Article

Innovating Hypertension Management Amongst Refugees in San Diego

4 min read

Refugees are a subset of the population that suffer displacement and other stressors, and once they reach their new home country, medical conditions including hypertension can go undetected and untreated. However, research into this very topic began in February 2021. The study entitled “Perceptions, Knowledge, and Attitudes Towards Hypertension Management among Refugees in San Diego” is being carried out by Dr. Tala Al-Rousan, a founding faculty member at the Herbert Wertheim School of Public Health at the University of California San Diego, in partnership with Dr. Job Godino who leads the Laura Rodriguez Research Institute at the Family Health Care Centers of San Diego.

Throughout the program, participants are using Withings BPM Connect, a smart blood pressure monitor, as well as the Withings Data Hub, a cellular gateway used to collect measurements. The study is funded by The National Heart, Lung, and Blood Institute of the US National Institutes of Health. It aims to contribute to a relatively small body of literature surrounding the unaddressed global challenge of uncontrolled blood pressure in displaced populations including refugees and asylum seekers. The problem of hypertension among displaced peoples is even more prevalent as the numbers of refugees continue to increase due to higher rates of violence, natural disasters, and health inequities.

A specific goal of the project is to examine the feasibility of self-administered blood pressure monitoring through supportive healthcare infrastructure. The study hopes to show preliminary data that refugee patients can and prefer to take leadership over their hypertension management from where they are residing in combination with receiving guidance on medication titration plans from their healthcare providers.

In combination with BPM Connect, Drs. Al-Rousan and Godino’s teams collect patient data using Withings remote patient monitoring (RPM) solution. Both device and RPM help solve several pain points that participants may face such as interrupted healthcare access, economic hardship, language barriers, and varying levels of health literacy and numeracy. Regarding interrupted access, going to the doctor can be difficult for participants as some may have employment that does not allow for brief leave from work; since the device can be used at home, less time needs to be budgeted. BPM Connect also uses one button to take measurements which reduces potential language and use factors. Finally, any question of whether participants can access the internet has been assuaged using Withings Data Hub, a cellular gateway that requires no installation from users and securely connects retrieved data to the Withings RPM solution without requiring a smartphone or Wi-Fi.

The study includes 80 Aramaic and Arabic-speaking refugees with diagnosed uncontrolled blood pressure. Participants were recruited in consultation with ethnic community-based organizations in San Diego that serve refugees including Al Majdal Center and others. Multicultural and multilingual investigators with expertise in refugee health, digital health, epidemiology, and chronic disease prevention are involved in the team.

The study asks participants to measure their blood pressure three times a day every other day for four weeks. Qualitative interviews are being conducted before and after the intervention period to understand the levels of acceptability of remote monitoring and whether participants feel more in control, empowered, aware, and engaged in better quality healthcare. Questions on the role of social networks in health education and medication adherence are also asked about in this study.

“This project is revolutionary in that it is the first of its kind to be addressing the unmet need of uncontrolled blood pressure, a silent killer to millions all over the world, in one of the most understudied and underserved populations which is the refugee population.” — Dr. Al-Rousan

An observation the team has noted in the program are the results of two randomized groups — one that receives in-person education about how to use BPM Connect and the other that receives the same education virtually. The virtual education group has not only received the intervention smoothly but actually preferred it over in-person instruction which may be explained by fears of contracting COVID, or simply convenience and saving on transportation and other costs. Additionally, the use of the BPM Connect has extended beyond the intended four-week intervention period.

The ongoing pandemic has highlighted health disparities that vulnerable populations face. Drs. Al-Rousan and Godino hope that this study will show how innovative digital health solutions fit within patients’ feelings of acceptance while displaying that taking healthcare to marginalized people’s homes enables these populations to relate to their health providers, engage in healthier behaviors, and better manage chronic diseases.

The study is now in the end phase and results will soon be published. For questions, please contact Dr. Tala Al-RousanTo find out more about how institutions are using BPM Connect and other connected health devices with the Withings Data Hub, you can visit Withings.com.

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World Sleep Day, the annual spotlight on sleep health that promotes education, research and patient care, is being held on March 14. Withings is marking the occasion by highlighting the extensive technology development and research the company is doing to promote better sleep and more accessible sleep diagnostics.

