The Booming Sleep-Health Medical Industry - 高速成長的睡眠健康醫療產業

Director 指揮 ： KEITH YUNXI ZHU 朱耘希

Supervisor 監視 ： Oliver Thomas Dalmi 達爾米 托馬斯 奧立佛

Authors   作者 ： Yuening Wang

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INTRODUCTION
引言

Recently, a China-Based intelligent medical device enterprise faced challenges raising capital in the United States of America, and inquired Financial Advisory assistance from THE KEITH & EVEN GROUP (US). To better assist this client, TKEG conducted a series of research on the Sleep-Health Medical Industry, and summarized the following to share with the public.
近期，一個總部位於中國的智慧醫療設備企業在美國面臨融資挑戰，並且向奕資美國尋求金融諮詢。為了更好的幫助這位客戶，奕資在睡眠健康醫療產業上進行了一系列的研究，並且總結了以下信息來與公眾分享。

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1

Summary
匯總

Sleep is a universal function of living species, and it comprises almost one-third of human life. As it takes up such a huge portion of human’s life, sleep disorders are seemingly very frequent and can have serious consequences on patient’s health and quality of life [1]. The most common sleep disorders are obstructive sleep apnea (OSA) and chronic insomnia. In US, the prevalence of OSA is estimated to be 12% of the adult population totaling 29.4 million people. Among those 29.4 million people, approximately 80% of the patients are undiagnosed totaling 23.5million. Among the OSA diagnosed patients, 85% patients are treated with nasal continuous positive airway pressure (CPAP) [2,3]. Similar situations apply to the patients suffering from chronic insomnia. The diagnose and treatment for the sleep disorders could be effective in many ways such as increase quality of life and reduce cost burden etc [3]. Nowadays, there are new technology and tools for self-assessment which make the diagnose and treatment easier and more convenient. Sleep health industry is a growing industry and expected to grow at a rate of more than 8% a year.
睡眠是生物的普遍功能，幾乎佔人類生命的三分之一。由於它佔據了人類生活的很大一部分，睡眠障礙疾病發生的幾率非常頻繁，會對患者的健康和生活質量造成嚴重的後果。最常見的睡眠障礙疾病是阻塞性睡眠呼吸暫停 (OSA) 和慢性失眠。在美國，阻塞性睡眠呼吸暫停 (OSA) 的患病率估計為成年人人口的12%， 大概總共有 2940 萬人。在這 2940 萬人中，約有 80% 的患者未確診，總計約有 2350 萬人。在阻塞性睡眠呼吸暫停 (OSA) 確診患者中，85% 的患者接受經呼吸機 (CPAP)治療。患有慢性失眠症的患者有面臨相似的情況。睡眠障礙的診斷和治療可以在提高生活質量和降低成本負擔等許多方面發揮作用。如今，有了新的自我評估技術和工具，使診斷和治療變得更加容易和方便。睡眠健康行業是一個不斷增長的行業，預計每年以8%以上的速度增長。

2

Obstructive Sleep Apnea (OSA)
阻塞性睡眠呼吸暫停

Obstructive sleep apnea is the most common type of sleep apnea. It is a condition characterized by episodic upper airway narrowing during sleep. During sleep, the activity of the upper airway dilator muscles decreases in a sleep-state-dependent manner [4]. In results, the patients will suffer from upper airway narrowing, load snoring and airflow reduction. Reduction in airflow can be either partial (a hypopnea) or complete (an apnea). The apnea hypopnea index (AHI) counts the total number of apneas and hypopneas per hour of sleep which is used to describe the severity of OSA.
阻塞性睡眠呼吸暫停是最常見的睡眠呼吸暫停類型疾病。這是一種以睡眠期間上呼吸道偶發性變窄為特徵的病症。在睡眠期間，上呼吸道擴張器肌肉的活動以睡眠狀態依賴的方式減少。結果，患者將遭受上呼吸道變窄、負荷打鼾和氣流減少所帶來的影響。氣流減少可以是部分的（呼吸不足）或完全的（呼吸暫停）。呼吸暫停低通氣指數 (AHI) 用於計算每小時睡眠中呼吸暫停和呼吸不足的總數，我們用呼吸暫停低通氣指數來描述阻塞性睡眠呼吸暫停 (OSA)的嚴重程度。

