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A New Digital Health System Is Getting to the Heart of Sleep Apnea

Itamar Medical developed the SleePath to help electrophysiologists assess patients' sleep apnea status and CPAP compliance and correlate that data to the patient's atrial fibrillation manifestations to achieve optimal outcomes after catheter ablation.

The road to poor health is often paved with good intentions.

Most of us know what we should do in order to feel better and live healthier, but that doesn't mean we're going to do it. That makes it really hard for our doctors to do their job, especially if we're dealing with a chronic condition like sleep apnea.

Sleep apnea patients know they should wear that darn CPAP (continuous positive airway pressure) mask they were prescribed, but that doesn't mean they will. Some companies, like Royal Philips, have already shown that digital health can be an effective solution to this problem.

But an equally frustrating, and yet far less recognized, problem exists for electrophysiologists (EPs) who are managing patients with atrial fibrillation (AF) who also suffer from sleep apnea.

Sleep apnea occurs in roughly half of patients with AF and is found in a higher proportion of AF patients who are scheduled for catheter ablation. Electrophysiologists have found that catheter ablation is most effective when used in conjunction with a CPAP regimen, yet there is a huge disconnect between the EPs and the sleep experts.

That disconnect is what inspired Itamar Medical to develop SleePath, an integrated digital health sleep apnea care pathway monitoring system that allows cardiologists to monitor patients with AF sleep apnea management status and compliance with CPAP devices on demand.

"The product was born out of our [cardiology] customers telling us that the big missing link for them is once they refer a patient to the sleep side, it's radio silence," Gilad Glick, CEO of Itamar Medical, told MD+DI. "They have no idea if the patient is undergoing a sleep study, they have no idea if a CPAP was fitted on them, and they have no idea if the patients complied with the therapy."

The Caesarea, Isreal-based company unveiled SleePath this week at Heart Rhythm 2018 in Boston, the annual meeting of the Heart Rhythm Society.

Using data from a CPAP machine from Philips Respironics, SleePath includes a cardio sleep dashboard that allows physicians to track multiple aspects of a patient's sleep apnea status from anywhere, anytime. The system is designed to monitor care pathway progress, diagnosis status and results, CPAP compliance, the number of days and hours on CPAP, and residual sleep apnea. That data is presented in a user-friendly visual format that makes it easy to see progress or deviation toward specific treatment goals and changes in metrics over time, according to Itamar.

“Effective management of sleep apnea is now believed to be critical for controlling atrial fibrillation post ablation. The ability for us, the electrophysiologists, to assess patients’ sleep apnea status and their adherence to CPAP on demand, and correlating it to the AF manifestations, is a big help,” said Elad Anter, MD, of Beth Israel Deconess in Boston, MA. “The information that SleePath provides is important for achieving optimal outcomes following catheter ablation. Knowing that a patient isn’t using their CPAP as prescribed is an important first step in opening a dialog with the sleep experts that can identify obstacles and help improve adherence.”

Glick said there was a lot of talk in the industry years ago of opening Afib clinics that would serve as a multidisciplinary center to integrate AF management with and related conditions like sleep apnea, weight loss, and hypertension.

"Nobody invested in making those tools around them," Glick said.

The SleePath solution represents the first step, technologically, toward making that integrated approach feasible, he said. 

Itamar also offers the WatchPAT, a home-use diagnostic device for sleep apnea, and the EndoPAT,  a device designed to test endothelial dysfunction and to evaluate the risk of heart disease and other cardiovascular diseases.

“Devices using our PAT [peripheral arterial tone] technology and our Total Sleep Solutions service are rapidly becoming important tools for improving the care of patients living with or at risk for a variety of cardiovascular disorders," Glick said. "SleePath provides cardiologists and electrophysiologists with insights into CPAP adherence that enable them to work their patients to achieve optimal outcomes. Now physicians don’t need to lose sleep over their patients’ sleep apnea.”

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