 

Because sleep affects so many chronic conditions - from diabetes, stroke and heart disease to obesity, anxiety and depression -  higher quality sleep is one of the few areas of impact that can universally change human health for the better. 

 

That’s why the Withings team has spent its waking hours for the past several years developing and testing technology to improve global sleep quality. In September, Withings Sleep Rx was given FDA clearance as the first contactless device to aid in the diagnosis of sleep apnea, joining the Withings Sleep Analyzer, a device that is CE marked to diagnose sleep apnea in the EU. 

 

Sleep Rx and the other Withings devices that use the same hardware are being used in major sleep studies around the world. Because the devices are contactless and lay under the patient’s mattress, they enable large-scale studies that would previously have been nearly impossible to conduct. Here is just a sampling of recent research using or related to Withings sleep devices.

 

Cognitive Performance of Critical Shift Workers

Non-daytime shift workers - like nurses, firefighters, mariners, military personnel  and transit drivers - have a 60% greater risk of workplace accidents. Using Withings Sleep Analyzer, which uses the same hardware technology as Sleep Rx, researchers were able to understand the cognitive impacts of different lighting conditions to develop a model for predicting performance under varying sleep conditions and time of day of the sleep.

 

Results supported the utility of simple non-intrusive sleep monitoring via consumer sleep technology to estimate post-sleep work shift performance and safety during non-daytime shift schedules. 

 

Jack Manners, Eva Kemps, Alisha Guyett, Nicole Stuart, Bastien Lechat, Peter Catcheside, Hannah Scott. Estimating vigilance from the pre-work shift sleep using an under-mattress sleep sensor. Journal of Sleep Research, 2024.

 

How Many Nights of Sleep Data Do We Really Need?

An article in JMIR Formative Research examines how traditional sleep assessments rely on short-term tracking (3–14 days), while a six-month study using Withings’ wearables and sleep sensors suggests this may not be enough. Researchers found that seasonal variations and long-term patterns significantly impact sleep health, reinforcing the importance of continuous monitoring to gain a more accurate picture of sleep behaviors.

 

Óskarsdóttir M, Islind AS, August E, et al. Importance of getting enough sleep and daily activity data to assess variability: a longitudinal observational study. JMIR Formative Research, 2022.

 

The Future of Sleep Research: Large-Scale, Decentralized Studies

An article in Current Sleep Medicine Reports details how the growing adoption of wearable and nearable sleep tech is enabling researchers to shift toward real-world, long-term data collection. Ongoing studies using Withings technology are paving the way for remote clinical trials, enabling deeper insights into sleep disorders and their broader health impacts.

 

Jaiswal SJ, Pawelek JB, Warshawsky S, et al. Using new technologies and wearables for characterizing sleep in population-based studies. Current Sleep Medicine Reports, 2024.

 

If you are conducting research that might benefit from Withings technology, please contact us at contact-pro@withings.com.

Interested in partnering with us?

Contact Us [post_title] => Major Advances in Sleep Health Technology Mark World Sleep Day [post_excerpt] => World Sleep Day, the annual spotlight on sleep health that promotes education, research and patient care, is being held on March 14. Withings is marking the occasion by highlighting the extensive technology development and research the company is doing to promote better sleep and more accessible sleep diagnostics. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => withings-sleep-research-roundup [to_ping] => [pinged] => [post_modified] => 2025-03-13 13:26:18 [post_modified_gmt] => 2025-03-13 13:26:18 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1848 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 1851 [post_author] => 11 [post_date] => 2025-03-13 13:26:08 [post_date_gmt] => 2025-03-13 13:26:08 [post_content] =>

Up to 30% of adults experience intermittent or chronic insomnia; 20% suffer from sleep apnea, although up to 80% of them are unaware and undiagnosed.1 Poor sleep and sleep disorders like Obstructive Sleep Apnea, have been linked to obesity, diabetes, hypertension, coronary artery disease, dementia, cardiovascular mortality, seizures, stroke, congestive heart failure, lowered immune response, and impaired judgment and reaction times. With such widespread prevalence and dire consequences, the theme of World Sleep Day 2025: MAKE SLEEP HEALTH A PRIORITY is an imperative. 

