How Do You Build a Successful Sleep Business?

Sponsor Messages and Show Introduction 0:00

Sleep Tech Talk is brought to you by Fisher and Pike. Fisher & Pike Health Care is a leader in CPAP masks design and innovation for over 20 years. Their unique technologies have benefited millions of OSA patients through their top CPAT masks. These advancements continue to further enhance patient experience and outcomes. Treating my sleep apnea has renewed my appetite for life. What matters to me now is giving my family a little treat. All right, it's time for another show and you know what that means?

It's Time for Precalibrations. So what's going on today, folks? Hey, Jerry, we've got with us today, Breton Lane. She is the president and chief operating officer of professional services at BetterKnight. With over 25 years of experience in sleep medicine, Bretton began her career as a sleep technologist at the prestigious institutions like the National Jewish Health Center and also the Children's Hospital Colorado. she's overseen thousands of sleep studies, led clinical operations and is passionate about making high quality sleep care more accessible and effective for patients.

She's here today to talk a little bit about her expertise in the space and maybe give us a bit of insight into the latest innovations related to sleep apnea care and sort of the world that is better night. So we're excited to have Breton with us today. Well, I am excited to have her on. I've known Breton like you have for years. And to just get to hear her end-to-end story is going to be fantastic because you can just see she's one of those people that, you know, like, have in your career, Robert, as evolved as the industry has evolved.

So I'm excited hear how she got here and sort of the backstory maybe that I haven't learned before. got into sleep and then moved on and ended up building a business and their own company. So for me, that's gonna be exciting to hear that part of the story. Well, we certainly met a lot of really smart people who are extremely motivated to be successful and Bretton fits into that category specifically. Let's talk to Breton. All right, on to the show.

Breton Lane's Early Career in Sleep Medicine 2:25

Sleep Tech Talk is sponsored by React Health. Within our Luna PAP device line, each offering is FDA approved, encompassing CPAP, APAP by-level and by level ST models. Our thoughtfully selected array of PEP interfaces and accessories complement our LUNA PAPP device-line while accommodating diverse patient requirements. 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-Moneycrow.

Folks, once again, an amazing, amazing guest for an Amazing Show just for you. But we do want to say thanks for all the love you've shown us, all of the likes. the views, the shares, and the subscriptions. Let's keep subscribing. Talking about subscriptions, we've noticed that it's barely a small fraction of the people that watch the show that are actually subscribed. So be sure to hit that subscribe button. It really helps the channel and gets the word out for all the sleep professionals out there and The Sleep Curious.

But that's being said, let's not forget our lovely sponsors. Thank you so much to our sponsors who helped make this show happen. And because of them, we're able to bring it to you. So be sure to check them out. A huge shout out to them. With that being, said Robert, what is going on today? Hey Jerry, we have a fantastic guest today with us. We have Bretton Lane. She is the President Chief Operating Officer of Professional Services at BetterKnight. Breton, We are absolutely thrilled to have you with this today.

we typically jump into the conversation and you know we want to know a little bit about your history and how you got into sleep medicine. You've been doing this a while kind of like the other three guys that are that part of this podcast. So tell us a little bit about yourself and how you got into the world of sleep medicine. Yeah, yeah, thanks. Thanks, Robert Emerson and Dr. Mann for having me here today. I've had a kind of, I think in some ways, sort of a typical story. i fell into sleep, medicine, you probably hear that from a lot of people.

graduated from college at the University of Nebraska in Lincoln. And I decided that I wanted to learn to snowboard. So I went to Denver, Colorado, moved there, didn't know what I was going to do. Didn't You know, in the lab cancer communication, genetics, that type of stuff. So I went started advertising or looking for jobs, interviewing, kind of going around and started running out of my post graduation monies and happened upon National Jewish Medical and Research Center. At the time it was run by Dr Bob Ballard and quickly after a couple years later, Dr Teofilo Li Chang joined, but I got hired and I actually got fired on as a sleep technologist initially scoring during the day, not actually working at night.

