium sized tonsils, so it didn't take much to
| block my airway while I slept.
| Clubber wrote:
| I think it's ridiculous that a CPAP machine requires a
| prescription. I wanted to buy one to try it but couldn't.
| Anyone know why this is? Is it just regulatory capture or is
| there a medical reason someone shouldn't be able to buy one?
| jjkaczor wrote:
| It is somewhat ridiculous - their logic is that it does
| require configuration/calibration to be setup initially for
| your pressure levels.
|
| However - I am reasonably confident that given a prescription
| and some documentation - and a decent instruction
| manual/video, most people could get through it. (I certainly
| had no issues with downloading some software/utilities,
| yanking the SD card and examining my data during the first
| few months)
|
| But - ultimately it is probably more about risk mitigation
| and liability for the doctor/sleep technicians and clinics
| who prescribe these things.
| pdonis wrote:
| _> their logic is that it does require configuration
| /calibration to be setup initially for your pressure
| levels._
|
| Which is ridiculous. By "configuration/calibration" they
| mean setting a value in the software settings. Something
| that takes 2 seconds and could easily be done by the user
| (in fact most CPAPs _have_ the ability to have the user set
| it, but it 's disabled by the manufacturer because of
| stupid regulations).
|
| _> ultimately it is probably more about risk mitigation
| and liability for the doctor /sleep technicians and clinics
| who prescribe these things._
|
| If people could just go buy them in drugstores by their own
| choice then doctors and clinics wouldn't be on the hook for
| having prescribed them. Plus there would be more
| competition and the devices would be cheaper and more
| widely available.
| TylerE wrote:
| I have a Resmed machine and it's super easy to change the
| pressure.
|
| You just do the super secret thing to enter "Clinician
| Mode".
|
| The super secret thing?
|
| Hold down the one input button for a few seconds.
| rootusrootus wrote:
| It is sort of ridiculous, which is why companies make it
| fairly easy to work around. You go somewhere like 1800cpap
| and they send you an at-home test kit, you return that to
| them and they have a doctor look at the output. The doctor
| writes a prescription, then 1800cpap happily sells you
| whatever equipment you want. You won't even talk to the
| doctor. And I can't guarantee this, but I suspect the doc is
| incentivized to always find something worth writing a
| prescription for.
| candiddevmike wrote:
| You need a qualified respiratory
| therapist/pulmonologist/sleep doc to configure it for you
| (that's part of the prescription, how much pressure you
| need), otherwise you could really mess up your lungs (too
| much pressure) or make your apnea worse (too little
| pressure). They'll also do ongoing monitoring and adjust the
| levels remotely.
| sithadmin wrote:
| Not really true for most people with modern APAP machines.
| Most direct to consumer providers prescribe APAP these days
| and don't do a titration study to dial in pressures.
| astura wrote:
| Some machines have auto adjusting pressure - my husband has
| one.
|
| I think this is his unit -
| https://lofta.com/products/resmed-airsense-10
|
| >With auto titration technology, the AirSense(tm) 10
| AutoSet(tm) monitors you- breath by breath and adjusts your
| therapy delivery to maximize outcomes
| TylerE wrote:
| Pretty much all newer machines do, and most insurance
| will happily give you one - at least Blue Cross will, as
| the cost difference over a plain CPAP is very nominal.
| asmithmd1 wrote:
| You know what is more ridiculous? You need a doctor to write
| a prescription to use this machine that ices your leg or arm.
|
| https://gameready.com/gr-pro-cold-therapy-unit/
|
| I think it must be some quirk of insurance that they will
| only pay for something IFF it requires a prescription
| dimitrios1 wrote:
| Depends on your health insurance plan. Many plans fund a
| health savings account that allows you to spend your money
| on any qualifying medical purchase, whether its OTC meds,
| medical devices, or heck even my yearly supply of band-aids
| and ibuprofen.
|
| If something requires a prescription, it's usually because
| the company wants a liability chain to go through a doctor
| and their malpractice insurance, rather than bankrupt the
| company.