 

Polysomnography, either in a lab or at home, is the clinical gold standard for measuring sleep health, but these studies can be expensive, inaccessible and difficult to schedule. They are usually single-night observations which rely on human interpretation of data and do not capture variability in sleep quality over multiple nights. Withings Sleep Rx is a discreet mat placed under the mattress which captures many of the same metrics as polysomnography with longitudinal, contact free monitoring in a real-world setting. 

 

Sleep Rx is the first contactless, in-home sensor to aid in diagnosing Obstructive Sleep Apnea. This is measured and scored using the Withings Index. The Withings Index uses heart rate and breathing inputs (both sound and variations of pressure in the bladder) to calculate an estimated frequency of adverse breathing events per hour during the night. Clinical validation of the Withings sleep mat shows good agreement with polysomnography-derived Apnea-Hypopnea Index (AHI) with high predictive performance (88% sensitivity and 88% specificity) to classify moderate to severe OSA .2

 

Sleep Rx continuously tracks heart rate with ballistocardiographygraphy (BCG) using a pneumatic sensor that measures the mechanical wave that each heart beat sends through the body. BCG has been validated against ECG and found to be highly accurate .3 Variability in heart rate can be used to detect sleep phases .4 Nocturnal heart rate is comparable to resting heart rate and is a good indicator of overall cardiovascular health 5.

 

The Withings sleep mat also incorporates a snoring algorithm which crosses breathing rate and audio signals to identify snoring patterns and differentiate them from environmental noises or a partner’s snoring. The algorithm has been shown to be 94.4% precise with a 75.9% recall 6.

 

In addition, the sleep mat analyzes movement, interruptions, sleep onset latency, duration, regularity, and efficiency. With a one-time set up, the mat automatically syncs data via WiFi with the HIPAA-compliant Withings API and integrates with the Withings Remote Patient Monitoring platform. Sleep Rx is available by prescription in the US.

 

The ease of use of Sleep Rx combined with its sophisticated and robust metrics make it an ideal tool for capturing sleep variability over multiple nights. This cutting edge technology presents exciting clinical research applications, opportunities to optimize treatment adherence, and the ability to enhance the precision of personalized sleep medicine.

References
    1. Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997 Sep, 20(9):705-6.
    2.  Lechat B, Naik G, Reynolds A, Aishah A, Scott H, Loffler KA, Vakulin A, Escourrou P, McEvoy RD, Adams RJ, Catcheside PG, Eckert DJ. Multinight Prevalence, Variability, and Diagnostic Misclassification of Obstructive Sleep Apnea. Am J Respir Crit Care Med. 2022 Mar 1;205(5):563-569. doi: 10.1164/rccm.202107-1761OC. PMID: 34904935; PMCID: PMC8906484.
    3. Brüser, K. S. Christoph. Adaptive beat-to-beat heart rate estima- tion in ballistocardiograms. IEEE Trans. Inf. Technol. Biomed. Publ. IEEE Eng. Med. Biol. Soc. 2011, vol. 15, no. 5, pp. 778–86.
    4. Redmond, P. de C. S. J. Sleep staging using cardiorespiratory signals. Somnologie – Schlafforschung Schlafmed. 2007, vol. 11, no. 4, pp. 245–256.
    5. Kim Fox, Jeffrey S. Borer, A. John Camm, Nicolas Danchin, Rober- to Ferrari, Jose L. Lope. Resting heart rate in cardiovascular disease. JACC. August 2007, vol. 50, Issue 9.
    6. Norman RG, Pal I, Stewart C, Walsleben JA, Rapoport DM. Inte-robserver agreement among sleep scorers from different centers in a large dataset. Sleep. 01 Nov 2000, vol. 23(7):901-908.

Interested in partnering with us?