I, and it was kind of an interesting story because the day that I got that job, I actually got a job offer from the American center of cancer causation and present prevention exact same day. And, you know, my, pathway was going to go one direction, but I was just so fascinated. by what I saw at National Jewish to be a sleep technologist and what was going on. And I just said, this is what i'm going to do. So I joined, got started. I also, and I always tell people I started, it was 2001. But I actually started in this field at just $12.47 an hour.

as a sleep technologist. And I got my, so of course I couldn't necessarily afford even in that day to live in Denver. So I actually started moonlighting at Children's Hospital as well in their pediatric sleep lab in the evening, scoring sleep studies for them, learning about the children's side of it. I just got steeped the first five years of my career in Denver, Colorado. Awesome. Well, Bretton, you certainly have made your way from a daytime scoring tech and a children's pediatric tech as a secondary.

Thinking about how things stand for you today, I mean, your part of Better Night, a national service provider and you're certainly seeing or you've been a part of a lot of change with Better Night as the company has developed and You've, been, a big part, of that so tell us about you know sort of your journey and in leading the charge of A big national sleep company and what that's been like for you Yeah, you know, I had several experiences. National Jewish was just a great place to get those initial experiences, hands down.

Working with Dr. Teofilo Lechong and Dr Aloya and others and getting that type of standard, within my system was really great.

Building Better Night and Expanding Services 7:31

And then I decided I wanted to move to California and I got the opportunity there I fell into another large, it was a private practice, but a really nice large group called Pacific Sleep Medicine who did a lot of pharmaceutical trials. They were seven branches in Southern California, one in Oregon, and I got the opportunity to get involved in 2007 in the The world of mergers, acquisitions, growth of sleep centers, et cetera. And so, you know, I had done everything at that point in time. I hadn't I, had transitioned into operations from technical director lead tech, the technical, director to operations was general manager at, that time of the Western region.

And then, um, and then I, I kind of got, got to, you know, getting onto nine year nine and my growth and I was seeing all these other new things come out. It was just 2010. There was a lot of home sleep testing happening. People were starting to use modems, but we weren't all putting modem on our PAP therapy patients at the time because it costs more money. Those machines were more and it wasn't necessarily required yet. And so I came across a much smaller company in San Diego, California, and came on as a operations manager.

I was employee number 20. They actually had been doing home sleep testing in the managed care environment from 1995. Two women started the company. One was working at the VA in Sand Diego and the other one was at UCSD. The went to Europe, bought two home-sleep test recorders and started sleep data. And by the time I met them, they had some pretty good managed care contracts. They were well known on that diagnostic testing. And a few, the medical director, one of the major medical groups had asked them to get involved on the DME side as well.

So they have started the company for therapy. they just gotten a contract and that's why they brought me on. From there, we had some changes in ownership, but we really had the passion of those initial founders of doing well by doing while doing good by good, of making sure that patients were compliant with therapy, even though they were home sleep testing. We used to tease them because they would say it was value add to call. And we'd say from the business side, there was no money. It was free.

But they always call and say, how are you doing? Have you gotten set up on your CPAP? What's going on? And they start coaching from there. So from there, we started to collect data. We collected data from all the PAP therapy machines. we collected the data throughout our EMR. So we really started having this journey, not having a medical practice other than the diagnostic testing, but we starting having the journey working with specialists like pulmonology, cardiology but also PCPs. To get patients through managed care environments for home sleep testing and then on to onto therapy, but then long term, chronic care management.

So we had created a real nice database care, management, population management reports. And this was like, 2013, we were getting so we have data going back now. We were touched like everybody else by recalls, by 2G networks not being supported, 3G network not been supported changes in algorithms. But at the same time, we still have data going back that far on patients using that's tied to their diagnostics data. And so in about we had some various iterations. We actually started a company that was a CBT.

