Continuous SpO₂ · Therapy verification · MaaS

Make OSA treatment therapeutic.

A prescription is not an outcome. SleepVigil verifies — every night, through whichever treatment your patient is on — whether the therapy is actually doing its job. CPAP, oral appliance, supplemental oxygen, positional. We watch the one signal that proves it: peripheral oxygen saturation. Avoid the chair. Avoid the cascade. Avoid the spend that follows when nobody is watching.

Start a deployment → See what we watch for ↓
24/7
Therapy verification on the same clinical dashboard your team already reads. Every night, not one night a year.
∞
Therapy-agnostic. CPAP, oral appliance, supplemental O₂, positional. SpO₂ is the outcome we anchor to — whichever modality was chosen.
1
One signal that proves it. From first reading to longitudinal trend, alarm, and chart-ready report — without leaving the platform.
SpO₂ %
98
HR bpm
62
04:01:22
z z
POSTERIOR · RENAL VIEW KIDNEY L & R HYPOXIA tissue injury
Patient in a dialysis chair, connected to a hemodialysis machine under fluorescent light
SleepVigil monitoring a sleeping patient at night, holographic dashboard showing SpO2 waveforms and therapy verified status
TIER 01 · MANDIBULAR ADVANCEMENT DEVICE · TITRATABLE UPPER TRAY fixed · custom-fit LOWER TRAY titrates anteriorly HINGE 0.25 mm steps ANTERIOR ADVANCEMENT · 5–7 MM
TIER 02 · CONTINUOUS POSITIVE AIRWAY PRESSURE · DELIVERY SYSTEM PRESSURE · cmH₂O 8.0 FLOW 38 L/min AHI 1.2 PRESSURE BAR 5 10 15 20 CPAP UNIT auto-titrating DELIVERY HOSE heated · 22 mm NASAL MASK vented cushion DELIVERING 8.0 cmH₂O
04:01 · BEDROOM · SLEEPING

The body is on its own.

Most patients sleep without anyone watching their oxygen — even after a sleep study, even after a prescription. One night in a lab is a snapshot. The other 364 are unmonitored.

04:17 · APNEIC EVENT · SEVERE

SpO₂ is falling.

A severe obstructive event lasts forty seconds. Saturation drops from 98 to 76. The patient stirs but doesn't wake. By morning, no one will know it happened. It will happen again tomorrow night, and the night after that.

DOWNSTREAM CONSEQUENCE

The kidneys notice.

Hypoxic injury accumulates in the organs least able to advocate for themselves. Repeated nocturnal desaturation has been associated with progression in chronic kidney disease — a quiet contributor to a loud diagnosis.

YEARS LATER · OUTPATIENT DIALYSIS

The destination most cascades arrive at.

Four hours, three times a week. Whatever happened at four in the morning, night after night for years, is part of the reason this chair is occupied. Nobody connected the night to the chair — because nobody was watching.

SLEEPVIGIL · INTERVENTION

What if someone had been watching?

Same patient. Same bed. But this time, a sensor on the finger and a dashboard in the cloud. SleepVigil verifies — every night, through whichever treatment was chosen — that the SpO₂ floor is actually rising. The cascade doesn't start if you catch it in the first chapter.

TIER 01 · ORAL APPLIANCE THERAPY

Bring intelligence to treatment.

Every patient responds differently. SleepVigil measures whether this patient's SpO₂ floor rises on this therapy — every night. Oral appliance, CPAP, positional, supplemental oxygen. We don't pick the treatment. We tell you if the one you picked is working.

TIER 02 · POSITIVE AIRWAY PRESSURE

When the apnea is severe, climb.

Moderate-to-severe disease usually warrants CPAP from the start — continuous pressure splints the airway open all night. When appliance therapy isn't enough, the data tells us. SleepVigil makes the choice empirical, not assumed.

BUT MORE ISN'T BETTER

Too much therapy backfires.

