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: I welcome you to go to our outcomesrocket.health/reviews where you could rate and review today's guest because he is an outstanding contributor to health care from the great country of Ireland. His name is Colin Lawlor. He's the CEO at SleepScore Labs based in Carlsbad California. They're improving lives and advancing the science of sleep health. They're doing it by taking a look at sleep through the entire continuum from education through recommendations that can involve over-the-counter as well as treatments to help people sleep better and be healthier. What I want to do is open up the microphone to Colin to round out that introduction. Colin welcome to the podcast.
: Thank you very much Saul, delighted to meet you and thanks for the opportunity to speak today.
: Absolutely so Colin. Maybe you want to fill in the blanks there on your background or anything that I may have missed so that the listeners can get to know you better.
: Thank you. I think probably only two things which might might be helpful. The first one is we believe that the sleep health epidemic as it was called by the CDC as recently as 2016 is a global problem and it's one where solutions are available. However for the consumer it's really really hard to understand where to start, where to go for help. What we're aiming to do is to connect the consumer to an understanding of their sleep score which will help them to understand their own sleep and also to connect them to solutions and providers who have proven solutions and by connecting those dots for the first time. We hope to enable a complete solution in the sleep House area and the only other thing to add to that which is important is that we're not trying to do this alone. Sleep is an issue which everybody enjoys every night so that's the whole seven point six billion people on the planet. Three point five billion people have a problem with pretty much every night. So it's a very very big problem. What we're trying to do is to build a partnership starting with a great team of sleep score labs. We're also working with other great companies and great partners in order to consolidate a response which can actually really make a difference.
: Super and tell me a little bit more about what sleep Core Labs does so that we have a good understanding of the solutions and problems you guys solve?
: So sleep score Labs is at its heart it's about helping the consumer to understand their own sleep and that requires measurements. So you think about it, we understand our diet we understand or exercise on the diet and exercise were enabled by the introduction of new ways of understanding it. So for example we had the harmonization of food labeling 30 plus years ago where every food product is now labeled. Even in restaurants you can see the calorie content, the fat content, the salt content. So we get to measure what we eat and that helps us to make good decisions in relation to what we eat. That in turn enables services so syncs Weight Watchers Jenny Craig all the way through today to map my fitness on all of those services use the very same idea which is to manage a problem. It's natural for us. So for measurement of our nutrition the problem has been solved and the market has changed substantially since that was enabled same things been happening an exercise that ticked off those heart rate monitoring. Ad now it's also a step counting. But at the end of the day most people know that the more steps you do the better it is for your health. The more active you are the better it is. And so these technologies essentially helps to spur services products which make life better in terms of exercise. When you think about those two things there is a very difference between those two things and the other key pillar of health which is sleep because I remember everything I ate yesterday I can recall it pretty accurately and I can do that probably for three or four days pretty accurately. Same with exercise. So can you. So can most people. However when it comes to my sleep I cannot recall it because I'm actually unconscious during the process so it's actually really difficult for me to recall it and the more I try to concentrate on things like oh how many times that I wake up and how long do I wake up for the more I concentrate on those things the more difficult it is for me to sleep well so the sleep part of the three pillars of health has been completely misunderstood because we don't understand that ourselves because we can't. So therefore we need a way to measure it which is subjective and which can help us to understand what is actually happening during our sleep. So we start the whole process with a sleep score technology so we have a number of technologies. The first of which we have brought to market as a non contact sensing technology and that basically sits beside the bed. It uses high frequency radio waves low power to measure movement. And with that we can understand whether you were awake or asleep and what quality of sleep you're achieving all throughout the night for you. And with, that you can understand your sleep but we don't think that that's enough. We think that it's also really critical that we use that technology to measure all of the interventions that people are currently using everything, mattresses, pillows, pills, all the way through to interventions for snoring etc. and figure out which ones actually work for whom and which ones don't. So essentially at the heart of what we're doing it's about measurement first helping you to understand your sleep but also using that measurement to finally begin to figure out what works and what doesn't work for him.