It was called Optisome. And we were looking at the, we worked with Derek Lowy. He's big in cognitive behavioral therapy and we kind of used his tools and created a CBTI program towards employers to improve presenteeism, to improved sleepiness on the scales. We actually published a paper with Deborah Lerner and showed ROIs on that and everything, Deborah Learner Outer Tufts. But we really couldn't take off at that point in time. It was a very different sell going into employers. going into more of that wellness space on that particular side.

The market really started shifting in about 2015 saying, come back to sleep apnea. We need a sleep-apnea solution going end-to-end. With all my regulatory experience that I had gained with mergers, acquisitions, and then with a lot of additional regulatory and legal support, we created the foundation to go on all 50 states. and be able to provide some or all of our services. With the exception of Dental Sleep Medicine, we kept a dental sleep medicine company in San Diego at that period of time because that was something we had added as well, knowing that you need all these types of things to treat a sleep apnea patient.

And so we really believed in the dental Sleep medicine side as a part of that team. So we took that and then we were ready to go. We actually had just started And two things had happened for us. We had just started in December of 2020, was it 2019? And November of 2019, we had released our very first MVP of the Better Night Solution. It was end to end. And we were really working in the truck driving DOT area, trying to reach those types of patients, chain of custody protocols, all of those things.

But we had it set up so that we could do everything virtually and we have done research and published research around virtual masks or virtual setups versus not everything was validated, very excited. And we actually happened to have changed our voice or phone system from an algorithm server based phone To a virtual phone system, and about 3 months later, we all got the government shut down. We all had cobit, you know, got coded everybody go home. And our San Diego, where San diego based at the time now we're based all over the people work everywhere, almost every state probably for us, but.

We are it team was just amazing. They used our oxygen trucks put together a protocol and just dropped it equipment and did virtual steps and two weeks. We were up and running and sleep program all through coven and, you know, unfortunately, a lot of the. sleep techs and the sleep labs that were hospital-based had to go on a pause and had go help with COVID testing and sorting and treating. And we just got running and there was a real need for us. People embraced telemedicine, as we all know, faster than we thought they were gonna embrace it.

That got us here. I think we've grown the company by, I mean, top line, almost 30X now. 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, its performance defined. Go to fphcare.com forward slash nova nasal to learn more. Treating my sleep apnea has renewed my appetite for life. What matters to me now is giving my family a little treat. Wow. Brendan, that is quite a story. And fortunately, I've been able to have these intersections in your life along that journey, which has been pretty amazing.

You know, one of the things that's fun about you is, and you know both Jerry and Robert are a part of that, is the busiest people and your in that class for sure do other stuff. So along with all this that you do, you're on the editorial committee for the AST's A to Z Magazine and lead that committee. So Andy, you were on the board a few years ago on top of that. How important is that though? Because as we think about our listeners and they're like, I just don't have time to give back. I don' have to time time invest in that, how has that been important to you?

because you're running a company and making time, to make sure we have great content in the A to Z magazine with AST. how do you make all that work? Well, I mean, first of all, very passionate about sleep medicine as we all are. It's something easy to fall into. it makes so much sense. You've got your diet, your exercise, sleep, and some water. Those are the things you need to really be here. So it just makes so much sense to overall, you know, general health. And you think when you participate in these volunteer acts that it's a huge commitment.

It's as much of a commitment as you want it to be.

Volunteering, Career Paths, and the Future of Sleep Tech 16:48

So you can do things intermittently. You can things, ongoing. If you do this for a while, pull back because you're in a really busy time. The AST has been great for me for that. At times when we were going through a great change, you know, I, said, hey, can't do the board, but I can do, um, the committee, and the ASP committee. Um, so I think that's the part, people get daunted up front, when I'm trying to recruit people to come participate and do volunteer work. It's one of the first things I'm so busy.

I know you're busy, but literally it's maybe 15 minutes a month, and then every once in a while when you are able to write something or look at some regulations, whatever committees you on, I am sure the BRPT has the same thing from our colleagues that participate on that side as well. Why is it important? Because sleep is important, because our environment is changing so much and it is just evolving into so many different places. I think sleep is one of the last places that you can actually have a clinical career and profession without the traditional educational program, whether it's an allied health certificate or others.

