A recent flurry of reports in the lead-up to World Sleep Day (19 March) paints a mixed picture of the way Indians have been sleeping since the outbreak of the covid-19 pandemic. But two themes keep surfacing in all the findings. One, that there is a growing awareness of quality of sleep among Indians; and, two, this is accompanied by a rise in new technologies to treat sleep-related disorders from the comfort and safety of the home.
On 15 March, sleep and home solutions company Wakefit released its annual Great Indian Sleep Scorecard (GISS) 2021, which confirms the former trend. Of the 16,000 people surveyed from major Indian cities between the ages of 18-45 years, 42% said a better quality of mattress would enhance their quality of sleep as against 22% in last year’s survey. In January, Chaitanya Ramalingegowda, the co-founder of Wakefit, told Mint Lounge that the company witnessed an uptick in demand of its products almost by 70% during the pandemic. Indians seem far more willing to pay for better quality sleep now than ever.
On Wednesday, Philips India’s Sleep Survey 2021 further noted a rise in interest among Indians for telehealth consultations on sleep-related disorders, with 60% expressing a willingness to use these services. Philips India also announced the launch of a new product called Care Orchestrator, a sleep and respiratory care management system based on technology that allows physicians to remotely monitor their patients’ health through cloud technology. As it happens, Care Orchestrator is the newest entrant into the Indian market, which is getting steadily crowded with similar products.
A prominent player in India’s sleep and respiratory health segment is RedMed, which positions itself as the global leader in digital health and cloud-connected medical devices. “In the last 12 months we have changed more than 118 million lives around the world with our cloud products and devices,” Carlos Montiel, the vice-president of Latin America and South Asia at ResMed, says on a video call from Brazil. “By 2025, we hope to take the number up to 250 million.”
India remains a crucial focus for ResMed, which is the market leader among the makers of CPAP (Continuous Positive Airway Pressure) measuring devices in the world that are used to diagnose sleep apnea. With high growth in demands for smart wearables, the market for which recorded triple-digit growth in 2020 in India, though, there is now a concerted push for devices that are portable and can deliver data quickly. ResMed’s Air Mini, for instance, is the size of a human palm and, hence, a travel-friendly option for those who are frequently on the move.
While smartwatches track sleep effectively, medical-grade devices are powered with algorithms that can differentiate stages of sleep, explains Dr Sibashish Dey, head of medical affairs at ResMed for India and South Asia. “It is difficult to map stages of sleep, for instance, without nasal interfaces,” he says, “and these data are vital to diagnosing different kinds of sleep apneas.”
The bigger problem, of course, is the public’s limited understanding of apnea as a sleep disorder. While there is usually much talk about insomnia in the public domain, much less awareness, or clarity, exists about different types of apneas—when it is possible to correlate sleep apnea with comorbidities such as cardiac disease, diabetes, hypertension, and so on. Globally, an estimated one billion people suffer from apnea, Dey says, though 80% may not even be aware that they have a health problem.
“The myth in India is that snoring is a sign of good health and sound sleep,” says Chhitiz Kumar, business leader, Precision Diagnosis and Connected Care, Philips Indian Subcontinent. As part of its campaign to raise awareness about sleep disorders, Philips India started a free helpline last year. People suffering from sleep problems can call it to get basic medical advice and information about sleep clinics that are closest to them.
Last October, Philips India also launched a training programme for doctors to fill the current gap in medical education regarding sleep. “We organised a six-month online certified comprehensive sleep medicine course with the Academy of Pulmonary Critical Care and Sleep Medicine under the aegis of the Indian Sleep Disorders Association,” says Kumar. The first batch of these freshly trained doctors graduates this month.
“While brands work on sensitizing people towards sleep apnea, it is also vital to equip physicians with the right know-how to screen, diagnose and treat sleep disorders in general, and sleep apnea in particular,” Dr JC Suri, the lead trainer of the programme, adds.
A key challenge of using tech to track sleep is maintaining a steady adherence level on the part of the patient who is using a device. The data can fluctuate or not register correctly if the device is not connected properly, or if the patient is uncomfortable wearing it and fidgety. Keeping this possibility in mind, Indian start-up Turtle Shell created Dozee, a sleep tracker that is contactless, based on “an install-and-forget model”, as Mudit Dandawate, co-founder of the company, says.
Dozee is a thin sensor sheet that can be placed under a mattress, as much as18 inches thick, which monitors various vitals, based on the vibrations of the heart. After collecting this primary data, transmitted via Bluetooth to the Dozee app on a phone, it is converted into different biomarkers, including a person’s sleep cycle, heart rate, stress levels, respiration, and so on. These can then be sent to a doctor using a cloud service.
“Our aim is to produce clinical and actionable data to save lives,” Dandawate says. “This year we are hoping to partner with 5,000+ hospitals to treat some 3 million chronic illness patients. We also want to reach 1-2 lakh households by enabling remote patient monitoring services.”
At the moment, a majority of Dozee buyers are hospitals, people with chronic illnesses, and those who are 90 or more years old. “A lot of people after being discharged from hospitals buy Dozee so that it can watch over them and send out alerts to doctors if needed,” adds Dandawate. “Children living away from elderly or ailing parents are also buying it to track their parents' health better.” Technology can not only help you, but also your loved ones, sleep better now.