Among US adults, there are approximately 29.4 million people that are suffering from OSA and nearly 80% of people are undiagnosed. The major barriers for people getting diagnoses with OSA is due to lack of public awareness of the symptom and severity of the conditions, high cost for treatment as well as lack of primary are physician education on the urgency of diagnosis and treatment [3].
在美國成年人中，大約有 2940 萬人患有阻塞性睡眠呼吸暫停 (OSA) ，將近有 80% 的人未被確診。如此大量未被診斷為阻塞性睡眠呼吸暫停 (OSA) 的主要障礙是由於缺乏公眾對症狀和病情嚴重程度的認識，高昂的費用以及缺乏對診斷和治療緊迫性的教育。

Continuous positive airway pressure (CPAP) is the standard treatment for moderate to severe OSA. However, adherence to CPAP is limited and non-CPAP therapies are frequently explored. Oral appliance (OA) is currently widely used for the treatment of snoring, mild, moderate, and severe OSA [6]. Positional therapy which requires patients to keep sleeping on their side is also a treatment for OSA. Positional therapy is less invasive and therefore have better adherence than CPAP [7].
持續氣道正壓通氣呼吸機(CPAP) 是中度至重度 OSA 的標準治療方法。然而，患者對呼吸機的依從性有限，所以醫療系統經常探索非呼吸機療法。口腔矯治器（OA）目前廣泛用於治療打鼾、輕度、中度和重度阻塞性睡眠呼吸暫停 (OSA) 。要求患者側睡的體位療法也是阻塞性睡眠呼吸暫停 (OSA) 的一種治療方法。體位療法的侵入性較小，因此比呼吸機具有更好的依從性。

3

Chronic Insomnia
慢性失眠

More than one third of adults experience transient insomnia at some point in their lives. In about 40% of cases, insomnia can develop into a more chronic and persistent conditions [1,8]. Chronic insomnia is associated with several negative health outcomes and a severely reduced quality of life [11].
超過三分之一的成年人在他們生命中的某個階段都經歷過短暫的失眠。在約 40% 的病例中，失眠可發展為更慢性和持久的病症。慢性失眠與多種負面健康結果都有關聯，會導致生活質量嚴重的下降。

A systematic sleep history is mainly used to assess and diagnosis insomnia. The insomnia assessment involves understanding the patent’s typical sleep pattern at night as well as the effects of poor sleep on the patients. Common daytime consequences include depressed mood, irritability, and lack of energy etc [9,10]. Behavior therapy and pharmacotherapies are the most common two treatments for treating chronic insomnia.
系統的睡眠史主要用於評估和診斷失眠。失眠評估包括瞭解患者夜間的典型睡眠模式以及睡眠不佳對患者的影響。常見的白天後果包括情緒低落、易怒和缺乏活力等 。行為療法和藥物療法是目前治療慢性失眠最常見的兩種療法。

4

Impact of Treating Sleep Disorders
治療睡眠障礙的療效

Impact of treating sleep disorders like OSA and chronic insomnia includes increasing patients’ quality of sleep, increasing patients’ quality of life, decreasing the patient’s comorbidities such as diabetes and cardiovascular diseases, improving patient’s mental health, reducing the substance abuse, increase patient’s occupational productivity and decreasing the accidents and distractions that happen to the patients [3].
治療阻塞性睡眠呼吸暫停 (OSA) 和慢性失眠等睡眠障礙會提高患者的睡眠質量，提高患者的生活質量，減少患者的糖尿病和心血管疾病等併發症，改善患者的心理健康，減少患者藥物濫用的幾率，提高患者的職業生產力和減少發生在患者身上的事故和干擾。