| sithadmin wrote:
| For what it's worth, there are tons of generic APAP devices
| available on your usual 'big' online market places being sold
| under labels like 'resoiration device' or 'sleep aid'. Don't
| know if they're actually trustworthy, but they're out there.
| There is also a small but thriving secondary market for
| devices in online web forums (though for sanitation reasons,
| this seems like a very suboptimal workaround).
| floatinglotus wrote:
| If you have OSA and you want to put a mask on your face at
| night and manage the titration yourself, you're seriously a
| candidate for the Darwin awards.
|
| I would love to manage it myself of course, but treating OSA
| is not 100% as simple as using a CPAP. And if you are indeed
| stopping your breathing while you are sleeping, do you
| personally want to be responsible for setting the machine
| properly?
| yurishimo wrote:
| It can be dangerous if used improperly and since it's related
| to your health I suppose that requires regulation.
|
| My grandmother died from complications with her CPAP machine
| (long story and user error) so I don't know that making them
| available off the shelf is a great idea. At least behind a
| prescription, more care can be put into the testing of the
| devices rather than churning them out by the lowest bidder
| for pickup at your local Walmart.
|
| I've tried to think of other devices/treatments that are
| available OTC and I'm coming up short. Drugs are heavily
| regulated and quality tested. I think the big factor is that
| using the device requires unconsciousness which ups the risk
| if something goes wrong.
|
| All speculation on my part.
| tareqak wrote:
| I would like to learn more about how the following up,
| monitoring, and care adjustment would work for patients
| previously diagnosed with sleep apnea.
| maxgreenfeld wrote:
| If you have been diagnosed with sleep apnea, you should be
| periodically checking in with a sleep coach, respiratory
| therapist or physician as appropriate. And that should be
| informed by objective data whenever possible. We are
| establishing workflows to make this as seamless as possible and
| ensure quality care.
| jenkstom wrote:
| And that's straight up a pipe dream that has nothing to do
| with reality.
| ClearAndPresent wrote:
| Why are you collecting email addresses to deliver the results of
| a self-reported test that would drive shopfront purchases? Just
| allow users to take the test online, deliver the results, steer
| them towards the products. You'll get their email if they order,
| no?
| sparrish wrote:
| I took the quiz but wouldn't put in my email address for the
| results.
|
| I WFH, I haven't worn a collared shirt in over a decade. Who
| knows their necksize?
| maxgreenfeld wrote:
| Thanks for the feedback! We've removed the email address
| requirement.
| ClearAndPresent wrote:
| Thats great! I tried filling in the quiz and submitting and
| encountered a Captcha that was partially formatted on screen
| so I couldn't see all the images, nor the submit button. No
| way to move forward at all.
|
| 1 https://imgur.com/a/DcZSFHd 2 https://imgur.com/a/FLc5YzE
|
| I hope you get your site in order, it sounds like a promising
| market.
| kareemm wrote:
| You removed the requirement but the field is still there and
| nothing says the field is optional. I read your reply as "we
| removed the field".
|
| FWIW I think it's reasonable to collect emails. But at least
| be honest as to whether the email field required (or not) on
| the form.
| maxgreenfeld wrote:
| It has been updated to make it clear the field is optional.
| patja wrote:
| Why no CPAP?
|
| Any sleep apnea solution that doesn't even offer CPAP feels
| inherently suspect and fringe. Especially when you just kind of
| gloss over it.
|
| I've been very happy with CPAP for over 20 years. If it ain't
| broke why fix it?
| cupofpython wrote:
| I use an oral appliance. There were a lot of barriers to get
| it, and I had to coordinate between an orthodontist and a sleep
| specialist. CPAP is pretty streamlined already, so it is
| possible they targeted oral appliance first because it is a
| good use case for getting the most value out of their business
| model
| maxgreenfeld wrote:
| Great point. There's definitely a lack of coordinated care
| between dental and medical providers that we're looking to
| solve.
| maxgreenfeld wrote:
| CPAP is the gold standard in treatment, and we'll be supporting
| it in the next few months. But it doesn't work for everyone, so
| we're also offering validated alternatives as options for
| patients who aren't interested in CPAP or are noncompliant.
