31-NOX company T3 and Noxturnal general overview use

 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
It‘s been more than a decade that ...
 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
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
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)
PG – Speed, Ergonomics and Reliable Data
 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?
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
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
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)
 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 – 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
 What is snoring?
 “Symptom that is observed in the ear of another
NOISE  best assessed by audio
 Why does it occur?
Partial obstruction of
the upper airway with
increased respiratory
effort causing tissue
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 Overview
Immediate recording results (automatic analysis)
The Ease of Use: Noxturnal Signal View
The Ease of Use: Noxturnal Reports
 Standard reports fully
 Export capabilities to Word,
Excel, pdf (one click open to
 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 ...
BT – Example NOX EtCO2 Interface
 Fits with the Nonin RespSense™ Capnography
 Adds full end tidal CO2 (EtCO2) signal interface to
the T3 system
 Does not occupy any other channels of the T3
 No cables between recorder and EtCO2 monitor,
only nasal cannula connected to the patient
WristOx2TM, Model 3150
Oximeter optimized for NOX T3 developed
in co-operation with Nox Medical
 Designed to support the NOX T3
 Smaller and lighter, supports
pediatric usage.
 Simple - Elegant - Reliable

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