Efficient Sleep Scoring for Sleep Centers

Written by
Aarogram Team
Published on
April 11, 2023

Clinical sleep scoring services are a critical component of sleep medicine. Accurate sleep scoring helps clinicians identify and diagnose sleep disorders, such as sleep apnea, insomnia, and narcolepsy, and develop appropriate treatment plans. High quality sleep scoring is central to providing a comprehensive picture of a patient's sleep health. This information allows clinicians to develop personalized treatment plans that address the underlying causes of a patient's sleep problems.

In the kickoff episode, we sit down with Will Spriggs, President of Sleep Center Services, LLC and ApneaMed in St. George, Utah. He shares insights from his 25+ years of experience in sleep scoring in this conversation.

Listen to the full episode here.

Transcript of the full episode:

Shruti: Hello! and welcome to the Efficient Care Podcast, a unique podcast series that brings you conversations with healthcare practice owners and innovators where we deep dive into their journeys and business learnings over the years. I am Shruti Mehrotra, Head of Marketing at Aarogram. In today's episode, we will discuss the ins and outs of sleep scoring with a very special guest, Will Spriggs.

He is the president and owner of Sleep Center Services, LLC and ApneaMed in St. George, Utah. He has 25 years of experience in sleep medicine under his belt. He is seen and done it all, from working with patients running overnight studies, scoring thousands of sleep tests, attending countless conferences, managing sleep labs, writing textbooks, and teaching college lessons to finding three companies.

Will, we are so excited to have you with us today! Thanks so much for joining us.  

Will: Thanks for having me, Shruti.

Shruti: I am going to get into the macros of sleep scoring in a bit, but first, tell us a bit about your background and your journey. How did you become involved in sleep centers in the industry?

Will: Like a lot of us in the sleep industry, I started as a night tech running overnight sleep studies in a hospital while I was in college. It was a great job to have in college because I was a night owl anyway. And, then once the patients went to sleep, I had some time to study for my classes. I was a bit of a starving student, so I picked up PRN work at any lab I could find.

Often working seven nights a week gave me experience working with a lot of different equipment, different patient populations, different protocols, and different settings. Once I passed my board exam, I was able to use, and utilize that experience and write training materials and textbooks for other technicians who were studying for their boards.

Shruti: What do Sleep Center Services do and what made you start it?

Will: When I stepped away from my full-time job to start Sleep Center Services, it was a leap of faith. I had a great job working with people. I loved running a sleep company with 16 labs and 75 employees at the time. A couple of sleep labs had reached out to me about doing some contract scoring for them.

And scoring was my favorite thing to do. I had a couple of young kids at home, so I decided to try and make it a full-time gig. So, I work from home and spend more time with my family. I was able to quickly build a good client base and eventually hired some just incredible RPSGTs to do the scoring for me.

And since then, we have expanded our offerings to include physician services as well, such as interpretations and telemedicine consults.

Shruti: Yes. So, what did you like so much about sleep scoring when you were younger? What did you enjoy about it?

Will: You know, I love the technical side of it. It has always just been interesting to me to see what happens while a person is asleep, what their brain is doing, what their body's doing. That is just something, after all this time, has not gotten old for me.

Shruti: Does it require you to be very mathematical and detailed when you are looking at the charts?

Will: Yes. There is a lot of math involved, but also a kind of mathematical type of mindset.

When you are going through and looking at, especially the brainwaves, for example, The EEGs kind of diving into those and looking at patterns, looking at frequencies and amplitudes and things like that. There is a lot of specific math, but also kind of that general mathematical mindset involved. Absolutely.

Shruti: Wow, that sounds technical. And let me ask you, what are some of the most interesting studies your company has scored?

Will: We get asked to participate in a lot of validation studies for new testing equipment or even treatment devices. We scored validation studies for companies like Microsoft, Amazon, and Apple as they are looking to ensure the accuracy of their new testing devices. It was fun to see the new Apple Watch come out recently with sleep-tracking capabilities and SPO two because we scored several of their validation studies. We have also done research studies for both children and adults.