: Super interesting Colin and listeners one of the things that we got to think about as healthcare leaders is how much sleep we're getting, the quality of that and I love Colin's example here bringing out an analogy between what happened in the diet industry with food measuring it. We've got to be able to measure sleep as well. So I love the progress that's being made by Colin and his team and I'm excited to dive in a little bit deeper. Can you tell us a little bit about what needs to be and every medical leaders agenda today?
: Absolutely. Well I think certainly I would argue sleep but then your listeners would expect me to say that.
: So I will say to everybody listening for your own health, for the health of your family, for the health of your teams, for performance please think about sleep please Measure, please get your sleep score. And please begin to think about what you can do. But out a bigger picture level, I think there are some parallels between the journey that we've experienced in sleep so far and health care overall. And I'd like to call up maybe two parts or two issues which I think are probably relevant to everybody. The first one is I'm calling it the difference between the consumer and the patient. So in the medical sector we tend to talk about patients and that's great because we have patients so we have to provide services to those patients. But the very definition of the word patient limits our understanding of that person and we focus on the specific illness and the specific interventions and those very very tight things around that. In truth, every patient is for the most part, also a consumer. They live lives. They go on vacations. They work sometimes. They are active, they have families they participate in communities and so forth. So my point is that only understanding the patient means only understanding a small part of their lives. And if you only focus on that it's really difficult to help consumers or patients make the changes that they need to make to ensure that the therapies that we in the medical sector are connecting them to are actually effective. So I'm guessing what I'm trying to say is that we have to begin to look at the people we serve in a much broader richer way than the simple term patient implies.
: It's an interesting thought. Absolutely. Why look at it so siloed.
: Right. Right. Under siloing is in many ways a challenge because we see across health care today, the challenge very often is not just a both appropriate diagnosis and not just about connecting the patients to the appropriate therapy but in lots of areas of health care we're struggling with lack of compliance. So as a result the interventions that we spend all this time an effort to connect the patients who don't work. And at the end of the day, that I believe is significantly influenced by the fact that we don't understand them as well as we should and we don't deliver the supports that we need to deliver in the way that we should. And that's illustrated for example by some of the great work that's been done by ResMed for example which is a founding partner and joint venture partner and Sleepscore Labs, ResMed is global leader in sleep apnea therapy and sleep apnea therapy involves a person wearing a Sipah mask and being connected to a machine every night while they sleep. So Doc is a compliance challenge in itself. However most patients feel so much better the next day that they actually put up with that and they get used to that and they get so much strong benefits from that that they continue to be compliant. But there were some who struggled and Resmed spent a lot of time and effort redesigning the entire flow from beginning to end and in connecting the patient or consumer to improved data and services and insights and that has radically transformed our compliance. So by looking at the patient not only as a patient in the very narrow sense but looking at the more holistically, ResMed for example has led the way in very substantially changing points in its sector. That's the kind of thinking we need to apply everywhere in healthcare because it's not just a specific issue in isolation in its own silo. We've got to look at the person and their lives on the challenges and the things that motivate them and connect all of those dots if we really want to make a difference.
: Yeah you know Colin, that's a great call out. This is a really interesting distinction that I think we need to keep in mind is if you make that slight adjustment in considering the patient as a consumer, all of a sudden the walls of limitation that you restrict yourself with perhaps subconsciously on on what you can do for this patient. They get knocked down and ResMed did. And you know Colin team are doing. Your imagination can go beyond the typical to create solutions that actually make an impact on these patients. Super interesting discussion here, Colin. Can you give us an example of how you guys have improved outcomes through the things that you're working on?
: Sure absolutely. So one of the products we developed and which is now in the market is the sleep score Max and that started life as a very sophisticated advanced technology which accurately measure a sleep outside of the sleep lab. So the benefit of that is you place it beside your bed. The consumer doesn't need to wear anything and therefore the measurements itself doesn't influence the thing we're trying to measure which is really critical when it comes to sleep. You don't want some same stop to some part of your body waking you up in the middle of the night that's not a good idea.