If the United States address more about the treatment of sleeping disorder, it will result in a truly transformational impact on the society. patients could expect a major drop in life-threatening conditions such as stroke and heart disease and a more enjoyable life and relationships. Employers also would see a jump in employees’ productivity and performance [3].
如果美國更多地關注睡眠障礙的治療，它將對社會產生真正的變革性影響。患者產生中風和心臟病等危及生命的疾病將大幅減少，生活和人際關係也會更加愉快。雇主也將看到員工生產力和績效產生質的飛躍。

5

Potential Investors for Sleep-Health
潛在睡眠健康投資者

1. Treating Sleep disorders could substantially save cost by reducing workplace absences, better managing comorbidities, and increasing productivity. According to Frost & Sullivan, there is a reported 40% decline in workplace absences, and 17.3 increase in productivity after sleep disorder treatment initiation. The potential investors for sleep health treatment are
   治療睡眠障礙可以幫助企業透過減少工作場所缺勤、更好地管理合併症和提高生產力來大幅節省成本。根據 Frost & Sullivan的數據顯示，在開始睡眠障礙治療後，工作場所缺勤率下降了 40%，工作效率提高了 17.3%。關於睡眠健康治療的潛在投資者有
   
   AAA Foundation, Aetna, Alphabet (Google), Concerta, Humana, Hufffington Post, Kaiser Permanente, Scheneider, and UPREHS.

2. Large medical device companies could also be the potential investors for the sleep health industry. For example, ResMed, the largest CPAP vendors could invest in sleep tracking system and detectors that could help them target the potential patients for using CPAP as a treatment for OSA. From this perspective, potential large investors include
   大型醫療器械公司也可能成為睡眠健康行業的潛在投資者。例如，最大的 持續氣道正壓通氣系統(CPAP)生產商 ResMed 可以投資以及收購睡眠跟蹤系統和檢測器，以幫助他們搜尋用持續氣道正壓通氣系統(CPAP)作為阻塞性睡眠呼吸暫停 (OSA) 治療的潛在患者。從這個角度來看，潛在投資者包括
   
   ResMed (瑞思邁), Koninklijke Philips N.V (飛利浦), Natus Medical Incorporated, Nihon Kohden Corporation, Fisher & Paykel Healthcare, Compumedics Limited，Itamer Medical Ltd, Merck & CO, Sleep Number Corporation

3. Other potential investors in the sleep health industry include:
   睡眠健康行業的其他潛在投資者包括
   
   BMC Medical Co., Curative Medial, Apex Medical Corporation, Cadwell Industries Inc, SOMNOMedics, GMBH, Advanced Brain Monitoring Inc., Braebon Medical Corporation, Cleveland Medical Devices Inc., Eight Sleep, SIMBA, Sleepace, Solace Lifesciences, Somnox, Sleep Cycle, Withings, Polar Electro, Pzizz Ltd, Fitbit Inc., Garmin Ltd, ReST, Sunovion Pharmaceuticals Inc., Eisai Inc., Sanofi, Mallinckrodt Pharmaceuticals, Teva Pharmaceuticals Industries, Pfizer Inc.

6

Industry overview
行業概況

Sleep health industry is a growing industry especially in the recent years. There are at least 3 major acquisitions happened in the year 2021 regarding the sleep tracking device. The sleep-health industry is collectively estimated to be worth between $30 billion to $40 billion and has historically grown by more than 8 percent per year [12]. The emergence of COVID-19 has also contributed to the increasing incidence of sleep disorders.
睡眠健康行業是一個不斷發展的行業，尤其是近年來。 2021 年至少發生了 3 次關於睡眠跟蹤設備的重大收購。據估計，睡眠健康行業的總價值在 300 億至 400 億美元之間，而且歷史上每年增長超過 8%。COVID-19 的出現也導致了睡眠障礙發病率的增加