Pressure set too high triggers treatment-emergent central apneas, aerophagia, mask leak, and the kind of intolerance that ends in a CPAP machine in a closet. Mandibles advanced too aggressively cause TMJ pain and tooth movement. The patients who quit didn't disappear — they returned to untreated apnea.

THE MIDDLE GROUND

Just enough therapy. No more, no less.

SleepVigil is the instrument that helps the clinician and the patient find the dose that keeps oxygen reaching the kidneys, the heart, the brain — without overshooting. The lowest pressure that works. The smallest advancement that works. The therapy the patient actually keeps using. That is the difference between a prescription and a result.

Device-agnostic by design

We don't sell another oximeter.

SleepVigil is the layer above the hardware. Whatever pulse oximeter your patient population already wears — clinical, consumer, FDA-cleared, not — we ingest the signal, clean it, watch it, and put it in front of a clinician when the trend matters.

No vendor lock-in. No procurement battle. No 90-day pilot to figure out if the thing on their finger talks to the thing in the cloud. It does. We made sure of it.

01
Hospital telemetry
CONTINUOUS · WIRED
02
Bedside pulse oximeters
FDA-CLEARED · BLE
03
Overnight recording oximeters
HSAT · DEVICE-MEMORY
04
Wearable rings
CONSUMER · NOCTURNAL
05
Smartwatches with SpO₂
CONSUMER · SPOT-CHECK
06
Chest-worn continuous patches
CLINICAL · LONGITUDINAL
Know what you're reading

Not every SpO₂ reading is the same.

The wearables market is split. A handful of devices are 510(k)-cleared by the FDA for SpO₂ measurement — meaning the manufacturer has demonstrated accuracy against arterial blood gas. Most consumer smartwatches and rings frame SpO₂ as a "wellness" feature, which means it isn't labeled, validated, or marketed for medical decision-making. SleepVigil ingests both. We just don't pretend they're equivalent.

Device
Form factor
SpO₂ mode
FDA designation
FDA-CLEARED · MEDICAL DEVICES
01
Withings ScanWatch Withings · 2021
Smartwatch
Spot + nightly trend
510(k) cleared
02
Wellue / Viatom O2Ring K191088 · 2019
Smart ring
Continuous overnight
510(k) cleared
03
Masimo MightySat / W1 Masimo
Finger / wrist
Spot + continuous
510(k) cleared
04
Nonin WristOx 3150 Nonin Medical
Wrist clinical
Continuous overnight
510(k) cleared
05
EMAY SleepO2 / SleepU EMAY
Wrist recording
Continuous overnight
510(k) cleared
06
iHealth Air iHealth Labs
Finger oximeter
Spot-check
510(k) cleared
CONSUMER · WELLNESS USE ONLY
07
Apple Watch (Series 6+, Ultra) Apple · see note
Smartwatch
Spot + nightly
Wellness only*
08
Samsung Galaxy Watch (4+) Samsung
Smartwatch
Spot + nightly
Wellness only
09
Fitbit Sense, Charge 6 Google · Fitbit
Smartwatch / band
Spot + nightly
Wellness only†
10
Garmin pulse-ox watches Fenix · Forerunner · Venu · Epix
Smartwatch
Spot + altitude
Wellness only
11
Oura Ring (Gen 3+) Oura
Smart ring
Nightly trend
Wellness only
12
Whoop 4.0+ Whoop
Wristband
Nightly trend
Wellness only
* Apple Watch · context Apple Watch ECG is separately FDA-cleared (since Series 4). The blood-oxygen feature was disabled on U.S. devices from January 2024 to August 2025 during the Masimo patent dispute; the ITC formally terminated the case in April 2026 with a redesigned sensor pathway.
† Fitbit · context Fitbit's PPG-based AFib detection is FDA-cleared separately. The SpO₂ readout itself is not — it's framed as "Estimated Oxygen Variation" for sleep insight rather than absolute medical measurement.
What "wellness only" means It does not mean the data is useless. It means the device is not labeled, validated, or marketed by the manufacturer for medical decision-making. Consumer SpO₂ is good at trends; less reliable at absolute values, and well-documented to perform worse on darker skin pigmentation.
How SleepVigil uses both Clinical decisions anchor to FDA-cleared device data per patient. Wellness data feeds the longitudinal trend layer — especially valuable when the patient is already wearing the device every night. Two streams, weighted differently, in one record.
Published evidence · peer-reviewed · cited

What the evidence actually says.

