CPAP vs Oral Appliance Therapy: Which Sleep Apnea Treatment Is Right for You?

Show Intro and Guest Preview 0:00

All right, it's time for another show and you know what that means. It's Time for Precals. Gentlemen, what do we have for the show today? Hey Jerry, today on Sleep Tech Talk, we're excited to welcome Eric Mongeau, the newly appointed Chief Commercial Officer at Daybreak. Eric is a highly experienced healthcare leader with a strong background in commercial strategy, sales leadership, and scaling patient-centered sleep and respiratory solutions. Most recently, he spent more than six years at Aeroflow Health, where he helped drive significant growth and expand access to important therapies for patients with sleep disorder breathing.

Now, at daybreak, Eric is helping lead the commercial efforts behind one of the most innovative approaches in sleep apnea treatment, a fully virtual at-home custom oral appliance care model. We're gonna talk with Eric about the evolving sleep-apnea landscape and see what he's got to say for himself. And it's awesome. It's going to be fun to see too, because his career has been fascinating, watching him kind of move from CPAP to this. I'd love to hear his insights, what he's seeing and even why he made the leap, cause that's such a different world going from, you know, CPAPP DME into oral appliance.

So it'll be to his journey. Absolutely. He does have a little bit of experience with oral appliance. I know he was with ResMed for a long time and they, of course, had the Narval back in the day. So, you know, it'll be interesting to hear what... And by the way, until probably a year ago, I've known him for years and years, and I was mispronouncing his name. And I don't think I actually ever told him that either, that I used to mis pronounce his names all the time. Well, that's okay, because I think everybody's used to you mispronouncing names, period.

Thanks, Jerry. It's classy. On to the show. Treating my sleep apnea has renewed my appetite for life. What matters to me now is giving my family a little treat.

Eric Mongeauu2019s Sleep Industry Background 2:06

Lights out. Welcome, everyone, once again, to another episode of Sleep Tech Talk, the sleep podcast with your hosts and friends, Emerson Kerr, Robert Miller, and me, Dr. Gerald George Moneykerog. Folks, thank you so much once again for joining. Hundreds of thousands of views. We cannot thank enough, but what we are going to ask you is to continue giving us the love, showing us love. And what you've noticed is that... There are hundreds of thousands of views, but only a fraction of y'all are actually subscribing.

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Choose Solesh. One selfie. Better sleep. Hey, Jerry, we're super excited today. We have an industry legend. He's been around the industry for a while now, but we have Eric Mongeau, who's the newly appointed chief commercial officer at Daybreak. Eric, welcome to the show. I don't know that I'm in the age group that can be called a legend, Robert, But I appreciate the intro and I am super-excited to be here. Yeah. So Eric, typically we start our podcast off, you know, just getting a sense of how you got into sleep medicine.

Um, so give us a little bit of your, your backstory and we can sort of work our way forward and, uh, You know kind of talk about your journey. Yeah, so realistically, this is actually almost my 30th year in sleep medicine. And the reason for that is my stepfather, sleep tech, respiratory therapist, and probably the first person I knew that had obstructive sleep apnea. I watched those devices go from something that was about two feet tall and adjusted with a screwdriver down to where we are today.

and I still remember the hole in the wall in a grass system with the little needles on it. and I used to use the leftover paper as doodle paper, as a kid.

Daybreaku2019s Virtual Oral Appliance Model 5:19

So that's how I got my start and then went through all the iterations of figuring out who I wanted to be when I grew up, found myself in a sales career, ended up in role at ResMed and went to a couple of promotions there, decided it was time to dip my toes into the DME side as provider and had been doing that for about the last eight or nine years. And then, you know, as Robert mentioned, just recently joined the team here at Daybreak and just feels like a real culmination of all of my experiences over the last number of years, and I think we're doing something really special.

Awesome. Well, Eric, tell us a little bit about your new role. You just mentioned your role there with DayBreak, so give us an idea of what's going on and maybe how all the things that you've worked on have sort of culminated to this point. Yeah, it's pretty wild, actually. If I could have kind of drawn something up on paper, I guess this is probably what it would have looked like. Daybreak for those who don't know. have built out what I would kind of call an industry first or a world first model around democratizing oral appliance and getting it into the patient's home and ultimately into people's mouths and get people treated.

