Renuma is a new digital platform that makes sleep apnea treatment easier than ever before.
Quality sleep is a really big deal! Over the course of the past 20 years, medical science and psychologists have made great advances in identifying and confirming just how important it is to get good quality and adequate sleep to support overall health and optimum cognitive function.
A commonly diagnosed sleep disorder, obstructive sleep apnea (OSA) happens when upper airway muscles relax during sleep and pinch off the airway, or some other structure obstructs the airway, which prevents a person from getting enough air. Breathing can pause for 10 seconds or more at a time and then resumes. This pattern repeats itself numerous times throughout every night. Undiagnosed sleep apnea is known to be directly linked to increased risk to cardiovascular and metabolic health. The scary part is that you might not even know you have this very common problem. As well, such disrupted sleep and sleep deprivation are also known to have other widespread and detrimental effects.
The idea for Renuma began with sleep specialist David Rosen, MD, highly qualified with four board certifications: pulmonary, sleep medicine, internal medicine and critical care medicine. “I felt a growing frustration with the inefficiency of caring for OSA patients within the traditional healthcare model. I would often walk into a new patient’s room and before even talking to them I would see the exhaustion in their face and the physical features making their diagnosis of obstructive sleep apnea all but guaranteed. I asked myself: ‘If it’s obvious to me they have sleep apnea and obvious to the patient they have sleep apnea, is it really a good use of their time to come see me just so I can order a sleep study?’ I felt something needed to exist for those individuals who very likely had OSA, but could reduce some of the unnecessary steps in the diagnosis and treatment process.” Thus was born the concept of Renuma.
Rosen, a Tenafly resident and Kehillat Kesher member who grew up in Teaneck and is a Yavneh Academy parent, partnered with Aaron Hoffer, certified respiratory therapist, to bring Renuma to a larger community. Hoffer, a Teaneck resident who is a member at Rinat and is a Yeshivat Noam and Frisch parent, has worked his whole career in this field, and graduated from NYU with a double major in health management and respiratory therapy. Hoffer also earned an MBA with honors from Touro University focusing on health administration management, and is a 20-plus year member of The American Association of Respiratory Care. Now in his current role as president of M D Respiratory Services, Inc., he has helped treat over 20,000 patients with OSA.
“Over the course of the years that I was treating patients, I saw the same frustrations that Dr. Rosen saw, but from the other side of the pendulum. Often I would know what the patient required, but was forced to delay care so that the doctor’s office could coordinate paperwork in order to satisfy insurance requirements. Renuma is the answer to those challenges as it coordinates the care the patient requires.”
Renuma’s online platform (www.renumasleep.com) makes it easy to engage in the process. Dr. Rosen explained, “The initial survey is completely free with no strings attached and it accomplishes several things.” Users create an online account and complete a survey; the survey generates a report based on a sophisticated algorithm created by a sleep specialist, which is then delivered to your inbox. You can also share it with your other healthcare providers if desired.
“Beyond telling you whether you are at significant risk for OSA, it also presents a ‘proprietary explainer video’ about what exactly OSA is and why it’s important to treat it. Next, it assesses whether you are a good candidate to have a sleep study done in your home, or whether you should have a more involved study in a sleep lab,” explained Dr. Rosen. If there are other significant medical problems such as heart failure or emphysema, it could mean the condition is more complicated than OSA and probably requires an office visit with a sleep doctor before setting up a sleep study.
Based on Renuma’s review of the online survey, options are recommended about whether to order a sleep study shipped directly to one’s home for $199, or to schedule a $15 telemedicine consultation with Renuma’s sleep specialist to further discuss OSA risk and possible additional testing. Completing the online study also provides an option to end the survey with no further financial obligation.
If the home sleep study is selected, the testing device is delivered within a few days. The sleep study can be performed in the convenience of one’s home overnight and arrives complete with instructions that easily guide the setup process. The next morning, the results of the sleep study are uploaded to the cloud via your smartphone, and the testing device can be either discarded or returned postage-paid for environmentally friendly disposal. A few days later, the report is available privately via the account log-in inbox, signed by a board-certified sleep doctor along with the video that explains how to read and understand the report.
