When my wife had trouble sleeping, her doctor referred her to a sleep laboratory. The lab gave her two options: she could spend the night in the hospital or take the monitors home and sleep in her own bed.
She chose the latter.
The equipment was awkward to say the least – elastic belt straps to measure your breathing; a finger oximeter to monitor oxygen levels; a thin wire stuck to his nose and mouth; and a large device the size of an old-fashioned Walkman to record the results.
Other home monitors for sleep disorders – particularly those used to track brain activity – include electrodes attached with suction cups, paste, or gel.
With all the gear on her body, it’s a wonder my wife was able to sleep at all. And she couldn’t turn on her side so she usually gets her Z’s.
The whole experience helps explain why many sleep problems go undiagnosed.
The Tel Aviv-based startup X-trodes has developed a less invasive and more convenient system for electrophysiological measurements in medical quality.
The X-trodes solution can be used in the sleep laboratory or ideally at home. The company raised $ 4.7 million earlier this year from Japan-Israel High Tech Ventures, Welltech and private investor Jeremy Coller.
100 medical uses
“Smart Skin” from X-trodes is not only there for sleeping.
“There are over 100 medical applications for electrophysiology,” Ziv Peremen, CEO of X-trodes, told ISRAEL21c. “We decided to focus on two for our first product – sleep and remote rehabilitation for muscle injuries.”
Smart Skin electrodes can measure EEG (brain waves), EOG (eye movement), EMG (skeletal muscles), EKG (cardiac activity) and EOIG (olfactory activations) for up to 10 hours.
Wireless, non-stick electrodes collect and transmit data via Bluetooth. Photo courtesy of X-trodes
The technology has been developed for around 15 years under the direction of Yael Hanein, Professor of Electrical Engineering at Tel Aviv University. Hanein became interested in electrophysiology when she was at the University of Washington in Seattle.
“At some point I came across this open topic very early on, ‘How do you improve the electrophysiology of the skin?” She tells ISRAEL21c. “Everyone was limited by these cables and large devices, but we didn’t have a solution. Now we’re doing it. “
The university’s technology transfer company, Ramot, enabled Hanein’s work to introduce X-trodes to be licensed in 2020. Hanein now divides her time between her university research and her position as CTO of X-trodes. (Their electrodes were recently used in a Technion study to detect “liars” by the movement of their facial muscles.)
Smart skin electrodes are made of a soft and flexible material. Each one looks like a small sticker but contains more than 10 layers.
These electrodes are disposable, but you can use them to shower. Photo courtesy of X-trodes
These electrodes are disposable. “You throw them away after a few days, although you can shower and even bathe with them,” says Peremen.
Just a strip of medical tape holds the wireless electrodes in place. They transmit data via Bluetooth to a small receiver, which forwards them to the patient’s (or doctor’s) mobile device. The data should be integrated into a doctor’s existing software systems.
“We’re trying to provide exactly the same information a doctor would get from a sleep study, so that it fits as seamlessly as possible with the doctor’s current flow,” says Peremen.
He notes that up to a third of the US population has some type of sleep disorder, but most are reluctant to go to a sleep laboratory.
Since there are more than 30 types of sleep disorders – from simple vanilla insomnia to narcolepsy and RBD (REM sleep behavior disorder) – Hanein envisions patients wearing their X-trodes for several nights.
“A test for one night can’t tell you anything,” she says. “If it’s episodic, the problem can happen one night and not the next.”
While devices like an Apple Watch can track your sleep, “they’re not medical grade,” Peremen points out, “and they focus almost entirely on apnea. We don’t know anyone who can achieve the same quality as us. “
After an injury
For muscle rehabilitation, X-trodes can monitor what happens while walking or running and optimize programs after injuries with personalized ratings.
“You can jump, bike, run, run with it,” explains Peremen.
The technology can measure muscle patterns, fatigue rate and symmetry between the legs in real time.
“Balance is a big issue in injury and rehabilitation,” notes Peremen. “When you have an injury and don’t do the rehabilitation process properly, the pain can become chronic.”
X-trodes can measure muscle patterns and more. Photo courtesy of X-trodes
X-trodes is not just hardware: machine learning and intelligent algorithms quickly compare the data of a patient wearing the device with the results of other patients that have been uploaded to the X-trodes cloud.
To sleep, attach four electrodes to your forehead, two next to your eyes and two to your chin. There are a total of 16 electrodes for muscle rehabilitation.
“When you see it, it feels like science fiction,” says Peremen. “It is really exciting to see that we can broaden our horizons with medical monitoring and make it accessible to many people. It’s not just a medical device. It is a data solution that gives us access to data that is inaccessible today. “
The X-trodes product is currently being tested by 20 research groups around the world. Filing with the FDA is scheduled for 2022 in the hope that a product will be approved and available by the second quarter of 2023.
Building a company during Covid
X-trodes has 24 employees – 14 employees and 10 subcontractors.
From left, X-trodes CFO Alon Netser, CTO Yael_Hanein and CEO Ziv Peremen. Photo courtesy of X-trodes
Has Covid-19 influenced the company’s development? “The fact that people do not have access to sensible sleep tests was known even before Covid,” Hanein told ISRAEL21c.
“Still, we are very proud that during Covid-19 we managed to build the startup, hire people, get funding and learn how to communicate with investors and employees online.”
The pandemic, Peremen adds, “has dramatically increased interest in telemedicine and remote monitoring. It gave us a lot of momentum. “
For more information on X-trodes or how to participate in the company’s current home sleep studies, click here