Contact Us [post_title] => Withings Sleep Rx: Allowing Sleep Specialists to Make House Calls [post_excerpt] => New large-scale, longitudinal studies show that monitoring sleep for at least 14 nights at home with a connected sleep tracking mat, can reduce the 30% high error rate of sleep apnea diagnosis from the usual single-night, in hospital polysomnography (PSG) technique. This technology can identify which patients most need expensive, intrusive, and difficult to access PSG. Longitudinal data also detects variability of Obstructive Sleep Apnea from night to night which is associated with hypertension [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => withings-sleep-rx-allowing-sleep-specialists-to-make-house-calls [to_ping] => [pinged] => [post_modified] => 2025-03-13 13:26:08 [post_modified_gmt] => 2025-03-13 13:26:08 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1851 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 1845 [post_author] => 11 [post_date] => 2025-03-13 13:25:51 [post_date_gmt] => 2025-03-13 13:25:51 [post_content] =>

Professor Danny Eckert of the Adelaide Sleep Institute at Flinders University didn’t set out to be one of the world’s foremost sleep experts. He started as an elite cyclist, representing Australia at the World Championships. Wanting to use his head as well as his body, he studied exercise physiology and sports science in the afternoons, trained on his mountain bike in the mornings, raced competitively, and presumably left some time for sleep. After receiving his degree, he was offered a prestigious appointment with the South Australia Sports Institute. 

 

But on the Friday before he was due to start his internship, he was also offered a 3-year position with a respiratory and sleep unit in a hospital. When he reported for his new job at the Sports Institute on Monday, he immediately asked his new boss if he could take a walk to consider his options, came back, and left for a field he knew nothing about. “It turned out that everything I’d learned about the body being at its most vulnerable and physiologically interesting when you push it as hard as you can during exercise is also true when you are sleeping and the body is at its quietest.”

 

Professor Eckert was on fertile ground for his newly chosen field. Australia has long been a leader and innovator in sleep science, especially in respiratory medicine. When he started studying sleep apnea, the research centered on anatomy: the collapse of the upper airway, especially due to obesity. As such, treatments such as Continuous Positive Airway Pressure, (CPAP, invented in Australia), mouthguards, and surgery were designed to open the airway.

 

Professor Eckert’s groundbreaking work changed nearly everything we thought we knew about sleep apnea. Importantly, he identified three nonanatomical endotypes that can cause sleep apnea. Between them, they account for 70% of sleep apnea cases. 

 

1) Low Arousal Threshold: Light sleepers who wake up when their muscles relax. 

2) Instability in Breathing Control: Sleepers who are too sensitive to minor changes in carbon dioxide. Their overactive respiratory system turns off their drive to breathe.

3) Poor Muscle Responsiveness to the Narrowing Airway

 

Simplified, scalable diagnostic tools and machine learning can identify the endotype(s) that causes a particular patient’s sleep apnea. Endotypes can inform targeted therapies and lead to an 80% success rate for treating sleep apnea. This individualized, precision medicine approach includes emerging pharmaco-therapies, such as drugs that can activate the muscles, or strategies, such as cognitive behavioral therapy, that can help light sleepers. 

 

What’s next? With 70 researchers working on 40-50 studies at any one time at the Adelaide Sleep Institute, there are many exciting developments to come. One area of interest is sleep irregularity. Researchers have found varying bedtime by even 30 minutes throughout the week is associated with a 30% higher chance of hypertension; vary by 90 minutes and increase the odds by 90%, regardless of the total amount of sleep. 

 

New technologies that allow longitudinal data are especially useful for studying sleep variability. Combining sleep data with measures like body fat, step counts, and blood pressure will allow for quicker treatment changes, better monitoring of treatment effectiveness, and reach many more people who suffer from sleep disorders.

 

The three pillars of health are exercise, diet, and sleep, but sleep directly affects the other two. Not getting sufficient or quality sleep makes us crave bad food and makes it hard to exercise. That’s why Dr. Eckert believes sleep is the foundation for optimal health. Through research and scientific and technological breakthroughs, Professor Eckert thinks we are at the precipice of transforming the entire sleep field. That’s a comforting thought for the billions of people around the globe desperate for a good night’s sleep.

Interested in partnering with us?

Contact Us [post_title] => From Bicycles to Sleep Cycles: How Professor Danny Eckert’s Pursuit of Peak Performance Led to Major Advances in our Understanding of Sleep [post_excerpt] => Professor Danny Eckert of the Adelaide Sleep Institute at Flinders University didn’t set out to be one of the world’s foremost sleep experts, but he has changed nearly everything we know about sleep apnea. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => from-bicycles-to-sleep-cycles-how-professor-danny-eckerts-pursuit-of-peak-performance-led-to-major-advances-in-our-understanding-of-sleep [to_ping] => [pinged] => [post_modified] => 2025-03-13 13:25:53 [post_modified_gmt] => 2025-03-13 13:25:53 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1845 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 3 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 1848 [post_author] => 11 [post_date] => 2025-03-13 13:26:17 [post_date_gmt] => 2025-03-13 13:26:17 [post_content] =>

World Sleep Day, the annual spotlight on sleep health that promotes education, research and patient care, is being held on March 14. Withings is marking the occasion by highlighting the extensive technology development and research the company is doing to promote better sleep and more accessible sleep diagnostics.