: Picturing that column like, you know I'm thinking okay, how am I going to, you have something attached to you kind of like when you do in a sleep lab in a hospital. It affects the psychology of the sleep. Now this is a device that sits on your bedside. You could do it at home?
: Yes you can do it at home. It's designed for use of home but we've done a lot of the research in hospitals and it's a essentially a I think about the principle that a bat uses. So it's a radio frequency technology, a very low power radio wave is a middle man bounces off the surface of your body and it turns to the device. So we send one of those waves out 16 times per second on the clock.
: And you have to be in the room by yourself right. You can't be there with your significant other.
: Absolutely not. We designed this particular technology so that we can zero in on the person we want to measure..
: Is that right? That's pretty cool. Okay, alright.
: So in situations where they work which is about 75 percent of situation people sleeping together you can see very very clearly with very high acuity the sleep of the person that we actually want to monitor and with that, we have built a whole series of devices which we give based on the specific circumstances which we form. So in addition to the sleep quality we also collect information on the room environment, the temperature of the light levels the background noise levels because they all influence sleep, right. We also collect some information from the user about their lifestyle so caffeine consumption, alcohol consumption, stress, exercise, those kinds of things.
: And these are manual manual inputs?
: Yes some are manual. Some are connected for example to health kits so we collect data from a variety of sources to make it as easy as possible for the customer. And our goal is to use that data to then understand well what seems to be the significant issue around sleep for this particular person and based on the issue we find we don't have a whole series of curated advice which is all based on a review of approximately 600 clinical papers in the space and we have as a result literally millions of variations of advice which are customized and personalized and given to the person that needs them based on the data.
: Very cool.
: What that's delivered in some of our early studies is a significant improvement in sleep duration and sleep quality particularly for people who have poor sleep at the beginning. So we've seen for example that approximately 50% of users improve their sleep duration after a few weeks by as much as 45 minutes per night.
: Now to put that into context, there are some studies which show that the impact for example of using prescription sleeping pills long term improves sleep duration by as little as eight to 13 minutes. So I think what we're finding is..
: Not very impactful.
: Not as impactful as we would all hope. We all know that these interventions are not really designed for long term use. What we do know that there are lots of people who are using them for the long term. So you know really again the issue here is trying to understand. In truth the consumer, their sleep their sleep environment the actual truth behind that at a level which the consumer can't recall any discussion with their doctor and even if they could recall, the doctor would struggle to have the time necessary to listen them, to really try to interpret all of that.
: Super fascinating and very intrigued Colin. So this is something that any consumer can pick up so they can go to your site and purchase one?
: Yes. You go right ahead to sleepscore.com. And there you can purchase the device. You can also purchase it from our partners at Pottery Farm at Westown. Put sleepscore.com and inside there you find all the information about how the technology works. And I was going to say one thing which I think is important. It takes a team of experts to make this happen. I mentioned this in the beginning in terms of partnership. So within the organization, we have a tremendous team of people who are really passionate about making a difference to sleep health and they includes sleep experts and researchers. We also partner with lots of people outside the company. So our advisory board is made up of some of the best leaders in sleep health around the world and in addition to that, ResMed, which is a significant investor in this joint venture is probably the biggest single investor in the research around the world. So we're really trying to take advantage through this broader team of the latest knowledge and the latest information in science and bringing that to the consumer and vice versa as we collect more and more data. So we now have about 4 million nights of sleep data broken down 30 seconds by 30 seconds there all night long with all of that data.
: Pile of data.
: Yeah exactly. So we're using that data already to begin to advance the science and that's what we hope to do.
: That's so awesome Colin and super intriguing right. So listeners, we have an opportunity for you to really take your sleep to the next level. If you are serious about your performance whether it be business, whether it be athletic, whether it be just family quality of life. Sleep is key. So measure it to improve it. Check out that link. We're going to provide it here in the show notes for you to check out Colin's devices here, things that you could do at the home. And just like we've talked about in the past about mental health. Right. This is one of the key areas sleep, mental health. They are not being measured the way they should be and with folks like Colin, making waves here in the space to allow us to do the measurements required, we're going to be able to get better sleep better mental health. So really love this. Colin, Can you share with us a time when you made a mistake or failed and what happened?