Therapy efficacy in clinical trials is well-documented across modalities. Real-world effectiveness is a different question — it depends on whether the patient actually uses the prescription, and on whether the prescription is the right amount. Below, the published trial data, on the record. Citations link to the original sources.

−30.7events / hr
Mean AHI reduction · CPAP
Umbrella review of 230 RCTs, 36,353 pts
(Figard et al., eClinicalMedicine, 2025)[1]
−27.4events / hr
Mean AHI reduction · Tirzepatide 10–15 mg, 52 wks
SURMOUNT-OSA Phase 3
(Malhotra et al., NEJM, 2024)[4]
68%
AHI reduction at 12 mo · Hypoglossal nerve stim
STAR trial, 126 pts
(Strollo et al., NEJM, 2014)[3]
3.3hr / night
Mean CPAP adherence · SAVE trial
2,717 pts, multi-year follow-up
(McEvoy et al., NEJM, 2016)[5]

Efficacy by modality.

AHI = apnea-hypopnea index · events per hour
Modality
AHI reduction
Source
Notes
01
Continuous positive airway pressure CPAP · auto-titrating or fixed
−30.7 events / hrSMD −1.65 (95% CI −1.87, −1.43)
Figard et al., eClinicalMedicine, 2025[1]
Patil et al., JCSM, 2019[2]
Most efficacious treatment for AHI reduction across all modalities. Achieves AHI ≤5 events/hr in over 90% of adherent patients. First-line per AASM clinical practice guideline for moderate-to-severe disease.
02
Tirzepatide GLP-1 / GIP receptor agonist · 10–15 mg / wk
−27.4 events / hr−55.0% from baseline at 52 wks
Malhotra et al., NEJM, 2024[4]
SURMOUNT-OSA Phase 3
Up to 51.5% of participants met disease-resolution criteria at 52 weeks (combined AHI <5 or AHI 5–14 with ESS ≤10). Mean body weight reduction 18.1%. Approved population: moderate-to-severe OSA with obesity (BMI ≥30).
03
Hypoglossal nerve stimulation Inspire UAS · implantable
−20.1 events / hrshort-term; −15.9 long-term
Strollo et al., NEJM, 2014[3]
HNS systematic review, 2024[7]
FDA-approved 2014 for moderate-to-severe OSA in CPAP-intolerant adults. Eligibility: AHI 15–65 (CMS); BMI <32–40; absence of complete concentric collapse on drug-induced sleep endoscopy. STAR trial showed sustained benefit at 5 years.
04
Mandibular advancement device MAD · custom-fitted oral appliance
−11.9 events / hrSMD −0.73 (95% CI)
Figard et al., eClinicalMedicine, 2025[1]
CPAP-vs-MAD meta-analysis, 2022[8]
First-line therapy per AASM for mild-to-moderate OSA, and for patients intolerant of CPAP. AHI reduction smaller than CPAP, but real-world health outcomes often comparable due to higher adherence.
05
Positional therapy SPT · supine-avoidance
−7.5 events / hrsupine AHI vs placebo
Frontiers in Medicine, 2025[9]
19 RCTs, 1,231 pts
Reduces supine AHI but not overall AHI in unselected patients. Useful as monotherapy for positional OSA (defined as supine AHI ≥2× non-supine AHI), or as adjunct to CPAP / MAD.
06
Behavioral / supportive interventions education, telemonitoring, CBT
+1.0 hr / nightCPAP adherence gain
Rotenberg et al., 2016[6]
Behavioral interventions improve CPAP usage by approximately one hour per night on average. CPAP adherence rates have remained 30–60% over twenty years of pooled data despite hardware improvements.
EFFICACY ≠ EFFECTIVENESS
Efficacy is what a therapy can do under ideal conditions. Effectiveness is what it actually does in the real world.