I've spent the last 16 years getting people on CPAP devices. And I did that from the manufacturing side and then from DME side. And what was interesting was when I was at ResMed, they had brought the Narval product into the States from France. And I spent a lot of time collaborating with a good friend of mine. Shout out to Scott Blodgett of Neon Coden. All the sleep tech folks might know Scott. We were trying to figure out how do you get dentists and sleep physicians to even speak to each other and doing dinners.

They'd sit in the dinner on one side of the table and one on the other and never to be met in middle. And so I've been trying to figure out how to get oral appliance and other modalities into the therapy flow for years and years. A good friend of mine, Robert Miller, joined this company around the same time that I was actually implementing Daybreak at Aeroflow myself. So the last EME company I went to was Aeraflow Sleep. And we were bringing Daybreak in and I got to learn about what that was like from the business partner sort of process.

And from there, you know, realized that there was a much larger opportunity here. So I joined the company in order to continue to build out what those pathways look like so we can help more people. Ultimately, that's really the goal of the organization is it's therapy agnostic. It's get more people tested, get people diagnosed, and partner with every single therapy that's out there. And it doesn't matter if it's a pill, if a CPAP, a positional tennis ball sewn in your shirt, whatever it is, we want to be talking to those folks and figuring out how we can all work together to help more folks.

Eric, you really cited a difficult bridge between sleep medicine and dental sleep. How do you feel like what you're doing modifies that or really helps with that situation? Because you're right, that is a difficult barrier in a lot of places. What are you doing at daybreak to mitigate that? Yeah, so I think at Daybreak, the way that we look at it is, and for those that don't know, we started with a proof of concept by going direct to consumer. and by helping people directly find a solution where they could go from a very simple home sleep test to doing an impression kit at home, to getting a custom-made oral appliance delivered into their mailbox.

And really nobody had done that at scale before.

Bridging Sleep Medicine and Dental Sleep 9:08

There's a whole host of reasons why we're good at that, and prior companies from our founders is a big reason for it. But that has allowed us to prove out That we can do this at scale we could do it effectively and in many cases we didn't even a more efficacious and more comfortable way for the patient than what traditional models have looked like and we all know you know if you go to your dentist today it probably says sleep apnea you in white letters on the glass door before you walk in. I don't think a lot of people really know exactly what that means from a patient perspective.

And so we have just taken a different route, I guess, a way of thinking about it. We brought all of the necessary folks into our ecosystem and we take all the hard stuff out of process. So for the patient, they're just like, this is great. I got diagnosed. I decided on a therapy and the therapy works. And now we're bringing that to the masses. Now we are partnering with DMEs. We're starting to think about what that looks like from your local dentist that you go and get your cleanings at. You know, we were talking about, you know what, that's going to look like for veterans.

Where we talking with fire departments, where talking police stations, were talk about associations of community colleges, retail outlets. It's amazing how many people realize that when you start breaking down the walls of traditional diagnosis and therapy, that all of a sudden, this is really the gateway to helping the 80% of undiagnosed patients with sleep apnea that are out there in the world. Erica, I really liked how you put it by saying it's a democratizing therapy for patients. It truly is.

You're providing patients a choice. And that's something that I see reoccurring in what we have been talking about here at Sleep Tech Talk over the past several, several episodes is Is the. The influx of choice for patients before it was you get a CPAP or a trade group that's about it and then there were some ENT surgeries that used to take place were they were not the most successful and you would see three six months later patients are back in the lab because that didn't work out but now we have successful treatments we've got pills we got.

The CPAP, of course, and now different types of CPAS are coming out. And now, the oral appliance. But I'm curious, I know you said about the commercial side of it, but what did you see that really, really hit you when you started getting into this world of oral appliance? You were on the DME side and you start seeing this other option that was actually working and getting to patients. What triggered you to make that switch that, hey, this is something that I want to go and touch lives with? So I'll tell you, it's probably a very personal one for me.

I'm now in my mid-40s. I wasn't going to wear that thing if you paid me millions and millions of dollars. And I truly have avoided taking a new home sleep test for the last 10 years because I sort of knew what the results probably would be. I saw value in the multimodality therapy just because to your point, if give people choice, it seemed like, hey, this is really moving in a right direction.

Ericu2019s Personal Patient Journey 12:40

But for me personally, I registered as a patient. I didn't want anyone, you know, gaming the system. Didn't them giving me special treatment. And I'm now happy to say my device is with FedEx as we speak and is on the way to me. I don't know that I've been this excited maybe since, I dunno, the last set of golf clubs I bought or when I buy my last car or something. I am so excited to put this thing in my mouth and my wife to tell me that I wasn't gasping for air at night to wake up without brain fog, to not feel like I needed a nap at 3 o'clock in the afternoon.