: There's quite a few of those I have to admit there are quite a few. So I'm afraid I graduated originally from Trinity College in Dublin but then for the rest of my life I really have graduated from the school Knox. All joking aside there. You know when I try to reflect on that question I think probably the one most relevant for this discussion and it was a time when we at the early stage of the development of this technology, we partnered with another company to bring a consumer sleep monitoring solutions to the markets and we bring it to the market. However it felt really in commercial terms. And what did we learn from that is the question you've asked think we learned two things. The first one was nobody really is interested in monitoring per se. It's really about why you're monitoring and what you can do with that and people are interested in improving their sleep. They're not really interested in the measurements step although it's a critical necessary step, it's not the outcome it's not the benefit. So I think we learned very clearly that bringing a monitoring solution to the market is absolutely not going to work in many many other companies abroad. Various monitors and trackers to the market and we can all see what's happening. It is not really a huge degree of interest. What is interesting is how do we improve my sleep. How do I improve my health, how do I improve my life and that requires something way more than a monitor, surely an accurate starting point is essential and monitoring is essential. But it isn't enough in itself. That was one to learning in the second. Learning which I think is probably resonates to lots of the people who are listening today. Partnering is not easy and it's essential because increasingly we really reach out and we want to make a difference to a large number of people. There are very few companies in the world that can do that alone. So partnering is essential. However it's not easy. So what that means is depending on the relationship you have with your partner. If it isn't close enough if it isn't strategically aligned enough then it's going to be really hard to make your way through the various challenges which occur in partnering because you're not necessarily 100 percent aligned. And as things don't work out, how you respond is influenced by your alignment so I think the two lessons for me are when you're partnering with somebody, spend the time off front to make sure that you really deeply are strategically aligned if you're tied to something very very important because it's not going to work out exactly as you expect and you need to be strategically aligned if you're going to see your way through that. The second issue is monitoring per se is not enough even though it's important step.
: Wow Colin, you walked us through some very valuable experiences and you're right, you know in health care we can't do it alone and we definitely have to partner. You've offered some really sound advice so listeners you may want to rewind and relisten to that. So I definitely will be Colin and then the other part 2 is is how we position our technologies. You know folks people don't want to know how the airplane works and what gadgets are used to keep you on track. They want to be on the island experience paradise. Just like with the technology that Colin had he he had this technology that was monitoring people it was cool, it was savvy but people don't care about that. They care about the quality of their sleep. So as we develop product as healthcare leaders, it's important that we focus on the island rather than the airplane. So what a wonderful point that you shared there with us Colin. And one that that healthcare entrepreneurs and business executives should be keeping up the top of their mind. Really appreciate you sharing that.
: Cheers some. My pleasure.
: So tell me you took us to the learnings. Tell us about one of the proudest moments you've had in the healthcare business?
: I think almost anything that I did at ResMed is definitely proud. That company just published its latest quarterly results if you haven't looked. Take a look. It's amazing. So they now have aboat 14 million patients that they support true sleep in one way or another every night.
: approximately four plus million of those patients are connected. So every breath is now monitored, every night it's the largest connected infrastructure in the world and they use the data to help the patients or the consumer to understand their own sleep and to motivate them. For people who are experiencing issues they have a whole bunch of services which are nodes are never true. Consumer friendly applications. I think that's the direction of the future. So any of my time would ResMed was proud from beginning to end. Proudest I think is the work we're doing at the moment. Right now it's still in progress and over the next couple of months more and more of that will unfold. But certainly it's a really amazing space to be working on. What we truly believe we're trying to do is to make a difference to people's lives and in so doing, if we can just simply move the needle for a large number of people by as little as 10 or 20 minutes every night we can make a huge difference to how they feel, how they perform, their relationships long term. So their long term health because we absolutely know and the data's mounting all the time. Doctors have direct correlation between sleep deprivation and pretty much every major chronic disease. So we believe passionately that we can move the needle a tiny bit for a large number of people we can make an enormous difference where we're proud of that but we're not too proud because we have to get it out into the market fully and make sure it's working fully before we can take a breath and take some credits.