CPAP is the most efficacious treatment for OSA in randomized trials. In SAVE — the largest RCT of CPAP for cardiovascular outcomes, with 2,717 patients across seven countries[5] — mean adherence was 3.3 hours per night, well below the 4-hour threshold typically required for clinical benefit. The cardiovascular endpoint was not met. Adherence-stratified subgroup analysis showed benefit at ≥4 hours per night. Tirzepatide produces a 55% AHI reduction in trials but is approved only with a BMI ≥30 and carries a 12-month titration period[4]. Hypoglossal nerve stimulation is the most invasive and most expensive option and is contraindicated in roughly one-third of candidate patients on DISE evaluation[3]. The verification gap — between what a therapy can do and what it does, between what was prescribed and what is happening at 04:17 in this patient's bedroom tonight — is not a quirk of the literature. It is the dominant clinical variable. SleepVigil exists to close it.

References
  1. Figard C, Ben Messaoud R, Baillieul S, et al. Effect of sleep apnoea interventions on multiple health outcomes: an umbrella review of meta-analyses of randomised controlled trials. eClinicalMedicine. 2025. doi:10.1016/j.eclinm.2025.103529
  2. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2019;15(2):301–334. doi:10.5664/jcsm.7638
  3. Strollo PJ Jr, Soose RJ, Maurer JT, et al. Upper-airway stimulation for obstructive sleep apnea (STAR trial). N Engl J Med. 2014;370(2):139–149. doi:10.1056/NEJMoa1308659
  4. Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the treatment of obstructive sleep apnea and obesity (SURMOUNT-OSA). N Engl J Med. 2024;391(13):1193–1205. doi:10.1056/NEJMoa2404881
  5. McEvoy RD, Antic NA, Heeley E, et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea (SAVE trial). N Engl J Med. 2016;375(10):919–931. doi:10.1056/NEJMoa1606599
  6. Rotenberg BW, Murariu D, Pang KP. Trends in CPAP adherence over twenty years of data collection: a flattened curve. J Otolaryngol Head Neck Surg. 2016;45(1):43. doi:10.1186/s40463-016-0156-0
  7. Costantino A, et al. Hypoglossal nerve stimulation for obstructive sleep apnea in adults: an updated systematic review and meta-analysis. Respiratory Medicine. 2024. PMID via ScienceDirect
  8. Mihai R, et al. Continuous positive airway pressure vs mandibular advancement devices in the treatment of obstructive sleep apnea: an updated systematic review and meta-analysis. Cureus. 2022. PMC8890605
  9. Comparative efficacy of sleep positional therapy, oral appliance therapy, and CPAP in obstructive sleep apnea: a meta-analysis of mean changes in key outcomes. Frontiers in Medicine. 2025. doi:10.3389/fmed.2025.1517274
Three ways to deploy

Pick the service that best fits your practice.

01 · CORE

Remote Patient Monitoring

RPM · CCM · CHRONIC CARE

Enroll patients with sleep-disordered breathing, COPD, CHF, or CKD. We handle the device fulfillment, the consent flow, and the continuous SpO₂ telemetry. Your clinicians see a single dashboard — alarms, trends, attestable time.

  • CPT-aligned data capture and time tracking
  • Configurable thresholds per patient cohort
  • EHR integration via HL7 / FHIR
  • Patient-facing app and call-center optional
02 · DIAGNOSTIC

Sleep Study as a Service

HSAT · OVERNIGHT · LONGITUDINAL

Home Sleep Apnea Testing without the eight-week scheduling delay. We ship, we coach, we read, we report. Multi-night recordings reveal what a single PSG cannot — variability, comorbid hypoxemia, and the patients lab tests miss.

