Patent Publication Number: US-2015073289-A1

Title: System and method for sleep disorder diagnosis and treatment

Description:
TECHNICAL 
     This patent application relates to computer-implemented software and networked systems, according to one embodiment, and more specifically to a system and method for sleep disorder diagnosis and treatment. 
     COPYRIGHT 
     A portion of the disclosure of this patent document contains material that is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction of the patent document or the patent disclosure, as it appears in the Patent and Trademark Office patent files or records, but otherwise reserves all copyright rights whatsoever. The following notice applies to the software and data as described below and in the drawings that form a part of this document: Copyright 2012-2013 Melissa Susan Lim, All Rights Reserved. 
     BACKGROUND 
     Sleep disorders are extremely common in the general population, with estimates of 15 million adults in the U.S. with persistent insomnia, and another 24 million adults and children suffering from obstructive sleep apnea. The current model of care is for people to seek consultation with their primary care doctor first about their sleep issues. From there, people are referred tier sleep studies, sleep specialists, or given medications. Treatment is often delayed, involves potentially habit-forming if medications, or is too expensive to pursue. 
     Smartphones are becoming the predominant link between data and people. Most current smartphones provide a capability to use mobile software applications (apps). A mobile software application (app) can embody a defined set of functionality and can be installed and executed on a mobile device, such as a smartphone, a tablet device, laptop computer, or other form of mobile computing or communications device. Conventional mobile apps are available that focus on one narrow aspect or another of different sleep problems. However, these conventional mobile apps do not integrate a set of diagnostic and therapeutic tools to fully assess and treat a user&#39;s sleep disorder. For example, current systems do not integrate a user&#39;s sleep history in a diagnostic and treatment system. Additionally, one may find a mobile app that plays soothing music, or another that wakes the user up at a particular time, or another that records snoring. However, these systems cannot combine data obtained in a diagnostic phase for use in a sleep disorder treatment phase. 
     SUMMARY 
     The various embodiments described herein offer a solution to the problems identified above by providing an interactive interview with the user, then guiding users to possible sleep disorder diagnoses and treatments. If the user shows signs of insomnia, the app instructs the use in behavioral therapy, provides a sleep log tool to monitor progress, and gives feedback to the user about their progress, following established clinical guidelines for treatment. If the user shows signs of obstructive sleep apnea, the user may employ the breathing disturbance monitoring device described herein to measure respiratory patterns at night. Screening studies for sleep apnea are integrated within the app itself. All the tools contained in the various embodiments described herein educate the user about their sleep problem and provide immediate assistance with ease of use and for a low cost. 
     The various embodiments described herein provide a software application that includes among the following features:
         a. An automated and prompted sleep interview similar to an interview a patient might receive in a doctor&#39;s office.   b. Feedback to the user based on the user&#39;s answers in the prompted sleep interview.   c. Guidance through behavioral treatment programs, including Stimulus Control Therapy and Sleep Restriction Therapy. The treatment programs for a particular user are customized and based on information gathered from the user and diagnoses automatically determined from the prompted sleep interview.   d. A sleep log meter so the user can keep track of sleep patterns in quantitative way.   e. Soundscapes to assist the user to achieve a relaxed state before bed and whenever the user cannot fall asleep.   f. Automated information presentations that describe possible sleep diagnoses in more detail, typical diagnostic tests, various treatment options, and the five closest sleep centers to the user&#39;s location.   g. Rewards Center where the user can redeem points collected for keeping sleep logs or for completing other actions to which incentives are tied. The user can redeem points for prizes, such as animal dream totems, exclusive musical recordings, additional soundscapes, and the like.   h. Breathing Disturbance Meter integration, which measures respiratory breathing patterns at night to screen for possible obstructive sleep apnea.   i. All graphs and questionnaires may be exported as PDF files and emailed to the user and/or a doctor.   j. The diagnostic and treatment features of the various embodiments were designed by a board certified sleep specialist.       

     The combinations of features described and claimed herein do not exist in an integrated and coordinated manner in any other app or software product with as single focus to help more people at the lowest cost possible to sleep better and therefore perform better. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The various embodiments are illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings in which: 
         FIG. 1  illustrates an example embodiment of a sleep disorder diagnosis and treatment system as at hosted application; 
         FIG. 2  illustrates an alternative example embodiment of a sleep disorder diagnosis and treatment system as to downloaded application; 
         FIG. 3  illustrates an example embodiment, implemented as a mobile device application (mobile app), that shows to home display screen of the user interface of the example embodiment; 
         FIG. 4  illustrates an example embodiment, implemented as to mobile app, which shows an initial questionnaire display screen of the user interface of the example embodiment; 
         FIGS. 5 through 8  illustrate an example embodiment, implemented as a mobile app, which shows various questionnaire display screens of the user interface of the example embodiment; 
         FIG. 9  illustrates an example embodiment, implemented as a mobile app, which shows a stimulus control therapy display screen of the user interface of the example embodiment; 
         FIG. 10  illustrates an example embodiment, implemented as a mobile app, which shows a sleep restriction therapy display screen of the user interface of the example embodiment; 
         FIGS. 11 and 12  illustrate an example embodiment, implemented as a mobile app, which shows sleep log display screens of the user interface of the example embodiment; 
         FIG. 13  illustrates an example embodiment, implemented as a mobile app, which shows a soundscape display screen of the user interface of the example embodiment; 
         FIGS. 14 through 16  are processing flow charts illustrating an example embodiment of a method as described herein; 
         FIGS. 17 and 18  illustrate charts of the breathing patterns of a patient as captured by the breathing disturbance metering system of an example embodiment; 
         FIG. 19  illustrates an example embodiment of the components of the breathing disturbance metering system of an example embodiment; 
         FIG. 20  illustrates the thoracic cage of a human and the relative placement of the breathing disturbance metering system of an example embodiment; 
         FIGS. 21 through 25  illustrate an example embodiment, implemented as a mobile app, which shows various report display screens of the user interface of the example embodiment; 
         FIG. 26  illustrates another example embodiment of a networked system in which various embodiments may operate; 
         FIG. 27  is a processing flow chart illustrating an example embodiment of a method as described herein; and 
         FIG. 28  shows a diagrammatic representation of machine in the example form of a computer system within which a set of instructions when executed may cause the machine to perform any one or more of the methodologies discussed herein. 