 

Because sleep affects so many chronic conditions - from diabetes, stroke and heart disease to obesity, anxiety and depression -  higher quality sleep is one of the few areas of impact that can universally change human health for the better. 

 

That’s why the Withings team has spent its waking hours for the past several years developing and testing technology to improve global sleep quality. In September, Withings Sleep Rx was given FDA clearance as the first contactless device to aid in the diagnosis of sleep apnea, joining the Withings Sleep Analyzer, a device that is CE marked to diagnose sleep apnea in the EU. 

 

Sleep Rx and the other Withings devices that use the same hardware are being used in major sleep studies around the world. Because the devices are contactless and lay under the patient’s mattress, they enable large-scale studies that would previously have been nearly impossible to conduct. Here is just a sampling of recent research using or related to Withings sleep devices.

 

Cognitive Performance of Critical Shift Workers

Non-daytime shift workers - like nurses, firefighters, mariners, military personnel  and transit drivers - have a 60% greater risk of workplace accidents. Using Withings Sleep Analyzer, which uses the same hardware technology as Sleep Rx, researchers were able to understand the cognitive impacts of different lighting conditions to develop a model for predicting performance under varying sleep conditions and time of day of the sleep.

 

Results supported the utility of simple non-intrusive sleep monitoring via consumer sleep technology to estimate post-sleep work shift performance and safety during non-daytime shift schedules. 

 

Jack Manners, Eva Kemps, Alisha Guyett, Nicole Stuart, Bastien Lechat, Peter Catcheside, Hannah Scott. Estimating vigilance from the pre-work shift sleep using an under-mattress sleep sensor. Journal of Sleep Research, 2024.

 

How Many Nights of Sleep Data Do We Really Need?

An article in JMIR Formative Research examines how traditional sleep assessments rely on short-term tracking (3–14 days), while a six-month study using Withings’ wearables and sleep sensors suggests this may not be enough. Researchers found that seasonal variations and long-term patterns significantly impact sleep health, reinforcing the importance of continuous monitoring to gain a more accurate picture of sleep behaviors.

 

Óskarsdóttir M, Islind AS, August E, et al. Importance of getting enough sleep and daily activity data to assess variability: a longitudinal observational study. JMIR Formative Research, 2022.

 

The Future of Sleep Research: Large-Scale, Decentralized Studies

An article in Current Sleep Medicine Reports details how the growing adoption of wearable and nearable sleep tech is enabling researchers to shift toward real-world, long-term data collection. Ongoing studies using Withings technology are paving the way for remote clinical trials, enabling deeper insights into sleep disorders and their broader health impacts.

 

Jaiswal SJ, Pawelek JB, Warshawsky S, et al. Using new technologies and wearables for characterizing sleep in population-based studies. Current Sleep Medicine Reports, 2024.

 

If you are conducting research that might benefit from Withings technology, please contact us at contact-pro@withings.com.

Interested in partnering with us?

Contact Us [post_title] => Major Advances in Sleep Health Technology Mark World Sleep Day [post_excerpt] => World Sleep Day, the annual spotlight on sleep health that promotes education, research and patient care, is being held on March 14. Withings is marking the occasion by highlighting the extensive technology development and research the company is doing to promote better sleep and more accessible sleep diagnostics. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => withings-sleep-research-roundup [to_ping] => [pinged] => [post_modified] => 2025-03-13 13:26:18 [post_modified_gmt] => 2025-03-13 13:26:18 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1848 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 40 [max_num_pages] => 14 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => 1 [is_tag] => [is_tax] => [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => 4c4cccd009c84d2156f7c3abc8b35a49 [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [allow_query_attachment_by_filename:protected] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) )
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Major Advances in Sleep Health Technology Mark World Sleep Day

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