The Sleep Agentic OS

The sleep center of the future won't be managed. It will be orchestrated.

SOMNIA is an operating system of coordinated AI agents running the entire sleep medicine lifecycle — intake, scoring, interpretation, therapy, behavioral care, billing, and longitudinal outcomes — under clinician command.

PATIENT 0042 · NIGHT STUDY · TYPE II HSAT AGENTS ACTIVE
WAKE REM N1 N2 N3 SCORING AGENT · N3 CONFIRMED ENDOTYPING · HIGH LOOP GAIN REPORT DRAFTED · MD REVIEW QUEUED
Two converging crises

The constraint on sleep health is not knowledge. It is capacity.

Diagnosis is bottlenecked, first-line insomnia treatment is undeliverable at human scale, and the clinicians who hold the system together are burning out.

80%of an estimated 30M US adults with obstructive sleep apnea remain undiagnosed
25MUS adults with chronic insomnia — served by only a few hundred certified behavioral sleep specialists
2 hrsof technologist time consumed by manual scoring of a single sleep study
58%of sleep medicine professionals have considered premature retirement
Category definition

Not another tool. The operating system the tools plug into.

  • Not practice management software — record keepers with AI bolted on
  • Not a PSG scoring platform — one task, automated in isolation
  • Not a PAP compliance tracker — telemetry without treatment
  • Not a consumer sleep app — wellness without clinical authority
  • Not a telehealth clinic — a channel, not an intelligence

The Sleep Agentic OS

The intelligence layer beneath and between every system in the sleep pavilion. SOMNIA ingests every data source, reasons across the full care continuum, and executes the work autonomously — inside clinician-approved boundaries, with every action audited.

Architecture

The six-layer stack

Tap a layer to open it.

L1The Sensory Gridthe nervous system

Unified ingestion across in-lab PSG, home sleep tests, PAP/BiPAP/ASV telemetry, FDA-cleared wearables, sleep diaries and validated instruments, EMR, staffing, and patient communications. One source of truth replaces the fragmented stack.

L2The Intelligence Corethe brain

The multi-agent system: scoring, diagnostics, endotyping, therapy optimization, behavioral care, triage, revenue cycle, scheduling, and staffing — specialists that work in concert.

L3The Orchestration Enginethe conductor

Event-driven workflow automation with human-in-the-loop gates on every consequential clinical decision, and a complete audit trail — every agent action logged with identity, inputs, and reasoning.

L4The Clinical Intelligence Layerthe diagnostician

AASM-accuracy automated scoring, endotype analysis, multi-night longitudinal assessment beyond the single-night snapshot, and predictive models for treatment response — interoperable with FDA-cleared AI tools.

L5The Remote Monitoring Layerthe extended senses

Continuous real-world monitoring through cleared wearables and RPM programs — powering chronic-care management and the longitudinal datasets that feed the foundation model.

L6The Stakeholder Experience Layerthe soul

Purpose-built agents for patients, clinicians, technologists, administrators, and payers — 24/7 education, ambient documentation, study QA, operational intelligence, and clean claims.

The workforce

The full fleet. Six divisions. One living organism.

Every agent below runs in the SOMNIA Command Center today. Consequential actions always carry a human signature.

Division 1 · Clinical Intelligence
Medical director

Orchestrator Agent

Activates specialists by context, integrates their outputs, and manages the conversation between agents and the human team.

Lead technologist

Scoring Agent

Full PSG and HSAT scoring at AASM accuracy — stages, arousals, respiratory events, limb movements — in minutes.

Physician's resident

Diagnostic Agent

Drafts interpretations with confidence scores and flags artifacts for human review.

Precision specialist

Endotyping Agent

Identifies physiological subtypes — loop gain, arousal threshold — and predicts treatment response.

Treatment optimizer

Therapy Agent

PAP and ASV optimization, adherence prediction, proactive outreach before therapy fails.

Evidence keeper

Sleep Librarian

Grounds every recommendation in the current guideline evidence base, on demand, with a citation packet for the chart.

Division 2 · Behavioral — The Insomnia Care Engine
Behavioral specialist

CBT-I Agent

Clinician-supervised digital CBT-I with adaptive sleep-restriction titration and COMISA sequencing.

Safety monitor

Deprescribing Sentinel

Tracks supervised hypnotic taper as CBT-I takes hold — a measurable safety endpoint, not a hope.

Night watch

After-Hours Triage Agent

24/7 patient line with strict escalation rules — resolves the routine, wakes a human for the rest.

Division 3 · Access & Experience
First contact

Greeter Agent

Welcomes every referral with a personal registration link — MQ readiness assessment embedded, sleep-study walkthrough included, 7th-grade level verified.

Intake coordinator

Triage Agent

Routes referrals to in-lab or home pathways and collapses time-to-diagnosis from weeks to days.

Patient's translator

Patient Summary Agent

Rewrites every visit at a verified 7th-grade reading level — the readability grade is computed, not assumed.

Growth engine

Referral Network Agent

Keeps primary care and specialty referrers engaged; reactivates dormant referral sources.

Division 4 · Revenue Integrity — powered by Shamar Guardian
Payer red team

The Adversary

Attacks every note the way a payer auditor would — before submission. Finds the denial before the denial finds you.