     
    
    
     DETAILED DESCRIPTION 
     In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the various embodiments. It will be evident, however, to one of ordinary skill in the art that the various embodiments may be practiced without these specific details. 
     In the various embodiments described herein, a system and method for sleep disorder diagnosis and treatment are disclosed. The various embodiments provide the ability to integrate a set of diagnostic and therapeutic tools to fully assess and treat a user&#39;s sleep disorder in a convenient and low cost mobile platform. In various embodiments described in detail below, a software application program is used to generate and enable the sleep disorder diagnosis and treatment system interface using a computer system, a web appliance, and/or a mobile device. As described, in more detail below, the computer or computing system on which the described embodiments can be implemented can include personal computers (PCs), portable computing devices, laptops, tablet computer personal digital assistants (PDAs), personal communication devices (e.g., cellular telephones, smartphones, or other wireless devices) network computers, set-top boxes, consumer electronic devices, or any other type of computing, data processing, communication, networking, or electronic system. 
     A mobile version of an example embodiment provides a user-friendly interface from which the user can easily view and interact with the various information presentations and prompts from a mobile device. As described in more detail below, a mobile software application (app) embodying; a mobile version of an example embodiment as described herein can be installed and executed on a mobile device, such as a smartphone, a tablet device, laptop computer, or other form of mobile computing or communications device. In another embodiment, a website can be used as a hosted service provider without installing any software on the mobile device. In this embodiment, a user can use the features described herein just by directing a browser to the website host through the use of the preinstalled or installed browser. These embodiments are described in more detail below. In an example embodiment, a splash screen appears whenever the user opens or launches the mobile application on the mobile device. This splash screen displays a host logo while opening the login screen or the live feed. 
     User log-in functionality in the mobile app provides a user-friendly user interface in which the user provides the email address and password associated with the user account. If the user does not have an account, the user can create an account from this user interface. The process of creating a user account is simple and only requires the user to provide the following information: name, surname, e-mail address, and password. By completing this information, the user can create an account and get access to customized sleep disorder diagnosis and treatment information. 
     Referring now to  FIG. 1 , in an example embodiment 100, a system and method for sleep disorder diagnosis and treatment are disclosed. In one example embodiment, an application or service, typically provided by or operating on a host site (e.g., a website)  110 , is provided to simplify and facilitate the downloading or hosted use of the sleep disorder diagnosis and treatment system  200  of an example embodiment. In a particular embodiment, the sleep disorder diagnosis and treatment system  200  can be downloaded from the host site  110  by a user at a user platform  140 . Alternatively, the sleep disorder diagnosis and treatment system  200  can be hosted by the host site  110  for a networked user at a user platform  140 . The details of the sleep disorder diagnosis and treatment system  200  of an example embodiment are provided below. 
     Referring again to  FIG. 1 , the sleep disorder diagnosis and treatment system  200  can be hosted by host site  110  and be in network communication with a plurality of user platforms  140 . The host site  110  and user platforms  140  may communicate and transfer data and information in the data network ecosystem  100  shown in  FIG. 1  via a wide area data network (e.g., the Internet)  120 . Various components of the host site  110  can also communicate internally via a conventional intranet or local area network (LAN)  114 . 
     Networks  120  and  114  are configured to couple one computing device with another computing device. Networks  120  and  114  may be enabled to employ any form of computer readable media for communicating information from one electronic device to another. Network  120  can include the Internet in addition to LAN  114 , wide area networks (WANs), direct connections, such as through an Ethernet port or a universal serial bus (USB) port, other forms of computer-readable media, or any combination thereof. On an interconnected set of LANs, including those based on differing architectures and protocols, a router and/or gateway device acts as a link between LANs, enabling messages to be sent between computing devices. Also, communication links within LANs typically include twisted wire pair or coaxial cable, while communication links between networks may utilize analog telephone lines, full or fractional dedicated digital lines including T1, T2, T3, and T4, Integrated Services Digital Networks (ISDNs), Digital Subscriber Lines (DSLs), wireless links including satellite links, or other communication links known to those of ordinary skill in the art. Furthermore, remote computers and other related electronic devices can be remotely connected to either LANs or WANs via a wireless link, WiFi, Bluetooth, satellite, or modem and temporary telephone link. 
     Networks  120  and  114  may further include any of as variety of wireless sub-networks that may further overlay stand-alone ad-hoc networks, and the like, to provide an infrastructure-oriented connection. Such sub-networks may include mesh networks, Wireless LAN (WLAN) networks, cellular networks, and the like. Networks  120  and  114  may also include an autonomous system of terminals, gateways, routers, and the like connected by wireless radio links or wireless transceivers. These connectors may be configured to move freely and randomly and organize themselves arbitrarily, such that the topology of networks  120  and  114  may change rapidly and arbitrarily. 