If treatment for OSA is warranted, a free follow-up visit is scheduled with a sleep doctor to decide which kind of treatment is best. Some options include CPAP (continuous positive airway pressure), an oral appliance or weight loss. If CPAP is elected as the treatment, a CPAP machine adjusted to the specifications indicated can be immediately ordered by enrolling in the service called “Renuma+.” Renuma+ provides CPAP equipment, replacement supplies every six months and ongoing remote monitoring of the treatment effectiveness under the supervision of a board-certified sleep doctor.
Directed and managed by Dr. Rosen, Renuma eliminates the unnecessary steps involved in diagnosing and treating OSA. The traditional approach has become bogged down by multiple slow-moving factors such as the need for prior authorization from the insurance provider, electronic medical record software impairing inter-organizational communication and the requirement to have an office visit before ordering a test—even when the clinical need for it is obvious.
Dr. Rosen lamented, “It therefore takes a patient weeks and very often months before they even get a sleep study, let alone start treatment. Add to that the rising cost of premiums, deductibles and copays for health insurance, with many not even saving much money by going the traditional route. With Renuma, in a matter of minutes, you can learn your risk for OSA and whether you are a good candidate for a home sleep study. You can know in less than a week whether you have OSA and can have a CPAP machine on its way to you if you decide to treat with CPAP.”
The process for monitoring efficacy with CPAP therapy is also significantly streamlined with the Renuma+ service. The Renuma+ approach is more proactive, while the traditional approach is reactive. If CPAP is working well for someone and they’re using the machine regularly, they do not need to invest time in coming for follow-up visits, “just to get congratulated” on their usage success, said Dr. Rosen. If CPAP is working well and follow-up patient surveys with Renuma indicate that the treatment is working, then follow-up visits with a sleep doctor are not necessary, thus saving deductibles, co-pays and time. Regularly scheduled automated assessments supervised by a sleep doctor provide medical direction to those who need additional care. They would then simply follow up as needed with a sleep doctor for a $15 telemedicine visit.
Adjustments to the CPAP machine’s settings can be done remotely as well. Regularly scheduled replacement of masks and other supplies allows people to “set it and forget it” when it comes to replacing supplies. It all just makes a lot of sense…and dollars too!
Dr. Rosen trained in sleep medicine at JFK Medical Center in Edison, New Jersey, with world-renowned expert Sudhansu Chokroverty, MD. He also currently serves as a peer reviewer for the premier sleep medicine journal, The Journal of Clinical Sleep Medicine. In addition, Dr. Rosen serves on the American Academy of Sleep Medicine’s political action committee. This committee helps lobby government officials to promote national policy initiatives that benefit the sleep of all Americans.
Dr. Rosen says he’s long had an interest in finding ways to use technology to enhance healthcare delivery, noting that he would print out progress notes from his own templated Word document as a third-year medical student, while most other students and doctors were writing them by hand. During his critical care fellowship, he created an automated arterial blood gas interpretation tool. Renuma is an evolution in the approach to OSA care because the tools and technology at our disposal were not even available five years ago, so he is seeking to bring those tools under one virtual roof.
Renuma’s goal is to assure that every patient’s decision is an informed one. “CPAP is the recommended treatment for severe OSA, because nothing can beat it in terms of efficacy and because severe OSA creates the highest risk for health consequences such as heart disease,” said Dr. Rosen. When OSA is not severe, a multitude of other options is available. For those who choose to try something other than CPAP therapy, Renuma’s diagnostic service provides a plethora of information towards attaining appropriate care. And if follow-up or more detailed sleep studies are required for confirmation of benefits, Renuma is also there to help. Dr. Rosen concluded, “Going forward, Renuma plans to integrate further treatment options into Renuma+.”
To find out more, visit
email [email protected]
or call 848-272-0794. Renuma wishes you a good night’s sleep—every night!
By Ellie Wolf
