Linde’s LISA® App: Smart support for sleep apnoea patients

With patient engagement being an important factor in maximising therapy outcomes, Linde’s new virtual coach helps sleep apnoea sufferers stay on track.

Franck, 50, one of many sleep apnoea patients being coached by LISA

“You’ll feel better after a good night’s sleep.” Or so goes the saying, testament to the restorative power of a solid slumber. Beyond the immediate benefit of feeling fresh the next morning and ready to go about your day, it is now thought that sustained high-quality sleep is as important a contributory factor as nutrition and exercise when it comes to decreasing the risk of a whole manner of chronic health complications: from obesity to heart disease to type II diabetes. But for sufferers of sleep disorders, high-quality sleep is ironically enough, something they can only dream of. By developing the LISA® app, Linde Homecare aims to use the power of digitalisation to help realise this dream and achieve better health outcomes for the sufferers of one such disorder: sleep apnoea.

Sleep apnoea: More than just a snore

175 million people in Europe are thought to suffer from obstructive sleep apnoea – a sleep disorder characterised by involuntary and repeated cessations of breathing. They are the result of the tongue or soft tissue in the throat collapsing during sleep and blocking the airway. This can happen many times during the night (sometimes hundreds) and each stoppage can last up to a minute. The result: interrupted, poor-quality sleep.

While loud snoring is indeed a major symptom of sleep apnoea – which might make it difficult for bed-partners to sleep – the consequences for the sleeper are much more significant. Often, the only clue that one even suffers from the condition is waking up with a headache or experiencing persistent daytime fatigue. If left untreated, in addition to an increased risk of the chronic conditions previously mentioned, sleep apnoea will affect many aspects of attention, cognition and mood. And this, in turn, can have damning consequences on everything from working performance, driving performance and social interactions.

But it’s not all a nightmare scenario: “Treatment options do exist and can be extremely effective – provided the patient is willing to adhere to the therapy,” says Walid Gharbi, who manages the digital transformation for Linde ́s Homecare division, EMEA. And therein lies the problem; to which Linde has found a promising solution.

Unmasking the problem: Patient activation

While an oral appliance (like a sports mouth guard) is the first line treatment for mild to moderate apnoea, the most popular therapeutic intervention for more severe cases is the use of a Constant Positive Airway Pressure (CPAP) device. This works by supplying a constant pressurised air flow to the sleeper’s throat thus preventing airway blockage. However, it does so via a mask that must be worn during sleep. “The mask can be pretty hard to get used to,” explains Gharbi, so much so that it is often the reason that patients don’t adhere strictly to the therapy plan and therefore don’t reap the full benefit.

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Hear Franck’s story
Getting used to the CPAP mask can be a barrier to engagement

“Patient adherence is vitally important for treatment efficacy,” Gharbi adds. “We wanted to make use of digital tools to really activate and motivate patients to fully engage in their treatment plan – because we know that this will maximise the benefits of the therapy.” This notion is supported by a growing body of evidence that patient activation does indeed lead to better outcomes and care experiences – and may also reduce costs. And so LISA ® – the virtual assistant and personal coach – was born.

Winning the sleep game

“Think of LISA® like a fitness app for your smartphone – but for sleep,” says Gharbi. “It acts like a personal coach, encouraging patients to start therapy, motivating them to continue and rewarding them for adhering to their treatment plan.” The app offers personalised feedback, daily snapshots, trend overviews and valuable insights using data derived directly from the “connected” CPAP device. This includes things like hours slept, number of apnoea events, number of mask leaks and more.

“The novelty isn’t in the data that the app gathers as such, but in the way it is delivered,” Gharbi explains. “We use gamification to motivate the users who set their own goals and earn LISA® points to climb through the ranks from champion to master to legend” The app also features a knowledge centre where patients will find everything they need to know about their condition, treatment and devices, as well as answers to FAQs and other tips for making therapy as comfortable as possible.

The age of the app

While LISA® was designed and developed to help Linde’s homecare patients to get the most out of their sleep apnoea therapy, it also represents a venture into somewhat new territory for the company: “Telehealth or remote patient care is something we have existing expertise in,” explains Gharbi, “but specifically this type of app-based patient engagement tool is new for us.” 

At the end of the day, sleep may be as important as exercise – and is an important “activity” in its own right. When it comes to fitness, one need only look at the size of the global fitness app market (expected to reach USD 10.9 billion by 2026) to get an indication of just how much people are willing to buy into such digital aids. LISA® is about leveraging this tracking trend – but for treatment. 

“We’re at an early stage right now, having launched in France and are exploring other markets,” Gharbi says, “but patient feedback so far has been positive.” And that’s the dream result.

The motivation factor: striving for that sleep legend status!