  • Multi-night oximetry — not single-snapshot
  • Board-certified sleep physician interpretation
  • Optional polysomnography escalation pathway
  • Fits inside existing primary-care workflows
03 · INFRASTRUCTURE

Monitoring as a Service

MaaS · WHITE-LABEL · API

For dialysis networks, sleep clinics, and health systems running their own programs. The full SleepVigil stack — ingestion, normalization, alarming, reporting — under your brand, in your contract. We are the plumbing; you are the practice.

  • White-label patient and clinician interfaces
  • Real-time API for SpO₂ events and trends
  • BAA-covered, HIPAA-aligned data plane
  • Deployment in weeks, not quarters
— Why we built it this way —
001

Titrate with real-time physiologic data.

SpO₂ doesn't lie. Measured continuously, overnight, it tells you whether a therapy is working for this patient — not in theory, not on average. Every titration decision backed by the same signal the ICU trusts.

002

Continuity over moments.

A one-night sleep study is a polaroid. A continuous overnight trend, sustained over months, is a film. Diagnosis lives in the second one.

003

Watch during treatment.

Dialysis itself is a hemodynamic event. Monitoring SpO₂ through a session — and through the sleep that follows — closes a loop most programs leave open.

004

Clinicians, not chatbots.

The dashboard is for the people who already make the decisions. We surface signal; we don't replace judgment. The escalation pathway lands on a human.

Do these sound familiar?

Obstructive sleep apnea affects 1 in 5 adults — and 80% don't know they have it. The symptoms below are so common they get dismissed as "just getting older." They aren't. Each one is a signal that your airway may be closing hundreds of times a night.

Nighttime
01

Loud, chronic snoring

Not just audible — bed-partner-level loud. Often punctuated by silent pauses where breathing stops entirely, sometimes for 30 seconds or more.

02

Witnessed apneas

Your partner sees you stop breathing, gasp, or choke in your sleep. Each episode ends with a reflexive arousal that fragments sleep architecture.

03

Frequent awakenings

Waking up multiple times per night — sometimes with a sensation of choking or air hunger. Nocturia (frequent urination) is another common trigger.

04

Restless, unrefreshing sleep

Eight hours in bed, zero hours of restorative deep sleep. You wake up feeling like you never slept at all — because the apneas prevented slow-wave cycles from completing.

05

Night sweats

Repeated oxygen desaturation triggers sympathetic surges — your body responds with sweating, elevated heart rate, and blood pressure spikes throughout the night.

06

Dry mouth or sore throat

Mouth breathing around an obstructed airway dries the oral mucosa. Waking up with a parched mouth and raw throat is a hallmark of untreated OSA.

Daytime
07

Excessive daytime sleepiness

The kind that makes you fall asleep in meetings, at traffic lights, mid-sentence. Not tiredness — pathological sleepiness from hundreds of micro-arousals per night.

08

Morning headaches

CO₂ retention and nocturnal hypoxemia cause vasodilation. The result: a dull, bilateral headache that peaks on waking and fades within an hour or two.

09

Difficulty concentrating

Brain fog, short-term memory lapses, poor executive function. Chronic intermittent hypoxia damages prefrontal cortex tissue — the cognitive effects are measurable.

10

Mood changes and irritability

Depression, anxiety, and emotional volatility are common. Sleep fragmentation disrupts serotonin regulation and amplifies the amygdala's threat response.

11

Decreased libido

Chronic sleep disruption suppresses testosterone production and disrupts hypothalamic signaling. Both men and women report reduced sexual interest and function.

12

Resistant hypertension

Blood pressure that won't respond to medication. OSA-driven sympathetic activation keeps arterial pressure elevated — treating the apnea often succeeds where a fourth antihypertensive fails.

If three or more of these describe your nights — it's not normal aging.

Check your risk now →
Schedule a vigil

Stop prescribing into the dark.

Talk to a deployment lead → Read the technical brief