     Networks  120  and  114  may further employ a plurality of access technologies including 2nd (2G), 2.5, 3rd (3G), 4th (4G) generation radio access for cellular systems. WEAN, Wireless Router (WR) mesh, and the like. Access technologies such as 2G, 3G, 4G, and future access networks may enable wide area coverage for mobile devices, such as one or more of client devices  141 , with various degrees of mobility. For example, networks  120  and  114  may enable a radio connection through as radio network access such as Global System for Mobile communication (GSM), General Packet Radio Services (GPRS), Enhanced Data GSM Environment (EDGE), Wideband Code Division Multiple Access (WCDMA), CDMA2000, and the like. Networks  120  and  114  may also be constructed for use with various other wired and wireless communication protocols, including TCP/IP, UDP, SIP, SMS, RTP, WAP, CDMA, TDMA, EDGE, UMTS, GPRS, GSM, UWB, WiFi, WiMax, IEEE 802.1 ix, and the like. In essence, networks  120  and  114  may include virtually any wired and/or wireless communication mechanisms by which information may travel between one computing device and another computing device, network, and the like. In one embodiment, network  114  may represent a LAN that is configured behind a firewall (not shown), within a business data center, for example. 
     The sleep disorder diagnosis and treatment system can be implemented using any form of network transportable digital data. The network transportable digital data can be transported in any of a group of file formats, protocols, and associated mechanism usable to enable a host site  110  and a user platform  140  to transfer data over a network  120 . In one embodiment, the data format for the user interface can be HyperText Markup Language (HTML). HTML is a common markup language for creating web pages and other information that can be displayed in a web browser. In another embodiment, the data format for the user interface can be Extensible Markup Language (XML). XML is a markup language that defines a set of rules for encoding interlaces or documents in a format that is both human-readable and machine-readable. In another embodiment, a JSON (JavaSeript Object Notation) format can be used to stream the interface content to the various user platform  140  devices. JSON is a text-based open standard designed for human-readable data interchange. The JSON format is often used for serializing and transmitting structured data over a network connection. JSON can be used in an embodiment to transmit data between as server, device, or application, wherein JSON serves as an alternative to XML. 
     In at particular embodiment, a user platform  140  with one or more client devices  141  enables a user to access data and provide data for the sleep disorder diagnosis and treatment system  200  via the host  110  and network  120 . Client devices  141  may include virtually any computing device at is configured to send and receive information over a network, such as network  120 . Such client devices  141  may include portable devices  144 , such as, cellular telephones, smartphones, display pagers, radio frequency (RE) devices, infrared (IR) devices, global positioning devices (GPS), Personal Digital Assistants (PDAs), handheld computers, wearable computers, tablet computers, integrated devices combining one or more of the preceding devices, and the like. Client devices  141  may also include other computing devices, such as personal computers  142 , multiprocessor systems, microprocessor-based or programmable consumer electronics, network PC&#39;s, and the like. Client devices  141  may also include other processing devices, such as consumer electronic (CE) devices  146  and/or mobile computing devices  148 , which are known to those of ordinary skill in the art. As such, client devices  141  may range widely in terms of capabilities and features. For example, a client device configured as a cell phone may have a numeric keypad and a few lines of monochrome LCD display on which only text may be displayed. In another example, as web-enabled client device may have a touch sensitive screen, a stylus, and many lines of color LCD display in which both text and graphics may be displayed. Moreover, the web-enabled client device may include a browser application enabled to receive and to send wireless application protocol messages (WAP), and/or wired application messages, and the like. In one embodiment, the browser application is enabled to employ HyperText Markup Language (HTML), Dynamic HTML, Handheld Device Markup Language (HDML), Wireless Markup Language (WML), WMLScript, JavaScript, EXtensible HTML (xHTML), Compact HTML (CHTML), and the like, to display and/or send digital information. In other embodiments, mobile devices can be configured with applications (apps) with which the functionality described herein can be implemented. 
     Client devices  141  may also include at least one client application that is configured to send and receive content data or/or control data from another computing device via a wired or wireless network transmission. The client application may include as capability to provide and receive textual data, graphical data, video data, audio data, and the like. Moreover, client devices  141  may be further configured to communicate and/or receive a message, such as through an email application, a Short Message Service (SMS), direct messaging (e.g., Twiter), Multimedia Message Service (MMS) instant messaging (IM), internet relay chat (IRC), IRC, Jabber, Enhanced Messaging Service (EMS), text messaging, Smart Messaging, Over the Air (OTA) messaging, or the like, between another computing device, and the like. 
     As one option, the sleep disorder diagnosis and treatment system  200 , or a portion thereof, can be downloaded to a user device  141  of user platform  140  and executed locally on a user device  141  (e.g., see  FIG. 2  described below). The downloading of the sleep disorder diagnosis and treatment system  200  application (or a portion thereof) can be accomplished using conventional software downloading functionality. As a second option, the sleep disorder diagnosis and treatment system  200  can be hosted by the host site  110  and executed remotely, from the user&#39;s perspective, on host system  110 . In one embodiment, the sleep disorder diagnosis and treatment system  200  can be implemented as a service in a service-oriented architecture (SOA) or in a Software-as-a-Service (SAAS) architecture. In any case, the functionality performed by the sleep disorder diagnosis and treatment system  200  is as described herein, whether the application is executed locally or remotely, relative to the user. 
     Referring again to  FIG. 1 , the sleep disorder diagnosis and treatment system  200  of an example embodiment is shown to include a sleep disorder diagnosis and treatment system database  103 . The database  103  is used in an example embodiment for data storage of information related to the sleep disorder diagnosis and treatment of users, the sleep logs of users, communications between users and host representatives, shared documents, images, soundscapes, meta data, and the control data for managing the user interactions and the associated user interfaces. It will be apparent to those of ordinary skill in the art that the database  103  can be used for the storage of a variety of data in support of the sleep disorder diagnosis and treatment system  200  of an example embodiment. 