These are all things I've been dealing with for years and I really didn't want to talk about and address it. Because I wasn't going to wear CPAP. I just wasn' t. And I literally sold CPOP for a living for the last 16 years. That was just something that was very personal to me. Since I've told that story, I told it today on the airplane to the guy sitting next to my. He went and signed up for Daybreak while we were in the air on Wi-Fi, un-American, flying across the country. And like the amount of times that this story now is being regurgitated, you know, loved ones since I've taken this job, friends since i've taking this, job business partners since, I take in this.

They're like, we had no idea it could be this easy. And it's just like nobody wants to know what they don't want to deal with. No, they didn't wanna talk about. And I think, you know, for me, I've always felt that whatever I'm selling, wherever I am working, it needs to be very personal to me and I need to really believe in it. And, with 100% certainty, believe what we are doing. Eric, now that you said you've been a patient and been part of that process, I would love for you to kind of take us on your journey of the process.

What it looked like, what you had to do, and maybe some of those nice surprises along the way that we didn't anticipate. Can you take down that road? Yeah, so I can tell you I'm probably the world's worst patient, which I was sort of intentional because I wanted to see how the organization would react to somebody that was as poorly behaved as I am. And, you know, I fly across the country almost every week to our offices in Los Angeles, and I live in the Boston area. So my schedule is a little tough.

And so I signed up. I got this really cool, you know, custom box with Daybreak Yellow. It looks like, Apple or someone made the packaging and inside there was tiny little fingertip night owl device. And it just so happened we were gonna go for a last little ski weekend up in New Hampshire. and I said, perfect, I'll do it at the hotel. So I wore my night Owl two nights at hotel, my kids thought it was totally bizarre that daddy was rapping a little, you know, bandaid around his finger with this little device, but they wanted to understand what it was.

And my wife was like, oh, here he goes again, testing something else. On Sunday morning, I took the second night of the test and I had a text message, text, message I think within 30 minutes. It said, good news, you have sleep apnea. And from there, it said, you need to now get in a telehealth appointment. And so I scheduled my tele health appointment, got on my telephone appointment and they said you'd be a great fit. You have an AHI of 11 and this really makes a lot of sense for you. I said perfect, let's go.

And I then met my sleep advisor. I did intentionally not intentionally but got delayed quite a few times because again I was traveling a whole bunch. And i was getting reminder texts and interacting over that way and it was just it just felt like I. Was dealing with a very modern company and a. Very modern experience. And I was like, I like this. I liked the way that these people are talking to me. And then I got to the process where the impression kit showed up at the house I had done one of those before and so I was able to walk through that pretty easily and again Incredible packaging told you where everything goes really really easy It was about 20 minutes later and the impressions were back in the you know The FedEx bag or the UPS bag whatever it was and off I shipped them I Got a nice little notification when they arrived at our processing facility told me they arrives They got scanned into our system, and then manufacturing began.

And then I got a notification when my device shipped. It all just sort of happens in a very seamless way. I mean, you know what's happening throughout the process. Now when device arrives, which will actually happen while I'm here in Los Angeles, it'll arrive back at the house in Boston. So next weekend I'll start using it, then go into the titration process, where then I'll get checked in with and they'll see how I'm doing and I use my

The Daybreak Treatment Experience 17:28

little night owl device for a couple more nights. It'll probably show that my HI and RDI are dramatically reduced. And voila, I'm cured. It's just such a different experience from what you hear about probably from most people in this world when you think about what's it like to get a CPAP device, what it's like go and have surgery for Inspire, even going through the process with Excite OSA. These are all technologies that I've worked with over the years. I have spoken to, I had relationships with, and they have a place for so many patients.

And I think that's our whole point is like, everybody has a space. This one just really made a lot of sense for me as a patient. Eric, that is a fantastic overview of the experience and the process, but just changing gears just a little bit, as you think about the future of sleep apnea diagnosis and therapy, what are your thoughts on what the feature looks like? Wow. Um, you know, I guess, the biggest thing that I think about is how do we make this commonplace, right? How do make where there's no stigma, people aren't poking fun at CPAP in sitcoms and in TV commercials.