| daemonk wrote:
| I've gone through many sleep apnea oral appliances. The best one
| is this one: https://www.smlglobal.com/zyppah-k
|
| It might look a bit flimsy with the dental rubber bands, but
| that's actually the best feature. Most other oral appliances have
| a hook or solid point where both halves of the top/bottom mouth
| pieces are locked in place. What happens is that after 6-12
| months of usage, the stress points will eventually break and you
| are left with a useless device. This has happened to me with 3
| previous "solid locked" devices. The zyppah device requires you
| to change out the dental rubber bands every few weeks, but the
| flex it gives and longevity is worth it.
|
| If you have moderate-severe apnea, just go to a dentist who also
| specialize in sleep apnea and get it taken care of. You would be
| amazed at the difference it makes.
| sparrish wrote:
| Your pricing is crazy expensive.
|
| $200 for a mouthpiece that you can get online for $20. What so
| special that makes that piece of plastic worth more 10X more?
|
| $180 for a pillow you that can be had online for $30.
| renewiltord wrote:
| Is it actually cheaper to get everything somewhere else? My
| test is covered by the doctor but they would charge like $1k
| for the device if I wanted it which is where I was anchored.
|
| Would you mind sharing where I can get the testing apparatus
| for cheaper?
| hackernewds wrote:
| Any online marketplace if you search for the keywords
| mouthpiece snoring. Warning, as you will see in the reviews,
| that wearing a poorly fitted one for extended periods of time
| will affect your bite since it does dislocate your jaw. YMMV
| but that should explain why a proper qualified dentist can
| make you a fitted one for $1k
| sjg007 wrote:
| A dentist will charge $2k+
| maxgreenfeld wrote:
| There are a range of treatment options out there, and we focus
| on FDA-cleared devices that are supported by clinical efficacy
| studies.
| prepend wrote:
| I had similar markups at my sleep doctor. It was funny because
| a $20 part from Amazon would be sold for $200 and end up
| costing $50 for me after my insurance co-pay.
|
| At first they were real pissy about me buying things from third
| parties but eventually just gave me the part list and stopped
| mentioning how I never bought stuff from them.
| dubrocks wrote:
| They're scamming insurance companies
| Melatonic wrote:
| What are the best highly portable options for sleep apnea?
|
| I suspect I have a very mild case ( my mother has a more severe
| one but is also extremely overweight ). I do not really snore and
| often wakeup feeling quite refreshed. But I know partners have
| also told me that I occasionally in certain positions sound like
| I have labored breathing and will wakeup gasping for air.
|
| My problem is that I also enjoy backpacking and mountaineering
| quite a bit and a CPAP is never going to work with that. I know
| there are a lot of bullshit mini passive devices out there that
| do not really actually help - is there anything truly portable
| and lightweight I can bring with me?
| gogoincar wrote:
| There are a number of small units, the hose+mask will end up
| taking the majority of the space, which is annoying but not
| sure of an easy way around that. (Maybe short hoses?) Resmed
| airMini is pricy but very small, needs an external battery,
| Philips makes a portable unit that's a bit larger and has an
| optional integrated battery. You'd likely need a solar charger
| for backpacking. Humidification is probably the biggest trick -
| there are in-line moisture exchangers that help a lot, but if
| you have dry mouth issues it's hard to beat a water chamber.
| Suppose you could boil water on a camp stove for use as well.
|
| Def recommend try to get a study if you can find/afford it. I
| have a mild case, but getting used to CPAP was still life
| changing. That said, I find sleeping on my side is enough to
| avoid most symptoms for a few nights, and if I'm camping I
| stick to that (there are tricks for preventing back sleeping if
| it's an issue).
| maxgreenfeld wrote:
| Oral appliances are a commonly used, lightweight alternative
| for travel.
| Melatonic wrote:
| Any good examples? When I was looking into this a few years
| ago most of them did not have favourable reviews by doctors
| and individuals. Do they still require batteries or are they
| passive?
| maxgreenfeld wrote:
| These are passive devices. Some examples include Thornton
| Adjustable Positioner (TAP) devices, SomnoDent, Prosomnus,
| and others.
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