     Referring to  FIG. 2 , an alternative embodiment 101 is shown in which the sleep disorder diagnosis and treatment system  200  and associated database  103  can be downloaded and executed locally at a user device  141  of user platform  140 . In other embodiments, portions of system  200  and/or database  103  can be executed locally at a user device  141  of user platform  140  or executed remotely at the host site  110 , in each of these implementations, the functionality and structure of the sleep disorder diagnosis and treatment system  200  of an example embodiment is similar to the example embodiments described herein. 
     Referring again to  FIGS. 1 and 2 , an example embodiment is shown to include a sleep disorder diagnosis and treatment system  200 . Sleep disorder diagnosis and treatment system  200  can include a sleep disorder diagnostic module  210 , a sleep disorder treatment module  220 , a Breathing Disturbance Meter integration module  230 , a reports module  240 , a user account management module  250 , and an administrative management module  260 . Each of these modules can be implemented as software components executing within an executable environment of sleep disorder diagnosis and treatment system  200  operating on host site  110  or user platform  140 . Each of these modules of an example embodiment is described in more detail below in connection with the figures provided herein. 
     Referring again to  FIGS. 1 and 2 , the sleep disorder diagnosis and treatment system  200  of an example embodiment is shown to include a sleep disorder diagnostic module  210 . The sleep disorder diagnostic module  210  can be used to query information from a user and to use the information to make a sleep disorder diagnosis. In particular, the sleep disorder diagnostic module  210  can be used to present, prompt, and process user input on various user questionnaires. The user questionnaires include sleep-related interview questions and a STOPBANG questionnaire. The STOPBANG questionnaire screens for signs of Obstructive Sleep Apnea (OSA). STOPBANG is an acronym representing the symptoms that can be indicative of OSA: Snoring, Feeling Tired, Observed pauses in breathing, High blood Pressure, Body mass index greater than 35, Age greater than 50, Neck circumference greater than 40 cm (16 in), Male Gender, or post-menopausal female. Three or more positive answers from the user on the STOPBANG questionnaire are considered potentially indicative of OSA. 
     The sleep disorder diagnostic module  210  can be configured to generate a user interface to prompt a user for input on various questionnaires related to the user&#39;s sleep patterns. Based on the user&#39;s input, the sleep disorder diagnostic module  210  can determine whether or not the user is showing signs or symptoms of common sleep disorders. These questionnaires are not designed to provide a certain diagnosis. Rather, the sleep disorder diagnostic module  210  can process the user responses and automatically determine if the user is showing signs that suggest a possible sleep disorder or a possible sleep-related breathing problem. In this case, the sleep disorder diagnostic module  210  can signal the sleep disorder treatment module  220  to suggest particular sleep disorder treatments or OSA-related treatments. The sleep disorder diagnostic module  210  can be configured to store the user&#39;s responses to enable the user to share the responses later with a health care provider. The sleep disorder diagnostic module  210  can also be configured to use these questionnaires and related responses to start a discussion with the user&#39;s health care provider on associated sleep issues to determine whether a particular treatment is needed. If treatment is indicated, the sleep disorder treatment module  220  can be configured to recommend a type of treatment. 
     Referring now to  FIG. 3 , an example embodiment, implemented as a mobile device application (mobile app), shows a splash screen or home display screen of the user interface of the example embodiment. The home display screen is displayed on a user&#39;s mobile device when the mobile app is launched.  FIG. 4  illustrates an example embodiment, implemented as a mobile app, which shows an initial questionnaire display screen of the user interface of the example embodiment. The initial questionnaire display screen can be presented when the user activates a particular icon presented in the home display screen. 
       FIGS. 5 through 8  illustrate an example embodiment, implemented as a mobile app, which shows various questionnaire display screens of the user interface of the example embodiment. The series of questionnaires presented by the sleep disorder diagnostic module  210  prompt the app user for basic demographic information, such as age and date of birth. The various questionnaires also contain questions related to the user&#39;s sleep habits, such as the user&#39;s typical bedtime and whether the user takes any medications before bed. These are important questions that can affect the quality of sleep. The sleep interview presented and managed by the sleep disorder diagnostic module  210  serves as a starting point for a discussion and potential diagnosis of the user&#39;s sleep patterns. Based on the user&#39;s input, the sleep disorder diagnostic module  210  can determine whether or not the user is showing signs or symptoms of common sleep disorders. The sleep disorder diagnostic module  210  can signal the sleep disorder treatment module  220  to suggest to the user and/or select for the user particular sleep disorder treatments or OSA-related treatments. 
     Referring to  FIG. 8 , the sleep disorder diagnostic module  210  can also be used to present, prompt, and process user input on an Epworth Sleepiness Scale. The Epworth Sleepiness Scale (ESS) is a scale intended to assess daytime sleepiness that is measured by use of a very short questionnaire. The ESS measures how likely the user is to fall asleep as rated on a scale from 0 to 3, with 0 being not at all likely and 3 being very likely. A cumulative score of ten or higher on this scale suggests that the user is abnormally sleepy, and may point to an underlying sleep disorder. This can be helpful in diagnosing sleep disorders. The ESS was introduced in 1991 by Dr. Murray Johns of Epworth Hospital in Melbourne, Australia. 
     Referring again to  FIGS. 1 and 2 , the sleep disorder diagnosis and treatment system  200  of an example embodiment is shown to include a sleep disorder treatment module  220 . The sleep disorder treatment module  220  can be used to suggest to the user and/or select for the user particular sleep disorder treatments or OSA-related treatments based on the user responses captured and processed by the sleep disorder diagnostic module  210 . In an example embodiment, these sleep disorder therapies or treatments can include: 1) behavioral therapies, 2) stimulus control therapy (SCT), 3) sleep restriction therapy (SRT), sleep logs, and sleep efficiency assessments, and 4) soundscapes. These various therapies as implemented by the sleep disorder treatment module  220  of an example embodiment are described in more detail below. 