I mean, you go and you learn and really create something out of this. and you don't just have to do DME setups or do in-lab studies or scoring or operations. I mean, you can get into sales, product development, technology, marketing. You can go to retail. There's just so many things you could possibly do that I just think it's such a huge opportunity and it is such need. We're running so short. On sleep text, one of our acquisitions we recently had in New England. Oh, it's such a it so underserved.

Everybody's having a hard time. This is across the country too, but stabbing and taking care of patients that can't be taken care. Of one is not sleep apnea at some other sleep disorder. But two, they're too complex to be dealt with at home, and we can't find staff to actually do those anymore. We need this. You can just say somebody who comes from respiratory therapy or EEG can be a sleep technologist. They have to go through their own form of sleep training too. So all of these people, whether they're certified in some way or not, need to become sleep medicine specialists to practice here.

And we do that. It's important that we contribute and make sure that build that for the next generation of people who aren't going to run PSGs on paper, but they are going do something really cool. Yeah, no, you're absolutely right. I think the fun thing about hearing your story you know kind of end-to-end is you've remained curious along the way and it's you Know allowed you to see this evolution of sleep from I'm gonna go snowboard to You know now you're running a company you are leading teams and then you were volunteering on top of that So, you, know huge thank you and kudos to you for you.

Know following this journey and we're all the better for being a part of it Oh, thank you. Yeah, I appreciate all of you as well. We're all on the same mission, so. So, Breton, like Emerson said, it's very inspiring to hear what you've done, and it all started out with snowboarding. But if there's somebody young that's curious about a A career in the sleep industry, they're just starting to hear about it. What kind of words of wisdom would you have for them? Because obviously you've tried so many different things along this path, then you also named so may different options.

And what sort of advice would give somebody who's curious in getting into this field? I guess I would tell them to reach out to the AST or BRPT. Sometimes you come across somebody who's really special. You find somebody has time that actually has done this. Maybe within your group or your friends or school, there's somebody that can actually tell you about this recently asleep tech. I just happened to be visiting the lab. She actually was a frontline customer service person and she just happen to cross paths with me.

And yeah, we're going to start training her as a sleep technologist. So there's that way. But the other way is that there is so much information about what you can do. It's free. How you could get your career out, who you talk to. I mean, if you get on their websites, If you Google them, you'll find their groups. You can reach out and say, Who can I talk too? I'm interested in this field. And they intentionally created a lot of materials to help people understand what that means to them. What the pathway is like.

and what they could do. Well, so, Breton, you know, just thinking about sort of the future state, knowing we've got all of this AI. And, I think that, if I remember correctly, You guys have been able to incorporate some AI tools into your systems and your patient interactions. How does all that work today? And how have you found this new technology to be beneficial for patients and patient care? Yeah, 100%. I mean, we're just this the next three, five, 12, 20 years. It's amazing, it's scary and it is amazing and we have so much stuff to go forward to.

But this is something that needs to be attended, needs be supervised, and needs developed. And if we don't pay attention to it, if you're not looking into something and applying it to your personal life or your professional life, life is going to get harder and harder for you. So we started and the thing is all of this stuff, at least in our country, You have to have a top line and you have have bottom line. And so at the end of the day, if you're going to survive and continue to do all the good things that you want to in the field of sleep medicine, you have to figure out ways to do it that are going to be good or going help.

One of my mentors said this word to me once, she said, Breton, is it core or chore? And it's really stuck with me. And so I think when it is chore, then that is a place possibly for AI. So, and we all know we have scoring, sleep scoring and going through there, but you know, just running through and doing some analytics and getting that there. That's kind of a chore. The core of it is having that sleep technologist that goes through that validates it that looks at it, that then interprets that story and hands it over to the sleep physician so that they can do take their next piece of It's the same thing, that fact wrangling, That's a darn chore, you know?