: That is so awesome. Colin and you know I'll tell you what. We had our first son about 15 months ago.
: Thank you. It's been a blessing and it's also tough right. Because when they're growing up this sleep thing. And you know since he came. We've been definitely more focused on sleep how to get it how to help him get it. Because if he gets that we get it right?
: Right, absolutely.
: So we've been diving deep into this column and sort of the room and the sound, noise machines and temperature and all these things. So what you're saying is really resonating with me as I'm sure it's resonating with a lot of folks listening. I'm so intrigued with this. I think the vision that you and your team have is a highly impactful and inspiring one so kudos to you for this mission that you have in your hands. I think that you're definitely going to make a big impact. So congrats to you and your team.
: Thanks Saul. And if you could see me on Irish fair skin and blushing and also it's not it's not just you like you said it's not me. It's a team. We are on a mission. There's no doubt about that. What is a team. It takes a team to make anything like this happen. And hopefully we can make that difference in the points you make about your son and are so so key because what you teach your son about sleep now is going to impact him positively for the rest of his life. We know that sleep habits and habits are learned young. We also know that in childhood many many issues for example. And this is one of the great things we get talked to lots of people in lots of spaces where sleep intersects it intersects with almost everything. One of the great leaders doing research for example in A.D.H.D has told me that in almost 50 percent of children being diagnosed with A.D.H.D today do not have A.D.H.D. They have poor lifestyle.
: For example number that's a big number right?
50%, 5 0?
5 0 percent. So that's five zero percent.
Even if it's anything close to that number what that means is we got a whole bunch of kids who are actually being medicated for an illness they don't have and the medication causes sleep problems and those sleep problems exacerbate the underlying behavioral problems and so there is a absolutely a relationship between all these things. You know what we hope to do over time is to make more and more data available to help more and more people to understand what's going on and over time that will eventually help. So when you're thinking about your own son and his growing up I think you're spot on. Think about his sleep house. If you can help him with that, he will be happier. He'll perform better. He'll have less problems as he grows up and for the long term to be healthier.
: That is so fascinating. You know Colin I'm definitely going to have to pick up one of these things. Now take a look at sleepscore.com and you'll see the device it's it's actually quite aesthetically pleasing and very very reasonable price sleepscore.com. Definitely will be picking one of these up great great message here. Tell us about an exciting project this is an exciting project to begin with but is there is there a slice within what you're doing now. That's very very exciting that you want to share with us.
: There sure is. All right now we have been with our customers help. We have been measuring the impact of interventions on sleep. So we have approximately so far 40 thousand users approximately four million nights of sleep data and those users have very kindly shared with us things like what mattress they use, what pillows they use, what interventions they use and that's given us a really clear baseline for sleep quality mattress type, mattress brand and so forth all these things we're learning. Now what we've then been doing is we've been partnering with a large number of companies who offer solutions for all sorts of sleep issues from snoring through to basic comforts. And we've been measuring those solutions so our customers volunteered to be part of a small pilot study where we measure essentially the before and after impact of a given solution. So what that's helping us to do is to learn about what actually helps to improve sleep or in some cases disimprove sleep. And I think that's probably one of the most exciting things because right now the consumer spends about 60 billion dollars on all sorts of stuff to improve their state. Now the problem is we believe that probably half of it doesn't work. The other half of it is maybe purchase swipe the wrong people because of course we don't understand their sleep so we have found in our data set that we ask our users when they sign up what do they think their major sleep issue is and they tell us and then we measure their sleep in objective terms for a week or two. And what we discover is almost 85 percent of people doesn't issue wrong. In other words they weren't really clear as to what their real issue was and that kind of just goes to the very point of talking from we talked about which is people are unconscious for the process of sleep. So they find it impossible to objectively measure them track it. And therefore it's really hard for them to understand what exactly is their issue. So they just know they're sleepy they just know they're tired they just know they're not at their best. Some think it's just aging. It's not survey sleep changes with age but it doesn't have to be that we are all you know slower and more tired more miserable as we age. We can still have a great sleep health but people don't understand where to start because they don't solve the problem. And I think if we can really uncover how these interventions work or don't work we can then connect consumers to the appropriate solution which bypasses all the trial and error that currently goes on and unfortunately during that trial and error process for many consumers they give up because they've tried 4 5 6 interventions and they don't work or they feel they don't work and they give up and that's what we want to try and deal with. It's this kind of nihilism which is coming from trying to make something better failing and then not knowing what to do next.