     Behavioral therapies are treatments that focus on changing a person&#39;s behavior in order to treat a condition. The goal of behavioral therapy is to reinforce beneficial behaviors and discourage behaviors that are harmful or unhelpful. Behavioral therapies encourage the user to create healthy habits and to break unhealthy ones. 
     Behavioral therapy for insomnia may include a cognitive component, and thus is termed Cognitive Behavioral Therapy, or CBT. CBT is designed to change behaviors by focusing on how people think and feel about their behaviors and their disorder. CBT is meant to address negative emotions, such as anxiety or depression that may be associated with having a disorder, CDT also explores the thought processes that people go through while engaging in unhealthy behaviors and habits, which may indicate why they engage in those behaviors. The goal of CBT is to address the root causes of unhealthy behaviors and habits (i.e., negative emotions and thought processes), so that these behaviors can be replaced by healthier, more positive ones. The sleep disorder treatment module  220  can be used to guide the user through various CBT treatments based on the assessment of their condition as determined by the sleep disorder diagnostic module  210 . The example embodiment focuses on behavioral therapies because these therapies are safer and longer-lasting than sleep medications, and may be started or re-started at any time. In contrast to some types of sleeping pills or other medications, behavioral therapy does not result in a “tolerance” that limits continued benefit. The sleep disorder treatment module  220  recognizes that changing established behaviors is very difficult. That&#39;s why the app provides positive feedback to encourage users to keep trying. The sleep disorder treatment module  220  includes several therapies that teach users to help themselves sleep better. The sleep disorder treatment module  220  also presents, prompts, and retains sleep logs so users can keep track of their sleep disorder treatment progress. The sleep logs and the related reports are generated by the sleep disorder treatment module  220  and the reports module  240 . The goal of the various embodiments and treatment strategies is to help increase the quality of sleep in meaningful and lasting ways. 
       FIG. 9  illustrates an example embodiment, implemented as a mobile app, which shows a stimulus control therapy display screen of the user interface of the example embodiment. As part of the treatment or therapy options provided by the sleep disorder treatment module  220 , a Stimulus Control Therapy, or SCI, is used to treat insomnia. In the example embodiment, there are five main principles of SCT: 
     a. Go to bed when sleepy, not when you think you should go to bed. 
     b. Get out of bed when not sleeping. Do not stay in bed for more than 15-20 minutes, even if you are actively trying to sleep. 
     c. No naps. 
     d. Use bed and bedroom for sleep (or sexual intimacy) only. 
     e. Maintain a regular wake-up/get-up time (on weekdays, weekends, and holidays). 
     One of the goals of SCT is to help the user associate the bed and bedroom with sleep rather than the inability to sleep. Another goal is to help the user break habits that keep the vicious cycle of insomnia going, such as staying in bed half of the day to try to “catch up” on lost sleep. SCT helps the user to create new, healthy habits, and encourages the user to maintain a regular sleep/wake cycle. As part of this encouragement, the sleep disorder treatment module  220  guides the user through a set of display screens, information presentations, and prompts. For example.  FIG. 9  illustrates how the user can transition from the home display screen to a set of SCT display screens. The SCT display screen section allows the user to review the SCT guidelines and reminds the user of the guidelines before bedtime. The user is prompted to create, follow, and assess their sleep logs using SCT to determine if their sleep problems can be resolved with this treatment intervention. In a particular embodiment, the sleep logs can be accessed through the reports page. 
       FIG. 10  illustrates an example embodiment, implemented as a mobile apt), which shows a sleep restriction therapy display screen of the user interface of the example embodiment. As part of the treatment or therapy options provided by the sleep disorder treatment module  220 , a next level of behavioral therapy for insomnia is Sleep Restriction Therapy (SRT). SRT is a treatment program that uses controlled sleep deprivation as a therapy. Sleep deprivation is used as a tool to help the user fall asleep and stay asleep. In a typical treatment scenario as guided by the sleep disorder treatment module  220 , the user can begin by choosing an SRT program with seven hours of sleep a night or an SRT program with six hours of sleep a night. If the user has already started SRT and is in the middle of an SRT monitoring period, the user cannot start a new program. It will be apparent to those of ordinary skill in the art that SRT programs with other sleep time periods (e.g., other than six or seven hours of sleep as night) can also be implemented. As part of the SRT program, the user is prompted to set their desired wake-up time as guided by the sleep disorder treatment module  220 . Then, the sleep disorder treatment module  220  can assign a bedtime for the user that is six or seven hours prior to the desired wake-up time (depending on the SRT program time period selected by the user). The sleep disorder treatment module  220  can remind the user to wind down an hour before assigned bedtime, so that the user will be calm and not over-stimulated when they try to go to sleep. 
       FIGS. 11 and 12  illustrate an example embodiment, implemented as a mobile app, which shows sleep log display screens of the user interface of the example embodiment. As guided by the sleep disorder treatment module  220 , the user can enter their sleep log information by clicking on the right upper corner of a reports page screen presented by the reports module  240 . Each morning, the user can use the sleep log to indicate when they got into bed and when they got out of bed, and when they actually fell asleep and when they woke up. As shown in  FIG. 11 , the user can make these entries in the sleep log by sliding the icons along the bars as shown. Once the user enters this information, the steep disorder treatment module  220  can highlight in dark blue the hours the user was in the bed as shown in  FIG. 11 . If the user experienced awakenings in the middle of the night, the user may tap on each of the highlighted hour-long units individually to add details, such as the exact time the user woke up, how long the user was awake, and what occurred during each awakening, as shown in  FIG. 12 . Using all the information entered into the sleep log by the user, the sleep disorder treatment module  220  can calculate the user&#39;s sleep efficiency. In an example embodiment, the sleep efficiency can be calculated as the percentage of time the user was in bed relative to the time spent by the user actually sleeping. The goal for nominal sleep efficiency is a percentage equal to or greater than 85%. 
