Q&A: How a device aims to simplify the diagnosis of sleep disorders

Med-Tech Innovation News caught up with Ingvar Hjalmarsson, chief product officer at Nox Medical, to discuss the company’s sleep device range – which aim to simplify the diagnostic process of sleep disorders. 

Tell us about the Nox Medical T3 sleep device range.

The Nox T3 by Nox Medical is a Type III home sleep testing device (HST) designed to record physiological signals during sleep. The device is used by medical professionals to record and analyse sleep related disorders such as sleep disordered breathing (SDB), sleep bruxism and periodic limb movement in sleep (PLMS). Since its initial launch in 2009 more than 20,000 units are used worldwide. 

The New T3s device – what features does this have that the previous range doesn’t have?

The new Nox T3s maintains Nox Medical’s commitment to patient comfort and clinical accuracy and now features Nox RIP technology (respiratory inductance plethysmography) for more sophisticated sleep time estimation. Modern enhancements with the new Nox T3s include a refined Nox RIP technology, a new low-energy Bluetooth 5.0., software updates, and much more. The Nox T3s features Nox Medical’s newest innovation, the Nox BodySleep analysis, which is an artificial intelligence (AI) method intended to classify 30-second epochs into the states of REM sleep, NREM sleep and Wake. It uses RIP signals and actigraphy to measure the impact of brain state changes on the body and to estimate sleep states from those signals. 

Can you explain a little bit about the technology and development of this – including the lead time from the initial concept to production?

The main feature of the Nox T3s, the Nox BodySleep algorithm, is one of the many innovations born out of Nox Research, a dedicated team of scientists at Nox Medical working to advance sleep medicine. The Nox BodySleep is the result of several years working to engineer the novel Nox RIP sensors. The Nox RIP technology is now a foundational piece of every Nox diagnostic device. 

Nox BodySleep does not rely on traditional electrooculogram (EOG), electromyogram (EMG), or electroencephalogram (EEG) signals typically used to determine sleep stages. Instead, it uses algorithms to interpret how the body reacts to changes in brain state. Consequently, it allows physicians to assess patients’ sleep time in a home environment without complicating or compromising the patient experience. 

Nox Medical started working on the Nox T3s as a concept in 2018. The launch of the system was affected by the global pandemic, which caused some delays in production. However, the product was successfully launched in June 2020 and the company has been busy keeping up with demand in the market since then.  

How is the device used?

The Nox T3s System helps diagnose sleep disorders and must be used in conjunction with other methods of assessing clinical signs and symptoms. It is only intended to be maintained by medical professionals with relevant qualifications and skills. 

The Nox T3s System consists of a device recorder; a bluetooth pulse oximeter for pulse and oxygen saturation; built-in microphone for snore detection; two disposable Nox RIP belts that record changes in the respiratory volume of abdomen and chest’ and a nasal cannula that measures nasal airflow. In most cases, the patient is set up with the device at home and is able to hook it up themselves by following detailed instructions.

What kind of footprint do you have in the UK and Ireland markets?

Nox Medical products are available in the UK and Ireland through distribution partnerships. Our products are distributed and serviced by ResMed and are used by clinicians and sleep professionals throughout the countries. 

What kind of sleep-related conditions can this help to diagnose?

The Nox T3s System is used to help diagnose different sleep disorders and to assess sleep. It is used to measure, record, display, organise, analyse, summarise and retrieve physiological parameters during sleep and wake in patients older than two years of age. The Nox T3s allows the user to decide on the complexity of the study by varying the number and types of physiological signals measured. Among the conditions that the Nox T3s helps to measure and analyse are sleep disordered breathing (SDB), sleep bruxism and periodic limb movement in sleep (PLMS). Most Nox Medical customers use the System to aid in the diagnoses of sleep apnoea. 

How is it different from other similar devices on the market?

The Nox T3s is a next-generation HST device that is simple to use and cost effective while allowing for robust data collection and optimal patient experience. By combining smart technology in a single device with disposable consumables, clinicians now have a more precise and safe way to test, analyse and treat their patients. The main feature of the Nox T3s is the Nox BodySleep algorithm’s ability to conduct sleep time estimation without EEG.

Currently, many sleep diagnostic tests rely on nasal cannula sensors to measure respiratory pressure from the patient’s nose, but these signals can become disrupted if the sensors are moved during the night. The calibrated RIP flow derived from the Nox RIP belts can be used as a backup flow signal for the cannula in cases where the cannula drops out or, for additional hygienic option, or for some reason, patients cannot wear the cannula.