Obstructive sleep apnoea is the most common sleep-related breathing disorder and the third most common respiratory disorder. It’s estimated that over 1B adults have either mild to severe conditions. Untreated conditions can lead to a myriad of health problems including hypertension, stroke, arrhythmias, cardiomyopathy, heart failure, diabetes, obesity, and even heart attacks. Acurable has developed a wearable acoustic sensor for the diagnosis of obstructive sleep apnoea that can be used in the comfort of one’s home. Evaluations have traditionally involved overnight stays at sleep centers while hooked up to a number of machines that make sleep nearly impossible. Acurable’s AcuPebble SA100 is a tiny device that is affixed to a patient’s neck while they comfortably sleep that sends accurate biomarkers remotely to the cloud for analysis by clinicians. Diagnosis can be achieved in minutes at a reduced cost and without creating an imposition for patients.
London TechWatch caught up with Acurable Cofounder and Co-CEO Emilio Sanz- Pereiras to learn more about the business, the company’s strategic plans, recent round of funding, and much, much more…
Who were your investors and how much did you raise?
This was our Series A round and we raised €11M. The round is led by Kibo Ventures, with participation from Mundi Ventures, Comprador Holdings, Kindred Capital, KHP Ventures, Ascension Life Fund, and Mazabi.
Tell us about your product or service.
Acurable creates accurate and user-friendly wearable medical devices intended to be used by patients at home. The first of these is AcuPebble SA100, the first wearable medical device to obtain a CE mark in Europe for the automated diagnosis of obstructive sleep apnoea (OSA) at home, and has received FDA 510(k) clearance in the US. It is also the first device in the world that achieves the accuracy in likelihood ratios required by the US Agency for Healthcare Research and Quality (AHRQ) to consider a diagnostic method equivalent to the gold standard.
The device consists of a tiny wearable acoustic sensor, which is placed at the base of the neck and operates on the principle of acoustic sensing. The sensor continuously and accurately records the sounds generated by respiratory and cardiac functions. These biosignals are transferred wirelessly to a mobile device and then uploaded to a secure cloud. Sophisticated signal processing algorithms then automatically extract the relevant biomarkers for sleep apnoea diagnosis, and the next morning the clinician receives a sleep study report.
What inspired the start of Acurable?
Work on the AcuPebble technology began in 2004 when the medical director of the UK National Society for Epilepsy asked Prof Rodriguez-Villegas to use her pioneering ultra-low power microelectronics design techniques to develop an apnoea monitoring technology. The aim was to prevent Sudden Unexpected Death in Epilepsy (SUDEP), which kills up to 1000 people a year in the UK alone. In the course of her research, Prof Rodriguez-Villegas realised this presented a number of long-standing physiological monitoring challenges, the solutions to which could be applied to a number of healthcare applications.
How is it different?
AcuPebble SA100 is much smaller and more user-friendly for patients than existing diagnosis methods (which require the patient to sleep wired to a cumbersome device). Our device can be sent directly to patients in the post with no need to attend hospital, improving accessibility and reducing inconvenience, the time needed away from work, and the risk of any infection. The device works with a mobile application that patients can install on their own mobile phone, and which provides all the instructions required. The sensor itself is very easy to use, and barely noticeable while sleeping, which allows the patient to have a more natural night’s sleep. After completing the sleep study, patients upload the data and then simply post the device back in the return envelope provided.
Secondly, AcuPebble SA100 offers an automated diagnosis equivalent to the current ambulatory gold standard (efficacy results published in the prestigious British Medical Journal), which means that within minutes of the study being uploaded by the patient, the clinician receives the result. This eliminates the need for manual interpretation, saving hours of clinician time and resources, allowing patients to access treatment much more quickly and clinicians to spend more time providing patient contact and care.
What market you are targeting and how big is it?
We are about to launch commercially in the US and across Europe.
Obstructive Sleep Apnoea (OSA) is the third most common serious respiratory disorder, affecting up to 24% of adults and up to 5% of children (approximately 1 billion people globally). The condition causes sufferers to repeatedly stop breathing while they are asleep, usually due to obstruction of the airway. If left untreated, OSA can lead to serious health implications including high blood pressure, heart attack, type 2 diabetes, and dementia. It is also the cause of 25% of road accidents due to tiredness. Due to the high long-term costs associated with these comorbidities, several studies have demonstrated that early diagnosis and treatment of OSA is cost-effective and could save the NHS up to £55M per year, and up to $20K per year per patient in the US.
What’s your business model?
We work with hospitals, who typically pay per sleep study conducted with the AcuPebble device.
How are you preparing for a potential economic slowdown?
We are always careful with the way we deploy our capital, and our device is reimbursed by public and private healthcare systems (not paid out of pocket), so the impact of the economic slowdown will be small.
What was the funding process like?
Very time-consuming, but having done it 8 times already with other companies, you get used to the process. For us it went really well because we ended up highly oversubscribed, so we could choose the investors we preferred.
What are the biggest challenges that you faced while raising capital?
Time constraints, you need to continue running the business while focusing on the fundraise. This can be very difficult to balance at times.
What factors about your business led your investors to write the check?
They all believed we have a 10x technology that can fundamentally improve healthcare, and they believe the Acurable team can deliver on the vision we have for it.
What are the milestones you plan to achieve in the next six months?
Continue scaling commercially in Europe by entering 2 new markets, and entering the US market.
What advice can you offer companies in London that do not have a fresh injection of capital in the bank?
Understand the milestones you need to achieve to raise additional capital. That simplifies and shortens the funding process. If you go too early, you either get severely diluted or struggle to raise capital.
What’s your favourite outdoor activity in London?
The whole Acurable team loves escape rooms (not just me). It is part of the company tradition to do a new one at almost every team event. We are actually running out of options in London!