Some with seizure disorders, and some with Down syndrome. We have done a lot. It is always exciting when we have a new client come on board, who isn't your typical sleep lab testing for sleep apnea?

Shruti: Do you use an Apple watch yourself? Do you track your sleep?

Will: Yep. I do not have the newest one yet.

There are some apps that I use to track my sleep and, yes, it is pretty, fun to see.

Shruti: That's so cool. Yes. What are some of the challenges that Sleep Labs face when it comes to scoring their studies? Are there any challenges that crop up when you score study in-house?

Will: You know, the main challenge that seems to cause labs to reach out is turnaround time. Registered sleep techs can be hard to come by, especially in smaller areas. And the RPSGTs have a lot of responsibilities in the lab, so it can be difficult for them to get the study scored right away with all their other responsibilities. We have a large team of just incredible RPSGTs all here in the US who do nothing but score studies for us all.

They do a great job of adapting to the individual needs of our various clients, and they can keep the turnaround time to a minimum so the labs can work efficiently. And this allows the RPSGTs at the labs to do everything else that they need to do during the day and have one less thing to worry about.

Shruti: So, do some sleep labs have in-house technicians that score sleeps? As well.

Will: Yes. That is kind of, the traditional model.

Shruti: Are these technicians hard to come by because you described how technical and mathematical this field is?

Will: Yes. like I said, especially in rural areas, they can be very hard to come to, but even in more populated areas, it can be hard to find a good, registered tech who meets all the needs of your lab because our RPSGTs have a lot, a lot of responsibilities placed on them in the sleep lab. You know, usually, they are asked to manage the night staff and sometimes manage the day staff as well.

They are asked to troubleshoot the equipment and score the studies. A lot of times they are working directly with the patients and so there are a lot of different skills, and, Personality, attributes that are required to be able to handle all those responsibilities. So, it can be a challenge for sure.

Shruti: Right. Have you heard of this person who goes by the handle of LankyLefty on YouTube, by any chance?

Will: I don’t believe so.

Shruti: So, he is a sleep tech. Do you know this person?

Will: No, I don't believe so.

Shruti: So, all right, there is this sleep technician who, very much like you, started his journey by being a sleep technician when he was young and in college, and he is obsessed with scoring sleep studies.

And he has made a lot of videos on YouTube where, as he likes, he goes and teaches even people who want to read their sleep graphs. They can do it as if they follow him. And I think a few years ago he got diagnosed with sleep apnea himself, and so he has become even more dedicated to this.

This field is incredible. I encourage you to check him out. He is very cool and funny as well. Yes. So how has the field of sleep medicine evolved during the time you have been in business? Is it acceptable to auto-score studies?

Will: Great question. You know, the field has changed so much over the last 25 years, and that kind of change can be scary for a lot of people.

I am a person who loves change, so it has been exciting for me when I started working in Sleep Lab in 1998. Every sleep study was done in the sleep lab, and nearly every patient was a 300-pound middle-aged male because those were the patients who the doctors could identify as having sleep apnea. They were all severe.

Now with home sleep testing being so much easier and less expensive for the patients and with having so many screening devices and mobile apps and things like that readily available general to the public, then we can identify so many more people with sleep apnea and other sleep disorders, and we can help improve their lives as.

You mentioned auto-scoring. In general, I am not a huge fan of auto-scoring because I feel like it has a long way to go, but the technology is improving and if it is accurate and can help labs get their studies analyzed quickly, then there is absolutely a place for auto-scoring in our industry.

Shruti: Quick question, is auto-scoring the same as AI-assisted sleep scoring?

Will: You know, we are seeing the use of AI comes into the picture for scoring, which I think is a great way to help improve auto-scoring and help it become a little more accurate. It is not. It kind of is the same thing and it is kind of not. It is, essentially auto scoring, but getting feedback, from the score tech, from a live person and then changing, its algorithms and so forth to become more accurate.

Shruti: Right.