You know, people aren't thinking about a patient with obstructive sleep apnea as some big, heavyset guy asleep in the corner. I'm not the skinniest guy on earth, but I've been on GLP-1s for the last year or so and lost about 35 pounds. And I think that, you know, just getting it to a point where people really think about that mild to moderate range, which we know is the most undiagnosed. We like to say that sleep apnea is typical, but it's not normal. And if people think about it that way, that this is a disease that's typical, but not normal.

And there's a really simple solution. There's many simple solutions. I guess that how I think of it is, you know, let's get more people tested and let get people treated and ultimately, make a big depth in this sort of global disease. So, Eric, I really appreciate you saying that, that rather than it being a butt of jokes, there's more awareness and more acceptance. And something that we also talk about is the prevalence that you see now in the media. You're seeing it more. Yeah, you do have the jokes on sitcom, but people are starting to see it and starting accept it in more mainstream.

When you say this in terms of the future, what else do you see long-term? Because you've had your share of chronic care management. So how do see this fitting into that sleep apnea? Yeah, I mean it's funny, when I was at ResMed I had the fortune of working with some insurance companies and talking with the insurance company and hearing from them how they think about patients with sleep apnea, you realize very quickly that there's a fair lack of education there and they know the comorbid connections But insurance companies are still pretty siloed and I think the more that this becomes mainstream and the More that medical directors understand this and you know, pop health folks understand This and, you Know, we can go to ACOs and we Can go To large employer groups and You know we, can be you go, to the government right I mean you, know daybreak little little shout out here for our ceo and and the sleep apnea coalition that we've put together.

We have three states currently that the month of March is now Sleep Apnea Awareness Month. In my home state of Massachusetts, California and Arizona. It's actually the reason that I met our CEO for the very first time, is he was getting that done at the State House of Massachusets. And that's something that, I think, we can all be really proud of. I as an industry, need to do more of, and it's really something we're trying to, at Daybreak, reach across to all of our partners. In the physician side, in the therapy side in, the med tech side you know again in in.

The payer world you, know creating coalitions and in ways to to bring people together.

Future of Sleep Apnea Care 22:08

You know to really you work together to address this and I think that that's something as an industry we've all talked about it and we tried to find ways, to do it but we're really doing it now. We're really doing it for real. There's some incredibly exciting things I think that everybody will see here in the next six to 12 months that are going to just create incredible opportunities to get more people through the funnel. Eric, we're getting really close to time, but I do want to touch on the Sleep Apnea Coalition.

Could you talk a little bit about that, please? Yeah, so Robert actually might be a better expert on this than I am just because he's been around a little bit longer. But we basically put together our own, is it sleepapneaawareness.com? Is that right, Robert? Do I have the right URL? I think that sounds right. If it's not, we'll make sure we have it corrected in the show notes. Give the people the right URL so you can go and be a part. Please sign up for the newsletter. This affects every single one of us that are listening to this and watching this today.

We are firm believers that if you drive more and more folks at the top of the funnel, that's going to be good for everybody. And I think this is a real way that we're kind of putting our money where our mouths are. we funded this completely independently ourselves. We are not the biggest player in this space. There's obviously some very, very large publicly traded and well-backed med device companies. But they didn't take our first call, but they have taken the second and the third call. And we're at a point now where people are getting it and they're coming in and want to be involved.

We're partnering with other groups that are out there. And I think that's really where we're going to see the biggest impact. And we've got a number of other states that we are working with. We hope that this becomes something that goes from state to federal. losing the stigma and getting people to talk about it and know that there's easy pathways. And whether that's your primary care physician, your ENT, you're a dentist, a site that you go to, or a virtual sleep clinic, whatever it is that floats your boat, they're out there.

We just wanna make sure we can educate folks on what all the options are, because it's gonna help everybody. Yeah, and Eric, you know, I think one of the things about the coalition, too, that I can speak to is just that. I hope it's finally something that can help to break down some of those silos. When you think about, the world of dental sleep medicine, DME, diagnostic providers and even sleep physicians, because I Although we might even disagree about what date and what specific week we're talking about sometimes with some of the different awareness opportunities that are out there.

But at the end of day, I think everybody can absolutely get on board with every state recognizing sleep apnea as the condition that it is, the significant condition. Yeah, absolutely. Well, Eric, we are out of time. Is there anything that you'd like to touch on before we close? No, I just love to thank the audience. I've been working with sleep techs in some capacity for going on 16 years now.I've done a lot of masking services with a couple large cheese pizzas and a bottle of soda at eight o'clock at night or later.