China and the US have the highest prevalence of sleep apnea. With the increase prevalence of apnea and chronic respiratory disorders, the demand for the sleep devices is expected to increase during the forecast period. The apnea device segment is growing at a CAGR of 8.34% by 2026. Almost 50% of Americans use prescription based sleeping aids or OTC products, thereby booming the growth in the global sleep industry [13].
中國和美國的睡眠呼吸暫停患病率最高。隨著呼吸暫停和慢性呼吸系統疾病患病率的增加，預計在預測期內對睡眠設備的需求將增加。到 2026 年，呼吸暫停設備細分市場的復合年增長率為 8.34%。近 50% 的美國人使用處方助眠劑或非處方藥產品，從而推動全球睡眠行業的蓬勃發展。

Sleep health industry is continuously growing and advancing. AI or artificial intelligence is penetrating almost every market as it is an extremely useful and assistive tool that can be customized easily based on the need. AI, along with machine learning and deep learning system, can help in the automation of processes while optimizing and increasing their efficiency and reducing errors. It can help in increasing the pace of diagnosis, thus increasing the pace of treatment. It can minimize or irradicate unnecessary tasks in healthcare such as documentation, administrative work, which surprisingly takes a significant time from the physician's schedule. To diagnose sleep disorders, researchers use polysomnography, actigraphy, and electroencephalography to analyze brain activity during sleep. All these technologies create a huge amount of data which include patient sleep patterns and brain activity during sleep, which helps in diagnosing sleep disorders. AI can optimize these processes and help researchers and physicians to perform better [13].
睡眠健康產業正在不斷的發展和壯大。 AI 或人工智能正在滲透幾乎所有市場，因為它是一種非常有用的輔助工具，可以根據需要輕鬆定制。人工智能以及機器學習和深度學習系統可以幫助實現流程自動化，同時優化和提高效率並減少錯誤。它可以幫助加快診斷速度，從而加快治療速度。它可以最大限度地減少或消除醫療保健中不必要的任務，例如文檔、行政工作，這些從醫生的日程安排中花費了大量時間的任務。為了診斷睡眠障礙，研究人員使用多導睡眠圖、活動描記術和腦電圖來分析睡眠期間的大腦活動。所有這些技術都會產生大量數據，其中包括患者睡眠模式和睡眠期間的大腦活動，這有助於診斷睡眠障礙。人工智能可以優化這些過程，幫助研究人員和醫生表現得更好。

North America acquired a market share of 33.26% in the global sleep market in 2020. The US and Canada are the major markets in the region. The US sleep market held a dominating market share of 90.20% in 2020. This is also expected to continue during the forecast period. The leading position in the global sleep market is attributable to factors such as high incidence and prevalence rate of chronic sleep disorders, urban and fast-paced lifestyle, a high percentage of obese population, and increasing geriatric population. The growing prevalence rate of sleeping disorders is also being attributed to the growing prevalence of underlying disorders such as Parkinson's disease, type 2 diabetes, and COPD, among others. The US and Canada majorly rely on the usage of medications (hard solutions) rather than sleep aid devices (soft solutions). The medications market in North America was valued at $ 2.19 billion in 2020 [13].
2020年北美在全球睡眠市場的佔有率為33.26%，美國和加拿大是該地區的主要市場。美國睡眠市場在 2020 年佔據了 90.20% 的主導市場份額。預計在預測期內這種情況也將持續。全球睡眠市場的領先地位歸因於慢性睡眠障礙的高發病率和患病率，城市和快節奏的生活方式，肥胖人口比例高以及老年人口增加等因素。睡眠障礙患病率不斷上升也歸因於基礎疾病（例如帕金森病、2 型糖尿病和慢性阻塞性肺疾病(COPD)等）的患病率不斷增加。美國和加拿大主要依賴藥物（硬解決方案）而不是助眠設備（軟解決方案）的使用。 2020年北美藥物市場價值21.9億美元。

7

Reference
參考

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