Will: We at Sleep Center Services, scored the validation studies for one of the big AI-scoring companies out there several years ago. And so that was, that was an interesting thing to be a part of.

Shruti: That sounds amazing! and what does the future of scoring look like? Do you tell me a bit about AI-assisted sleep scoring, if you want to, and tell me something about your experiences with it?

Will: Yes. As I said, AI is, you know, growing, in I think a lot of fields and scoring, you know, in the sleep field is one of those that we are, seeing some AI, come into play.

Most labs that I talk to still want to have an experienced set of eyes looking at the data, including the patient history and the tech notes and things like that, that, you know, clinical things that AI cannot address, and wanting the manual scoring with. Most labs seem to be okay with auto-scoring for home sleep testing.

Because that is simpler. And it is mostly just looking at sleep apnea. You know, but in the lab, polysomnography is considered the gold standard for testing. And as part of that, most of the labs I talked to want to continue to use the gold standard for scoring those studies, which is manual scoring by registered state technologists.

Shruti: Do you think that as we begin to incorporate more and more auto-scoring and AI-based assisted scoring, do you think it will impact the way sleep center sleep centers are accredited?

Will: Yeah, I mean, I think eventually, you know, if the AI scoring and the auto-scoring can improve to a certain point, then I think eventually that will be recognized by the AASM and other accrediting bodies.

As you know, something that they accept and that they like to see and so forth. I think eventually, you know, that will, that will grab hold better.

Shruti: Right. I heard AASM are running a pilot program on this, and they have their data sets that they are standardizing. So, we can probably look forward to the future.

AI is going to play a big part in the way sleep scoring is done, in your sleep centers. So, what is the most innovative and unexpected revenue-generating strategy that you have implemented in your healthcare business, and how does it contribute to the growth and success of your organization?

Will: I think the most unexpected element that we have added to our services is providing interpretations for home sleep testing, especially for dentists. Dental sleep medicine has become a huge industry, as it provides a great alternative treatment for mild to moderate OSA patients, and we provide interprets for hundreds of dentists performing home sleep testing for their patients, and it has been great to be involved, in that sector, in the field.

Shruti: That's great advice for upcoming sleep centers or people who want to get into this business and do not have as much experience as you do. So, thank you for sharing that with us. At Aarogram we believe that being efficient as your, your business, in your business as a healthcare provider also means providing more patient-centric care.

Therefore, we ask this question to every guest on our podcast, and that is a fun one. What is the most ridiculous way you have ever solved a workflow problem in your healthcare setting?

A short loop?

Will: That's a tough one.

Shruti: So maybe if you remember, you wanted to go home a bit early from work, and if you thought of a shortcut to make things go faster at work.

Will: As a night tech, you produce all kinds of, you know, crazy things to solve problems. You know, we had, I do not even know if I should share this. So, I was working alone in the sleep lab and, this was. In my first couple of months as a night tech and. Had this big, big guy, probably 350-400 pounds, who insisted on sleeping naked.

And luckily, he was my only patient that night and we were just kind of in this dark corner of the hospital. And so, I said, okay, if that is what you need to do, I let him do it. And he had to get up to use the restroom a few times that night and him. Help with all the wires and everything, and so I just shut the doors to our corner of the hospital so no one else would come in the, the bathroom was down the hall and this guy, he just had no shame at all.

He had no problem at all just walking down the hall naked with all these wires on him and everything. And I was walking next to him holding his head.

Shruti: Sorry. I brought a for him

Will: And it was a lot more embarrassing for me than it was for him, I think. But we made it work!

Shruti: It is hilarious. Thank you so much for the lovely chat, Will, I learned so much from you today. Thank you for your time. Thank you for sharing your insights with us today.

Will: Thank you. I appreciate the time and the interview.

Shruti: So that was Will Spriggs talking about his sleep-scoring practice. He is a fine example of how healthcare providers are being innovative when it comes to running their practice efficiently to provide patient-centric care. Feel more interesting stories coming up. Please subscribe to this show so that you do not miss the latest episode.

This podcast series is brought to you by Aarogram.