And it's a group that's near and dear to my heart. So no, just really appreciate it for you guys to have me on today. Hey, thank you so much, Eric. And where can people get more information about you and about Daybreak? Yeah, feel free to look up my LinkedIn. Eric Mongeau, M-O-N-G-E-A-U, and Daybrake is thedaybreak.com. Come to the site. We've got a lot of great info. Feel free sign up if you've not been tested. Let's get you tested and find the therapy that's right for you. Hey, thank you so much, Eric.

And we'll be sure to have that information in the show notes and folks out there. Thank you. So much for joining us once again, and be Sure to hit the likes, the subscriptions, And most importantly, The shares and also a huge shout out once Again

Sleep Apnea Coalition and Awareness Efforts 26:18

to our sponsors, be All right, that was quite a show. Let us get going. So that means it's post-calls. Gentlemen, what did y'all think? It's really great to see how Eric has really transitioned. I mean, you can tell he is absolutely sold on what he's doing now with Daybreak. But he has gotten such a great experience of being able to have had the CPAP journey with ResMed and then Aeroflow and ended this. He's got such an unique insight. especially now as a patient to be able to navigate these waters.

So it's gonna be a lot of fun to see where he takes daybreak commercially and especially once he's on the therapy, what kind of sort of experience he has. But it was such a fantastic show hearing his journey and what he is doing now. Well, I have to say, you know, if Eric is a is an incredible success at daybreak, take full responsibility for recruiting him over to the company. If he's not, have no idea. No, just kidding. He will he will absolutely be successful. And I had to tell you in a very short time, he has already made a pretty big impact on the Company and and I knew that he would because even though we, you know, in our previous roles, both working for DME providers, I was always a little jealous, i would say, of the flexibility that he seemed to have working at a DMV provider that was large, but not quite as large as the company I with.

And, sometimes when you're at national DMT company trying to get things changed or to make meaningful change, it can be like moving the Titanic. At least in his previous role, he always seemed to be able to adjust and move with a focus on patient care. I hope that that message came across today on the podcast that he is someone who is committed to the patient experience, the patients journey, and ultimately getting patients treated. I would agree with you there because the word that he used, democratization of therapy, that really stuck with me.

And you could really tell he is a patient advocate and he wants to see what's best for the patient. It's really great to say that that's he's been through so much. He's worked with technologists at night and worked them with mass inservices, understanding what it means to be there with the patients all night long. up until this option, I mean, he's tried oral appliance in the past, but now this turnkey solution for patients, it brings another option as we keep talking about. And it's great to hear that he has been able to make an impact as well.

I think overall, this helps us in industry and it helps patients altogether. You know it's interesting hearing the word democratizing that's sort of come up a few times lately in my world and it is something to consider when you consider where we were. Gosh, back in the 90s, and you had just a couple of options. And where we are today, it's this bandwidth, almost like a dashboard of the options that caregivers have to choose from and patients have choose to from.

Closing Remarks and Sponsor Messages 29:58

It's really become more important than ever to be so knowledgeable if you're a clinician about everything. because there's new technology coming all the time. There's no diagnostics coming. All the I mean, it's Moore's law in motion of how things are doubling almost, you know, almost seems like daily. So it is important that we have that insight. And it s a lot of fun to watch. Of course, here at Sleep Tech Talk, we get to be at that on the cutting edge of that every every other week as we get to interview somebody.

So this is the place to be, to hear what's new and what is fresh in our world. Yeah, Emerson, it really is. It really does feel like that some parts of the industry really are moving toward this whole idea of precision medicine and finding the best solution for each one of patients who come through whatever vertical we all serve in. But at the end of day, the good news is more patients get treated. Yeah. I would agree. Yeah, a hundred percent. And you're right. Everything fresh and new. It's over here first at sleep tech talk.

All right, let's call it. Let's do it this time. So folks out there, thank you so much until next time cheers. A sound sleep calls for a high performing mask. Introducing F&P Nova Nasal with SwingFit Headgear. From fitting and seal to minimal noise and draft, it's performance defined. Go to fphcare.com forward slash nova nasal to learn more. Hello, I'm Massey Errington, President-elect of the American Association of Sleep Technologists. I wanted to reach out and let you know that the AST is your professional home and chief advocate.

As an AIST member, you'll gain up to 22 free CECs annually. You'll also have access to technology-specific education, as well as the community and advocacy that you need to advance your career and improve patient outcomes. With the AST's new strategic plan tackling sleep technology's biggest challenges head on, now is the time to Advance Our Profession Together. Visit astweb.org and discover where you belong.