     Although improvement in sleep quality is the ultimate goal for most people, improvement in sleep efficiency is a primary goal. Sleep efficiency is the sleep feature directly changeable by changing a person&#39;s behavior. It turns out that for most people, improvement in sleep quality follows improvement in sleep efficiency. If this is not the case, then another sleep problem may be present, like OSA or another diagnosis. 
     Once the user achieves a consistent 85% sleep efficiency for two weeks as guided and monitored by the sleep disorder treatment module  220 , the user is prompted to lengthen their sleep period gradually. In support of this feature, the sleep disorder treatment module  220  can automatically prompt the user to go to bed 15 minutes earlier every two weeks. The SRT treatment is complete once the user reaches and maintains an 85% sleep efficiency and feels generally refreshed during the day. The user will have then learned how much sleep they need to feel refreshed. Not everyone needs the mythic “eight hours of sleep per night.” Some people need more sleep and others need less sleep. The sleep disorder treatment module  220  is designed to accommodate a variety of sleep patterns in a variety of different users. 
     The sleep disorder treatment module  220  is designed to be used as a sleep maintenance tool as well, even after improvement in sleep patterns is achieved. The sleep disorder treatment module  220  can prompt users to keep daily sleep logs. If the user&#39;s sleep efficiency begins to fall, the sleep disorder treatment module  220  can offer another round of SRT or other therapy, starting from the beginning. Also, if as seven hour sleep restriction period does not improve the user&#39;s sleep efficiency, the user can be offered a six hour sleep restriction period. 
     It is important to note that Sleep Restriction Therapy may make the user feel worse before feeling better. This is because the SRT treatment removes the current “sleep coping mechanism” being used, and replaces it with a specified sleep schedule purposely meant to initially cause sleep deprivation. If the user sticks with the SRT treatment program, the sleep deprivation lessens and the user will start sleeping and feeling better. In a particular embodiment, a Rewards Center is provided where the user can redeem points collected for keeping sleep logs or for completing other actions to which incentives are tied. The user can redeem points for prizes, such as animal dream totems, exclusive musical recordings, additional soundscapes, and the like. Additionally, an example embodiment can provide automated information presentations that describe possible sleep diagnoses in more detail, typical diagnostic tests, various treatment options, and the five closest sleep centers to the user&#39;s location. 
       FIG. 13  illustrates an example embodiment, implemented as a mobile app, which shows a soundscape display screen of the user interface of the example embodiment. The soundscape display screen offers the user a variety of selectable soundscapes that can be played when the user goes to sleep or awakens. The soundscapes are audio clips of calming sounds and relaxing music, as well as meditations to help the user relax at the beginning or end of their day. 
       FIGS. 14 through 16  are processing flow charts illustrating an example embodiment of a method as described herein. In the manner described above, the sleep disorder diagnostic module  210  and the sleep disorder treatment module  220  guide the user through a process of sleep disorder diagnostic assessment and sleep disorder treatment options customized for the particular user. As a result, the user achieves improved sleep efficiency. 
     Referring again to  FIGS. 1 and 2 , the sleep disorder diagnosis and treatment system  200  of an example embodiment is shown to include a breathing disturbance meter integration module  230 . The breathing disturbance meter integration module  230  can be used to detect an OSA condition in a patient. The breathing disturbance meter integration module  230  is in wireless data communication with a breathing disturbance metering system described in more detail below. 
     Because the vast majority of people with sleep apnea have not yet been diagnosed, two barriers to sleep apnea detection may be the cost and accessibility of testing. After interpreting thousands of sleep studies, both lab and home studies, the inventor herein determined that a patient&#39;s sleep apnea can be detected the majority of the time in a single abdominal effort channel, wherein the breathing patterns of a patient are captured by a breathing disturbance metering system. 
       FIGS. 17 and 18  illustrate charts of the breathing patterns of a patient as captured by a breathing disturbance metering system of an example embodiment. As shown in  FIG. 17 , a sleep apnea condition is a 90% or greater decrease in the breathing airflow of a sleeping person lasting ten seconds or longer. As shown in  FIG. 18 , a sleep hypopnea condition is a 30% or greater decrease in airflow (from an established baseline) lasting ten seconds or longer. By monitoring the breathing patterns of a sleeping person, the sleep apnea condition and sleep hypopnea condition can be detected. The breathing, disturbance metering system and breathing disturbance meter integration module  230  can be used to detect, measure, assess, and respond to the potential OSA conditions present in a patient being monitored. The details of this system in an example embodiment are described below. 
       FIG. 19  illustrates an example embodiment of the components of the breathing disturbance metering system  500  of an example embodiment. The breathing disturbance metering system  500  can include a chest expansion measuring device  510  and/or a movement detection device  520 . Breathing monitors are well-known in the art. The chest expansion measuring device  510  and/or the movement detection device  520  serve to detect the movements of the chest cavity during the normal breathing cycles of a person. Once the breathing disturbance metering system  500  is calibrated to the normal breathing patterns of a particular individual, the degree of chest cavity movement can correlate to the volume of air respired for each breath. As explained above, anomalies in the breathing patterns of a particular individual can correlate to variations in the degree of chest cavity movement in a series of breaths over is given time period. In an example embodiment, the movement detection device  520  can include a level that can measure degrees of movement up and down or side to side. 