Documentation coach

Billability Coach

Repairs the note in real time so the documentation supports the code the first time.

Plain-language layer

Shamar Explain

Tells the physician exactly why a note was risky and what the fix changed — in one breath, no jargon.

Biller

Revenue Cycle Agent

Auto-coding, payer validation, prior authorization, denial prevention.

Division 5 · Operations
Lab scheduler

Scheduling Agent

Utilization optimization, waitlist backfill, in-lab and home-test coordination.

Operations manager

Staffing Agent

Demand-forecast scheduling, absence prediction, automatic on-call backfill.

Quartermaster

Inventory Agent

Masks, tubing, electrodes, the HSAT device fleet — and the resupply revenue line, worked automatically.

Continuous care

Remote Monitoring Agent

Aggregates wearable, PAP, and home-test streams to catch deterioration between visits.

Division 6 · Governance & Network
Accreditation keeper

Compliance Agent

AASM accreditation readiness, HIPAA posture, audit-response packets compiled on demand.

License watch

Credentialing Agent

Licensure, certifications, payer enrollment, CAQH — tracked and prepared before deadlines bite.

Educator

Training Agent

Staff CEU tracking and competency modules, with attestations queued to the medical director.

Epidemiologist

Sentinel Agent

Watches longitudinal sleep signatures for early markers of neurodegenerative, psychiatric, and cardiometabolic risk.

The tier above

Network Command

Multi-pavilion benchmarking, load balancing, and best-practice propagation — one organism, many sites.

The Insomnia Care Engine

First-line treatment that exists in guidelines but not in patients' lives is a solvable engineering failure.

CBT-I is the guideline-recommended first-line treatment for chronic insomnia. The workforce math makes it undeliverable by humans alone:

~25,000,000 US adults with chronic insomnia
÷ a few hundred certified behavioral sleep specialists
= care for the few, sedatives or silence for the rest

The CBT-I Agent delivers the full protocol — sleep restriction with adaptive titration, stimulus control, cognitive restructuring, relapse prevention — personalized nightly from diary, wearable, and psycho-respiratory data, with a supervising clinician approving each phase transition. Built on the PulmIQ / SleepIQ behavioral intelligence core, it is the first platform to treat comorbid insomnia and sleep apnea as one condition with one coordinated pathway.

SOMNIA MORNING BRIEF06:00 · 30-SECOND READ
🌙

Overnight sync3 studies auto-scored and interpreted. 2 PAP reports reviewed. 14 CBT-I check-ins processed.

🧠

Patient insight — 10:00 AMGood adherence, persistent fatigue. High loop gain detected. Recommend ASV transition — evidence attached.

🛏️

CBT-I cohortWeek-3 titration ready for 6 patients. 1 escalation flagged for specialist review.

📋

OperationsTech absence auto-backfilled. 0 denials pending. Tonight's lab at 96% utilization.

Every action logged. Nothing consequential moves without you.
The scoreboard

Judged on outcomes, not efficiency.

Every deployment ships with an outcomes registry — the platform's accountability layer and the evidence base for payers and federal partners.

MeasureLegacy baselineSOMNIA target
Referral to diagnosis3–6 weeks72 hours on the home-test pathway
Study scoring turnaroundDays; 1.5–2 hrs of labor eachSame night, minutes per study
Insomnia remissionFirst-line CBT-I inaccessible to mostGuideline-concordant digital CBT-I at scale
PAP adherence at 90 days~50% typicalEndotype-guided therapy targeting 80%
COMISA identificationRarely screenedUniversal dual-stream screening
Clinician sustainability45% burnout, pajama-time chartingNotes, scoring, and billing drafted by agents
The dual-track model

Upgrade the centers that exist. Create the centers that don't.

TRACK ONE

SOMNIA Inside

Existing sleep centers adopt SOMNIA as their operating layer. Scoring labor collapses, lab capacity rises toward full utilization, denials fall, and new reimbursable service lines — digital CBT-I, remote monitoring, chronic care management — open. The ROI is arithmetic.

TRACK TWO

The Sleep Pavilion in a Box

An 80%-undiagnosed gap cannot be closed by incumbent efficiency — the nation needs new capacity. Track Two packages the full agent stack, validated device kit, clinical protocols, credentialing playbooks, and revenue rails so clinician-entrepreneurs can open SOMNIA-native pavilions in months.

PHASE 1

Foundation

Sensory Grid, Scoring & Triage Agents, CBT-I Agent v1, outcomes registry live from day one.

PHASE 2

Intelligence

Diagnostic, Endotyping & Revenue Agents; orchestration engine; COMISA screening.

PHASE 3

Orchestration

Therapy, Scheduling, Staffing & Remote Monitoring Agents; first value-based payer contract.

PHASE 4

Capacity

Patient Agent at scale; Pavilion-in-a-Box launch with the first operator cohort.

PHASE 5

The Living Network

100+ sites, cross-center learning, Sentinel Agent — sleep as an early-warning vital sign.

Federal alignment

Built for the ARPA-H mandate.

A scalable, measurable answer to a first-line treatment the human workforce cannot deliver — extended from a working clinical stack, with endpoints captured in a built-in registry across diverse deployment settings.

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