That is hard. And so we have solutions now that are out there that, are just phenomenal in pulling things off the facts and getting them into our system so that qualified people can look at it and say, this is what we need to do with this particular patient. and it's so much faster. There's just so many other ways to apply these things. It gonna take time. We're not gonna be right every single time, but on how we use it. But we have to bring it into our industry. We just have too. So, Brendan, I was to piggyback off of what Robert asked.

And we are getting close to time, but I have asked this question. For current sleep technologists, people that are in the industry right now, there is, for some people, they are afraid of AI coming in, coming for their job, so to speak. Any words about that to them? I have not yet seen us not needing sleep health professionals. I mean, you know, we actively look at it. We constantly have job ads up. We all know each other for the most part in this world, and so there's always that, oops, me culpa, I just took your sleep tech, you know, we took yours, so we go back and forth.

You know we want you, to be here, want to you to a part of this. AI does come on board, but you can't take away that patient interaction.

AI, Patient Care, and Better Night's Mission 24:58

This is a patient-facing solution, even when it's virtual. have meetings like this virtually now right with patients and you have to obviously in the sleep center be able to handle those patients as well. You have a territory manager that can go down and can talk to physicians and tell them why it's important to screen for sleep apnea and really get in there and talk about their cases and their practice and how it aligns and customize it along the way. And so there's just so much that's needed with this type of knowledge and background and operational status that can be applied across so many various job types within the sleep industry.

You know, Brendan, the history of Better Night and all that you guys have done has been phenomenal. When you sort of take a step back and synthesize all of that, You know, what is, I mean, the beauty of today is we get to really hear the heartbeat of it, you know. Who is Bretton Lane and the organization you run? And it's really, i think, captures the soul of the organisation. But when you look at your success across the 50 states and in the growth that you guys have had, What do you feel like is that real heartbeat?

What really for the The tech who would love to work with you guys as a tech or a coach or the patient who'd love be a part of your services, what is it that makes Better Night so special that you have had that success that would draw patients, draw other caregivers to be part the Better Knight family? Yeah, I mean, it starts with the problem. The problem that exists out there today is that only 20-25% of the people in the United States, 25% people United states probably have undiagnosed sleep apnea, right?

Or have sleep Apnea. 80% are unddiagnose. So that's where the problems exist. We have a lot of work to do, and it's very motivating to tell people the story of why they're doing what they are doing and where we're going. I think that when you come to Better Night, you have lots of talent. There are people that I've worked with that are clinicians, Dave Parenteau, Billy Hebbiner, others who have been a part of sleep medicine and passion back into the early 2000s and even 1990s as well. So I've got these physicians who have been in it just as long, and they're just so passionate about what we do.

Business is hard, business goes up and down, the world changes, some things work, somethings don't work. But that core group of feeling and people that really want to make this work and persist even through hard times exists that better night and really wants to really make a difference. Bretton, thank you so much. This has been fantastic, but we are out of time. Is there, where can people get in touch with you or learn more about who you are and Better Night? Yeah, well, I'm on LinkedIn, Breton Lane.

You can look for me there. Um, you can go to www.betternight.com and we have our website. you Can look at what we're doing and have access. We've got, we've even got a jobs page, so. Awesome. Thank you so much. And we'll be sure to have that information in the show notes and folks out there. Lights on. Be sure to check out our clinical sponsor, Sleep Review Magazine. More details in show notes. All right. That was another show and it was quite a show. So that means it's time for post calibrations.

What'd you gents think? You know, Jerry, I think that, you know when you look at someone like Breton, her journey is, really the best part of what we do here at Sleep Tech Talk. It's really capturing innovators, entrepreneurs, people that are curious, that think outside the box. And when you think of somebody, as we talked about on the show, they started out just wanting to snowboard. Here she is leading a company that's in all 50 states. It's wildly successful. And it does something that's really interesting to have been fun to really dig into is their end to end level of quick care.