     These variations in breathing patterns can be aggregated into a breathing disturbance index (BDI). Because the breathing disturbance metering system is not measuring airflow, we derived new terminology to guide the development of a device able to measure abnormalities of one&#39;s breathing pattern based on abdominal movements. Respiratory effort reduction events, or RERE&#39;s, are defined as a &gt;=30% reduction in amplitude of a preceding abdominal effort waveform, lasting 10 seconds or longer. A respiratory effort exaggeration event (REEE) is an increase in a respiratory waveform of 150% to 400% over baseline. A REEE is not counted if immediately adjacent to a RERE. 
     In the example embodiment, the BDI can be computed as follows: 
     
       
         
           
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     In an example embodiment, the breathing disturbance metering system  500  can use clock  540  to measure a start and stop time. Initially, the user can press a button on the device  500  to activate the device  500  when they retire to the bed. In the morning, the user can press a button to deactivate the device  500  after they wake up. After activation, the breathing disturbance metering system  500  can sample the user&#39;s breathing patterns over preconfigured time periods (sampling period). For example, the breathing disturbance metering system  500  can be configured to sample the user&#39;s chest cavity movement (i.e., breathing pattern) for a five minute sampling period. During this sampling time period, the breathing disturbance metering system  500  can record the user&#39;s breathing patterns and save this data in the memory  560 . At the end of the five minute sampling period, the breathing disturbance metering system  500  can enter a low power mode (rest period) to save power. At a configurable time later (e.g., 15 minutes), the breathing disturbance metering system  500  can start as new five minute sampling period during which a new set of breathing pattern data is gathered and retained in memory  560 . Each set of breathing pattern data is time stamped with the current or relative time/date. In this manner, the breathing disturbance metering system  500  can gather breathing pattern data for the user over the entire night. As the breathing pattern data for a particular user is gathered, the breathing disturbance metering system  500  can use the processor  550  to scan the data for patterns consistent with apnea or hypopnea conditions. The processor  550  can score any detected respiratory effort reduction or exaggeration condition (e.g., RERE or REEF) for as level of severity. The respiratory effort detection data and related scoring can also be stored in the memory  560 . It wilt be apparent to those of ordinary skill in the art that a variety of related data can also be generated and retained. It will also be apparent to those of ordinary skill in the art that different sampling periods and/or rest periods can be used for a particular embodiment. Periodically throughout the night or the following morning, the breathing disturbance metering system  500  can establish wireless data communications with the breathing disturbance meter integration module  230  and upload the data saved in memory  560  to a memory in the user platform  140 . A wireless transceiver and mobile device interface  570  is provided in the breathing disturbance metering system  500  to enable this data communication. An energy storage device (e.g., a battery)  580  is provided in the breathing disturbance metering system  500  to power the system. In a particular embodiment, a sound capture device (e.g., a microphone)  530  can be used to record the sounds made by the user during a sleep cycle. These sounds can include snoring, which can also be an indicator disrupted sleep. For example, a decibel variation in a periodic manner can be consistent with sleep disordered breathing. In this manner, the sleep disorder diagnosis and treatment system  200  of an example embodiment can obtain real-time data related to the sleeping patterns of a user and data related to potential OSA conditions present in a patient being monitored. 
       FIG. 20  illustrates the thoracic cage of a human and the relative placement of the breathing disturbance metering system  500  of an example embodiment. As shown in  FIG. 20 , the breathing disturbance metering system  500  can be positioned for data recording at the top of the user&#39;s abdomen with the top of the device positioned at the bottom of the user&#39;s sternum. The breathing disturbance metering system  500  can be held in place with a belt or straps  502 . 
     Referring again to  FIGS. 1 and 2 , the sleep disorder diagnosis and treatment system  200  of al example embodiment is shown to include a reports module  240 . The reports module  240  can be used to present information to a user in the form of tabular or graphical reports.  FIGS. 21 through 25  illustrate an example embodiment, implemented as a mobile app, which shows various report display screens of the user interface of the example embodiment. In support of a variety of tabular reports, the reports module  240  can present a Sleep Log Report showing a list of nightly summaries of information from the user&#39;s sleep logs, such as the time the user went to sleep, total number of awakenings during the night, and how long the user slept. The Activity Report shows a list of nightly details about nighttime awakenings, such as why the user woke up and how long the user was awake. 
     In support of a variety of graphical reports, the reports module  240  can present several report formats in the form of graphs. For example, the user can look at the number of awakenings and sleep efficiency on a nightly basis. The user can also look at the average number of awakenings and average sleep efficiency over a specified period of time. This allows the user to look at detailed nightly data, as well as trends, and determine whether or not progress is being made in a sleep disorder treatment program. 
     Referring again to  FIGS. 1 and 2 , the sleep disorder diagnosis and treatment system  200  of an example embodiment is also shown to include a user account management module  250 . The user account management module  250  can be used to create and maintain a user account with the sleep disorder diagnosis and treatment system  200 . The use account management module  250  can also be used to configure user settings, create and maintain a user/user profile, and otherwise manage user data and operational parameters for the sleep disorder diagnosis and treatment system  200 . In the example embodiment described herein, a user can register as an identified and authenticated user in order to interact with system  200  and receive sleep disorder diagnosis and treatment. The registered user can enter their name, email address, and other personal information. Once this information is entered, a user account is created and the user can interact with system  200  and receive sleep disorder diagnosis and treatment. 
