HN Reliance’s Sleep Programme Is a Sign of How India’s Health Priorities Are Changing
By Arunima Rajan
In an interview with Arunima Rajan, Dr Subho Sarkar, Consultant, Pulmonary and Sleep Medicine, Sir H.N. Reliance Foundation Hospital , Mumbai says that integration of modern technology and use of AI for both the interpretation of sleep studies and the monitoring of treatment adherence will change the way we manage sleep disorders.
HN Reliance is known for bringing cutting‑edge specialities to Mumbai. What prompted the hospital to invest in a dedicated sleep‑medicine programme, and how long has it been operational?
Sir HN Reliance Foundation Hospital has been a pioneer in bringing cutting-edge specialities to the city of Mumbai. We recognised that sleep-related disorders, which are often underdiagnosed, were slowly progressing in the community as a silent epidemic. It not only affects restful sleep at night but also affects daytime performance and disrupts the normal hormonal and cardiometabolic balance of the body. This directly affects the quality of life and acts as the harbinger of various chronic metabolic diseases. The decision to invest in a sleep medicine program was strategic: to cater to the patients with sleep disorders by providing high-quality diagnostics and treatment, and also improve the overall health outcomes of the community at large, thereby strengthening ourmultispecialty continuum of care. Our Sleep Medicine Programme has been operational since 2015, during which we’ve scaled diagnostics and treatment to meet growing demand.
Was patient demand, clinical research or philanthropic interest the driving factor?
It was a mix of becoming aware of the patient’s demand and rising referrals from various other departments like cardiology, ENT and primary care. This demonstrated the unmet need for such services and was an opportunity for us to translate that demand into an outcome-driven service. Institutional and philanthropic investment, keeping the patients’ needs at the forefront, combined with the research opportunities, led to the foundation of the sleep medicineprogram.
Can you outline the spectrum of sleep services offered at HN Reliance—diagnostic studies (in‑lab polysomnography, home sleep tests), therapeutic interventions (CPAP titration, oral appliances) and long‑term follow‑up?
We provide a wide range of sleep services: comprehensive outpatient assessment, screening of sleep disorders in our executive health check up package, in-lab diagnostic level 1 polysomnography, supervised in- lab CPAP titration, AutoPAP titration, validated home sleep apnea testing services, specialist dental collaboration for oral devices,multiple sleep latency test and maintenance of wakefulness test for excessive daytime sleepiness and behavioural treatments for insomnia. We also have a structured long-term follow-up plan with adherence monitoring and outcome tracking. We also support CPAP education and troubleshooting, mask fittings, and a telemedicine follow-up workflow when required.
Approximately how many patients do you manage each month?
On average, we manage approximately 15 to 20 sleep patients per month including both new and follow-up patients
What is the demographic profile of your sleep‑disorder patients?
Mostly adults aged above 35 years form the bulk of our sleep patients, with a slight male preponderance. Obstructive sleep apnea (OSA) is mostly diagnosed among middle-aged men and post-menopausal women. We are also seeing more and more younger professionals with insomnia, an increasing number of patients with obesity-related sleep disorders and sleep problems in older adults with complex comorbidities.
Do you primarily see adults with obstructive sleep apnea, or is there a significant paediatric, geriatric or insomnia‑related workload?
We primarily see a lot of middle-aged and older adults suffering from obstructive sleep apnea. However, we also encounter insomnia, or lack of sleep, in both the young and older populations. But we do have a multidisciplinarycollaborative approach when it comes to managing insomnia and paediatric cases.
Have you noticed any trends associated with urban lifestyles, such as increased insomnia among young professionals?
Yes. The urban lifestyle is changing sleep epidemiology. Weare seeing a lot of insomnia and circadian-rhythm sleep disorders among young professionals who are tied to shift work, increased digital screen time and work-related stress.On the other hand, sedentary habits and rising obesity in urban populations are increasing OSA prevalence.
How does HN Reliance integrate sleep medicine within its wider multispecialty framework?
We get a good number of referrals for management of sleep disease from various specialities like cardiology, endocrinology, ENT, psychiatry and occupational medicine. We also run daily executive health check-ups where we comprehensively screen for sleep disorders with the help of questionnaires. We also conduct multidisciplinary discussions with other departments when appropriate.
Are there formal care pathways that link sleep diagnostics to cardiology, endocrinology, ENT and mental‑health services for holistic management of comorbidities?
Yes. We have structured referral algorithms and pathways that ensure that patients with abnormal sleep studies are timely referred to cardiology, endocrinology, ENT department and mental-health services for various behavioural therapy. This has led to holistic management of the patient and improved compliance of treatment.
Technology and innovation are reshaping the ‘sleep economy.’ Are you employing new tools—AI‑assisted scoring, wearable devices, tele‑monitoring—to enhance diagnostic accuracy or patient convenience?
We actively use technology to improve our clinical outcomes and help improve patient comfort and adherence. Thisincludes teleconsultations, cloud-based CPAP adherence reporting and validated home sleep testing for selected patients. We are aware of the various wearable devices for the diagnosis of sleep disorders; however, we are cautious of over-reliance on such technologies without human insight because of validation issues.
How do you balance innovation with clinical rigour?
By insisting that every new tool improve measurable outcomes, efficiency, or patient experience. Artificial intelligence tools and wearables augment clinician decision-making rather than replace it. The final interpretation and treatment planning always rests in the hands of the clinician’s judgement.
Accessibility and affordability are persistent challenges in sleep healthcare. Does HN Reliance offer subsidised services, charity programmes or partnerships to ensure that lower‑income patients can access sleep diagnostics and treatment?
Access is a priority. We maintain subsidised slots and charity case provisions for eligible patients through hospital social services
Sleep disorders are often under‑recognised by both the public and healthcare providers. What outreach, education or corporate‑wellness initiatives is HN Reliance involved in to improve awareness and early detection?
Our outreach program includes public talks, digital education campaigns, CME sessions for general physicians, corporate wellness programs focusing on sleep hygiene and shift-work management, and awareness regarding sleep apnea and other sleep disorders.
Looking forward, how do you see the role of sleep medicine evolving at HN Reliance over the next five years?
Sleep medicine will become more embedded in preventive and chronic-disease management. We are in the course of expanding our sleep laboratory with more state-of-the-art equipment and personnel to meet the growing need for sleep studies across the city. Integration of modern technology and use of AI for both the interpretation of sleep studies and the monitoring of treatment adherence will change the way we manage sleep disorders.
Are there plans to expand lab capacity, launch clinical research, or collaborate with industry on new diagnostic technologies?
Yes — we are planning to scale lab capacity and formalise clinical research initiatives to study local epidemiology, treatment outcomes and adherence interventions.
In your view, how central will sleep health become to India’s overall healthcare landscape?
Sleep disorders are the rising silent epidemic in the country. In India, with the rising trend of cardiometabolic disease and urban lifestyle stresses, sleep health will be central to the core pillar of preventive medicine and chronic disease management. It is our responsibility to spread awareness regarding sleep health among the citizens of our country and provide them with accessible and affordable diagnostics and treatment for sleep diseases.
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