The Nox Team – a leader in Sleep Diagnostics NOX T3 – Starting a new era in home sleep testing

Easy, quick and comfortable Wireless extendibility and accessibility

Advanced technology for better diagnostics Respiratory Inductance Plethysmography (RIP) technology at it’s best True audio recording and reliable snoring detection Designed as the next generation of Sleep Diagnostics

The ease of using Noxturnal The next generation

Overview

Market leading sleep diagnostics was driven by “Icelanders” Sleep diagnostic hardware developed in Iceland got to a

standard in Polygraphy (Embletta®) and Polysomnography (A10, N/S Series)

Single use RIP technology was introduced to Sleep Diagnostics – designed at Flaga, Iceland

A still well known software platform (Somnologica™ Studio and Somnologica™ Science) was engineered by a team of software developers in Iceland

It‘s been more than a decade that ...

Here we are ... (again): Nox Medical

Company setup Main Office Reykjavik, Iceland Sales via worldwide distribution network Very effective structure for R&D,

Support, Sales and Marketing International clinical advisors

Nox ???

“Nox in Roman mythology is the goddess of the night.

A shadowy figure, Nox stood at or near the beginning of creation, and was the mother of personified gods

such as Hypnos (sleep) and Thánatos (death).

Her appearances in mythology are sparse, but reveal her as a figure of

exceptional power and beauty.”

Sleep Diagnostics

How much do we really need (and want)? (Astronaut John Glenn,

Thesis_RCS_Methods.pdf, Internet: http://theses.ulb.ac.be/ETD-db/collection/available/ULBetd-06112008-210149/unrestricted/Thesis_RCS_Methods.pdf)

Ergonomics How small can a recorder be? How many belts and straps around the patient are needed? How can we maximize patient comfort?

Reliable Data AHI – is there a reliable backup signal for the flow available? Snore – how reliable is the snore analysis? What additional information is available (e.g. flow limitation)?

Cost efficiency – from a user’s point of view How much time do I need to hook up a patient? How can I ensure best the success of the study? How quickly can I get my data analyzed and reported?

PG – Speed, Ergonomics and Reliable Data

Our Answer: NOX T3

NOX T3 - The smallest and most lightweight polygraph recorder Ease of use Quick setup Diagnostic statistics instantly available after download Latest technology to minimize cabling and patient impact Built-in data streaming capabilities via Bluetooth

NOX T3 Overview

“Standard” PG Requirements Nasal cannula flow (and mask pressure) Abdomen and Thorax respiratory effort

and derived flow from RIP technology Activity and Body position SpO2, Pulse (and Plethysmography)

The Plus of NOX T3 1 GB Internal memory providing multiple night recordings Interface with up to 7 auxiliary devices via Bluetooth (e.g. EtCO2) 2 x bipolar channels (ExG or others) Audio from a built-in microphone

Easy, quick and comfortable The most simple hook up The minimum of straps and wires The maximum of freedom for the patient

An ideal solution for pediatrics

!!!?

Moving into a Wireless World

NOX T3 receives signals wirelessly: General: up to seven auxiliary Bluetooth devices Nonin Bluetooth oximeter: eliminating the longest sensor wire in PG Nonin end tidal CO2 (EtCO2): wireless data transfer minimizing cabling Future: more and more new device generations will offer data

streaming via Bluetooth to be connected to T3

Emerging feature - NOX T3 transmitting signals wirelessly: Online recordings via Bluetooth or Bluetooth / LAN / WLAN Remote access via Bluetooth or Bluetooth / LAN / WLAN

Nox 2008: New and patented type of disposable RIP belts No cutting or crimping: 4 different sizes Super stretchable elastics

comfortable for patient and clinician 24k Gold plated Snap-ons

highest signal quality and proper connection Quick setup

50% time saving in preparing/training the patient

Advanced Technology - RIP Years of experience

Single use RIP technology in Sleep Diagnostic for more than a decade 2007: AASM clear recommendation for RIP (superior to Piezo)

Advanced Technology – True Audio The first Sleep Diagnostic Device with built-in microphone

Full audio recording – 8 kHz sampling No additional sensors and sensor fixation required Record the sound signal with or without possible audio playback

Listen to your patient Playback the true audio recording

Analyze the sound Add information to snoring data from a neck piezoelectric vibration

sensor and / or cannula Compare snoring data from different sources Analyze peak and average frequencies of the snoring sound

differentiate snoring in a new manner

Snoring What is snoring? “Symptom that is observed in the ear of another

individual.”NOISE best assessed by audio

Why does it occur? Partial obstruction of the upper airway with increased respiratory effort causing tissue vibration.

The assessment of snoring No "gold standard" available for subjective or objective

measurement of snoring

A wish …

The assessment of snoring

The reality …

NOX T3 and Bruxism The Nox T3 can be used to reliably assess bruxism

Measure 1-2 channel of EMG activity (chin and/or masseter muscle) Exclude other orofacial activity such as sighing and coughing by listening

to audio Listening for two teeth grinding episodes in audio to confirm diagnosis Confirms with all the channels described in the AASM2007 manual to

assess bruxism, even if is not a full polysomnography recording.

NOX T3 – Additional insights Nasal Cannula

Filter patient safety and proper long-term device functionality Safety connection to the device prevents strangulation risk Soft material ensures highest signal quality ( flow limitation)

High-Speed standard USB connection Study download within less than a minute (including analysis) No proprietary cables required for recorder preparation / download

Long term convenience No rechargeable battery lifetime limitations Easy battery door exchange

The Ease of Use: Noxturnal OverviewImmediate recording results (automatic analysis)

The Ease of Use: Noxturnal Signal View

The Ease of Use: Noxturnal Reports Standard reports fully

implemented Export capabilities to Word,

Excel, pdf (one click open to MS-Word)

Report customization based on existing report templates

Easy workflow to design completely new reports

The Ease of Use: Nox Recording Library

More to come …

Does the traditional sleep diagnostics change ? … Ambulatory sleep testing to increase … Small systems for the ease of use … Polysomnography to become as convenient as possible

Will it be a wireless future ? Remote access to device information Sleep recordings transfer via the “Cloud” Understanding sleep diagnostics as a network

A new generation of Sleep Diagnostics

Thank you for your attention !

Backup ...

Fits with the Nonin RespSense™ Capnography Monitor

Adds full end tidal CO2 (EtCO2) signal interface to the T3 system

Does not occupy any other channels of the T3 recorder No cables between recorder and EtCO2 monitor, only

nasal cannula connected to the patient

BT – Example NOX EtCO2 Interface

Designed to support the NOX T3 system.

Smaller and lighter, supports pediatric usage.

Simple - Elegant - Reliable

WristOx2TM, Model 3150

Oximeter optimized for NOX T3 developed in co-operation with Nox Medical