     Referring again to  FIGS. 1 and 2 , the sleep disorder diagnosis and treatment system  200  of an example embodiment is shown to include an administrative management module  260 . The administrative management module  260  can be used by an agent of the sleep disorder diagnosis and treatment system  200  to manage user accounts and to manage the sleep disorder diagnosis and treatment system. The administrative management module  260  can also be used to enforce privacy protections and content controls for users. Moreover, the administrative management module  260  can also be used to generate and/or process a variety of analytics associated with the operation of the sleep disorder diagnosis and treatment system  200 . For example, the administrative management module  260  can generate various statistical models that represent the activity of the community of users and related, diagnoses and treatments. These analytics can be shared, licensed, or sold to others under strict privacy protections and/or as data that has been processed to remove personal user information. 
     Although the various user interface displays provided by the example embodiments described herein are nearly infinitely varied, several sample user interface displays and sequences are provided herein and in the corresponding figures to describe various features of the disclosed embodiments. These sample user interface displays and sequences are described herein and in the accompanying figures. It will be apparent to those of ordinary skill in the art that equivalent user interface displays and sequences can be implemented within the scope of the inventive subject matter disclosed and claimed herein. 
     Referring now to  FIG. 26 , another example embodiment 102 of a networked system in which various embodiments may operate is illustrated. In the embodiment illustrated, the host site  110  is shown to include the sleep disorder diagnosis and treatment system  200 . The sleep disorder diagnosis and treatment system  200  is shown to include the functional components  210  through  260 , as described above. In a particular embodiment, the host site  110  may also include a web server  404 , having a web interface with which users may interact with the host site  110  via a user interface or web interface. The host site  110  may also include an application programming interface (API)  402  with which the host site  110  may interact with other network entities on a programmatic or automated data transfer level. The API  402  and web interface  404  may be configured to interact with the sleep disorder diagnosis and treatment system  200  either directly or via an interface  406 . The sleep disorder diagnosis and treatment system  200  may be configured to access a data storage device  103  and data $08 therein either directly or via the interface  406 . 
     Referring now to  FIG. 27 , a processing flow diagram illustrates an example embodiment of a sleep disorder diagnosis and treatment system  200  as described herein. The system  800  of an example embodiment is configured to generate a first user interface for sleep disorder diagnosis, the first user interface including a plurality of questionnaires for prompting, user input on a plurality of queries related to a user&#39;s sleep patterns, at least one questionnaire including queries related to the user&#39;s potential Obstructive Sleep Apnea (OSA) condition (processing block  810 ); generate a second user interface for sleep disorder treatment, the second user interface including a plurality of sleep disorder therapies to guide the user through a particular sleep disorder therapy automatically selected for the user based on the user&#39;s responses captured and processed by the first user interlace, the second user interface being further configured to capture and retain a sleep log, the second user interface being further configured to generate a sleep efficiency assessment (processing block  820 ); and detect an OSA condition in the riser by use of a breathing disturbance metering system in wireless data communication with the first user interface and the second user interface (processing block  830 ). 
       FIG. 28  shows a diagrammatic representation of a machine in the example form of a computer system  700  within which a set of instructions when executed may cause the machine to perform any one or more of the methodologies discussed herein. In alternative embodiments, the machine operates as a standalone device or may be connected (e.g., networked) to other machines. In a networked deployment, the machine may operate in the capacity of a server or a client machine in server-client network environment, or as a peer machine in a peer-to-peer or distributed) network environment. The machine may be a personal computer (PC), a tablet PC, a set-top box (STB), a Personal Digital Assistant (PDA), a cellular telephone, a web appliance, a network router, switch or bridge, or any machine capable of executing a set of instructions (sequential or otherwise) that specify actions to be taken by that machine. Further, while only a single machine is illustrated, the term “machine” can also be taken to include any collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein. 
     The example computer system  700  includes a data processor  702  (e.g., a central processing unit (CPU), a graphics processing unit (GPU), or both), a main memory  704  and a static memory  706 , which communicate with each other via a bus  708 . The computer system  700  may further include a display unit  710  (e.g., a liquid crystal display (LCD), plasma, or a cathode ray tube (CRT)). The computer system  700  also includes an input device  712  (e.g., a keyboard), a cursor control device  714  (e.g., a computer mouse or trackpad), a disk drive unit  716 , a signal generation device  718 , and a network interface device  720 . 
     The disk drive unit  716  includes a machine-readable medium  722  on which is stored one or more sets of instructions (e.g., software  724 ) embodying any one or more of the methodologies or functions described herein. The instructions  724  may also reside, completely or at least partially; within the main memory  704 , the static memory  706 , and/or within the processor  702  during, execution thereof by the computer system  700 . The main memory  704  and the processor  702  also may constitute machine-readable media. The instructions  724  may further be transmitted or received over a network  726  via the network interface device  720 . While the machine-readable medium  722  is shown in an example embodiment to be a single medium, the term “machine-readable medium” should be taken to include a single non-transitory medium or multiple non-transitory media (e.g., as centralized or distributed database, and/or associated caches and servers) that store the one or more sets of instructions. The term “machine-readable medium” can also be taken to include any non-transitory medium that is capable of storing, encoding or carrying a set of instructions for execution by the machine and that cause the machine to perform any one or more of the methodologies of the various embodiments, or that is capable of storing, encoding or carrying data structures utilized by or associated with such a set of instructions. The term “machine-readable medium” can accordingly be taken to include, but not be limited to, solid-state memories, optical media, and magnetic media. 
     The Abstract of the Disclosure is provided to comply with 37 C.F.R. §1.72(b) requiring an abstract that will allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. In addition, in the foregoing Detailed Description, it can be seen that various features are grouped together in a single embodiment for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the claimed embodiments require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive subject matter lies in less than all &amp;attires of to single disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separate embodiment.