She kind of touched on it a little bit, but I just love how she stayed curious and then on a personal level, you know, with the AST, she definitely does not have time to volunteer and yet she's another one of those people that gives back, even though her incomplete calendar is full every single day, she finds time to give back to her profession. And I think that is just really telling of her character. As I noted in the show, it's kind of the heartbeat of Who Better Night is, and it was just fantastic to get to hear that.

They were one of the first companies that I remember Emerson really putting out information related to value-based care models related sleep. And it feels like they were ahead of their time. You know, and she sort of alluded to that too with some of programs and services. My guess is we're probably gonna circle back around to some the things that they worked on early on and they're gonna be well positioned to be able to be successful in this sort of future state of having a population health approach to treating patients with sleep issues.

This word success, when successful, we use quite a bit when talking about Breton and better night. I think what's the core of it, and Emerson, you asked that towards the end of the conversation, is what is the score? And if you heard something throughout, it was passion. Taking care of those patients and I found that really really valuable because at the end of the day that's what she wanted to do is take care those patience she talked about an underserved area when they that recent acquisition that they made and they just don't have enough people to take.

Care of this patient she really wants to that for them and then we were talking about. about AI and that sort of thing. I was like, no, you can't replace the human touch. We really have to provide care for the patients. And for me, it's really nice to hear that, that somebody cares.

Closing Thoughts and AST Membership Promo 31:28

Somebody at her level, chief operating officer, president, I still care the patient. She said business is hard. It goes up and down, but the care doesn't go away. No, I think you're right. When you are purpose-driven, these things happen. You're led by the right things. And the patient stays first. Your employees are still important. Quality still matters. Then at the end of the day, your growth is exponential because you focus on doing the things for people and when you have that kind of purpose, the fuel from it is fantastic.

What were you going to say, Rob? Uh, you know, I, uh, remember back in the day that, the company sleep med, they had something in their mission statement to the, and this is a terrible version of it, but it was something to effect of, take care of patients the way you'd want to take your grandmother or something like that. It was, it's something of that effect. And, You know it always hit me that that was in there, that something that on their website and built into the mission of take of a patient the you want your grandmothers to be taken care.

So doing the right thing is absolutely the best way to do business. She mentioned Dr. Li Chong. Yeah, we've got to get him on the show. We do. But talking about doing right things that Emerson said, one time in an email, Li Chong had put that in there about Emersons saying that, doing that right. So it's not something new that... Yeah exactly. He's quoting the great Emberson Kerr. Oh boy. Well, you know what? You know, it's so funny to say I actually said that to someone the other day. I said one of the best moments is when you hear someone quote you and they didn't know where it came from.

And I, that's really a neat thing. Not saying that she was quoting that, but I think that part of what we get to do is We had to reach so many people, whether it's through our podcast or through out careers. And it has just been a fun journey to get to do that and to be a part of the national conversation. I mean, Sleep Tech Talk is that. We are the National Conversation for Sleep Technology and SleepTech. It's an extraordinary place to and I know all three of us are honored to And speaking of that, Emerson, I know this episode will come out before this takes place, but your host of Sleep Tech Talk have been invited to be the keynote speakers at this year's Current Concepts meeting in Florida.

So look for us in August. We're speaking on the first day, early in the morning, maybe 8 o'clock, and we're going to talk about sleep diagnostics, the past, present, future. And same thing with sleep apnea therapy. So stay tuned. We'll talk about that a little bit more on future episodes. Yeah, all three of them. Yes. Looking forward to that. But I did want to say a couple of things, Emerson. I would challenge you about being the national voice and say it's international because we've had people from other parts of the world on our show and it is exciting to see that Number two is, I've also been quoted before, but I can't repeat those words on.

It's a family-friendly show. That's right. We'll try to keep it as family friendly as possible. There you go. Yes. All right, that's good place to stop if you gents agree. Yeah, good show! Allright, folks, thank you so much and until next time, we say cheers! 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 AEST 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 advanced our profession together. Visit astweb.org and discover where you belong.