: Super fascinating Colin so I really have enjoyed this discussion. It's been so much fun especially because sleep is so important for all of us. I think the listeners definitely are getting a lot here as well. Let's pretend you and I are building a medical leadership course on what it takes to be successful in sleep and it's 101 of Colin Lawlor. So I'm going to ask you four questions followed by your favorite book that you recommend to the listeners. You ready?
: I'm all set. Thanks Saul.
: All righty. What's the best way to improve sleep. Health care outcomes?
: Well I think the first thing is to be aware of it and then start with the inputs. So learn about it objectively measure it and start from there because you can only improve an outcome if you know what you're measuring.
: Totally. What's the biggest mistake or pitfall to avoid?
: I think the biggest mistake is to avoid a very narrow focus and instead to more broadly connect with the consumers to understand what's truly going on, it's really hard to deliver an outcome if you misdiagnose the issue and it's really easy to misdiagnose the issue. If you don't have enough information.
: Beautiful how do you stay relevant as an organization despite constant change?
: I think that's a really simple one you've got a push to change yourself so if you're not leading you're following. So you've got a leash. And so if you're not a driver of the change yourselves you're going to struggle.
: Love that. What's one area of focus that should drive everything in an organization?
: I personally think it's the mission and it's down to Why are we doing this. What difference are we trying to make. And in our case it's about trying to make a real difference to the quality of people's sleep. We if know we can do that. We can reduce accidents improves proves our mood, reduce long term chronic diseases and that's a very powerful take. So our focus is really being clear on the mission. Why do we. Why are we trying to do this.
: What's your all time favorite book column that you recommend to the listeners?
So you give me a perfect segue. It's actually Start With Why by Simon Sinek. So if you've not read the book you at least go and watch his TedTalk, it's awesome. We'll start with why I think it's so inspiring. The book itself opens with the statements which kind of traps you and then then he delivers a really big surprise. This all happens on the first page and from then on he captivates you. The issue at the very heart of it is why are we doing this. That's what matters. If we can't understand why, then what we do and how we do it we can figure out what it's all about the motivation. If we can stay singularly focused on the mission we can make a difference in that space. I think that's what drives success for companies. We'll see. That's certainly at the heart of what we're trying to do.
: Beautiful. Listeners, don't worry about writing any of this down the entire transcript that we've discussed will be available along with the show notes and links to the things that we've discussed just go to outcomesrocket.health/sleepscore and you'll be able to find all of that there. Before we conclude Colin. I'd love if he could just share a closing thought and then the best place for the listeners could get in touch or follow you.
: I think at the end of the day for me it's about whatever you do whether you measure your sleep or you don't measure your sleep or at least think about it, sleep is not for wimps sleep is actually the latest newest performance enhancing drug which is actually good for us to find us. You'll find us at sleepscore.com and you'll also find me at LinkedIn Colin Lawlor C O L I N L A W L O R. We'd be delighted to connect with anybody that can help on the mission or if we can help you in research.
: Outstanding. Thank you so much for your time. This has been a brilliant episode and we have you to thank for that. Appreciate it. Looking forward to staying in touch.
: Thank you Saul take care.
Thanks for tuning in to the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to outcomesrocket.health. And again don't forget to check out the amazing healthcare Thinkathon where we can get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is "implementation is innovation". Just go to outcomesrocket.health/conference that's outcomesrocket.health/conference. Be one of the 200 that will participate. Looking forward to seeing you there.
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