50. Composure-Personalized Soundscapes to Improve Sleep Quality for Senior Living Residents

In this episode of Raising Tech, our host, Amber Bardon, has a fascinating conversation with Jeff McSpadden, Co-Founder & CEO of Composure. They dive into how Composure leverages remotely-managed personalized soundscapes to enhance sleep quality within Senior Living communities.

Explore how Composure's innovative SoundBlanket  effectively reduces sleep disruptions, promotes deep sleep, and ultimately elevates the overall quality of sleep for senior living residents resulting in enhanced behavioral outcomes and a reduction in daytime drowsiness and falls.

Raising Tech is powered by Parasol Alliance, The Strategic Planning & Full-Service IT Partner exclusively serving Senior Living Communities.

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Transcript

Amber Bardon: Welcome to Raising Tech Podcast. I'm your host, Amber Barden. And today my guest is Jeff McSpadden. Jeff is the co founder and CEO at Composure, which is an evidence based digital audio company that delivers custom soundscapes for senior living communities to improve sleep and drive health outcomes for older adults living with dementia.

Thanks Jeff, I am so excited to have you on the podcast today. As we were chatting a little bit before we started recording, we've had a couple of other entrepreneurs in the space. You've done some other things with environmental around lights and flooring. And I think sound and the impact sound can have, I'm really interested to learn about today.

So welcome to the show. 

Thank you. I'm happy to be here. Good to meet you and glad we can dive in. 

So tell me a little bit more about your story. So you're an entrepreneur and you have a background as a musician. So tell me about the journey that led you to  starting composure and where you're at today.

Jeff McSpadden: Yeah before I'll go in reverse order a little bit, just before starting the company I worked for about 15 plus years as a composer writing original music for film, TV and advertising. And there's a kind of an interesting phenomenon that generally gets taken for granted when you're watching a movie or TV show, and it's that sound element is actually doing quite a lot of the heavy lifting in terms of engaging you emotionally queuing you in lots of different ways that are all very purposeful to the story.

Sound is a very powerful force. It changes our reality. It influences how we behave and how we feel. And to me, I got really interested in how we can leverage that power outside of the realm of entertainment and take it into the realm of health care.

And that really was the genesis of me wanting to start a company in this space and really see how we can impact some real change. Prior to that, I worked as a performing musician for a number of years. I'm a recovering trumpeter. That was my full time thing for quite a while starting at the age of 16.

But the thing about playing on stage is understanding how connecting with people through music is really done and the difference between playing at somebody or performing music at someone and getting them involved and if they are involved, all of a sudden, the entire room just elevates.

The entire venue, it goes from an ordinary setting to an extraordinary experience. So it's a really powerful force that I've learned a lot about and I just live and breathe and everything that comes through the ears, if you will.

Amber Bardon: Tell me a little bit more about how did you take that experience and that knowledge and connect it to healthcare and then specifically senior living.

Jeff McSpadden: It's funny. I think one of the first things I started really examining is This concept of what I did in  media, which was essentially film scoring, right? if you understand the concept, it's creating purposefully and intentionally creating music experiences to support a storyline or to tell the, the the parts of a story that aren't being done on screen and and by actors and the concept of scoring a story Felt like it could also make the leap into functionality in our lives.

Like, how could we score certain experiences in our life? Solving for chronic sleep issues amongst a population living with Alzheimer's and dementia. There's a lot of challenges there. If the thesis was, if we could properly kind of score that experience from awareness of bedtime all the way to waking up refreshed in the morning we might be on to something, right?

And we wanted to give that a try and actually approached it through a clinical research trial first that that came out with some pretty inspiring results.

Amber Bardon: So let's talk a little bit more about how does this work? So how do you take sound and incorporate it into a resident at a senior communities routine. And then what is the impact that you've seen music have? 

Jeff McSpadden: Yeah. There's kind of two parts to how it's done, and I think that's what kind of makes Composure and our offering with our service SoundBlanket very unique is that we haven't just focused on one side of it.

It's both. And what I mean by that is in one side of it, there's the content, there's the actual audio and our sound sequences that we've created. And then on the other side, it's how it gets delivered. How do you operationalize that, with full understanding of all the needs, opportunities and challenges within these care environments, because frankly, we discovered very early on that if you just create another app you're already sunk because staff are too busy  and it's not what they're trained on and relying on a caregiver to remember to use a new thing to aid in the care is you're a bit behind the eight ball already. It was really about first understanding, do we have a good sense of what the content should be? To drive change to actually help people sleep better. And if they slept better, what are the other outcomes? We'll see from that. And so we can talk more about that side of it.

But then once we had that fairly well understood, it was okay. Now, how do you get this to benefit residents in these congregate living settings. So what we've devised is a turnkey system called SoundBlanket, where we install networked speakers, one speaker per bed in these residences.

And we can remotely manage all of those speakers anywhere in the world. And generally, we're right now we're at sort of the 1 of this service, right? If you will, which means we're [00:06:00] relying on time triggers to deploy sounds at the right time. And then some other couple easy settings that can be set up right on when we on board a new community which makes it a very personalized experience for each resident.

Amber Bardon: Tell me a little bit more about the music. Is it custom created? What does it sound like? Can you describe it for me? 

Jeff McSpadden: Yeah so in the entire sequence that SoundBlanket is comprised of there's only about 20, 23 minutes that is actually just music. The rest of the sequence, which actually is up to 8 hours long

is a frequency noise response approach, which I'll talk about in a second, but specifically about the music. It is all custom. We take my pedigree as a composer into consideration here. And a few other composers that we brought in early on to help us construct these.

We've developed proprietary musical sequences that play at the beginning of each evening around bedtime. And this musical part of the sequence is doing two things really well. One, it's used as a gentle environmental cue for bedtime with a few repeat exposures, people start to say, 

oh, I hear this. It's very soothing. It's very calming. And I'm ready to start getting into bed and then it over a 20 minute period we're leveraging the power of music to help calm or relax or activate our sort of rest response. If you want to speak in more clinical terms, right?

 To take a step back for a second, if people consider what sound does to our physiological systems and our neurological systems, it's really fascinating. If we listen to an unexpected, harsh, startling sound. It generally makes you jump, your pupils dilate, your heart starts to race, you get flooded with serotonin, the sort of, stress hormone.

Jeff McSpadden: And some  of that is great. That's what's helped us survive as human beings for thousands and thousands of years. It's part of our survival mechanism. But if you flood your system of that too often, it can have some negative impact on your physical health, right? But the opposite is also true with sound.

So if you're exposed to very soothing, relaxing sounds, it actually triggers that rest and digest side of the equation. So you get into a more calmed state you get those endorphins and the pleasure hormones as they call it, right? And it's a very powerful thing. So what we decided early on was we were going to create this musical

introduction to our sequence to leverage what works really well you provide a very calming, relaxing experience to trigger that rest response. You can help people decrease their level of anxiety depression. There's a lot of things that kind of prevent us from falling asleep.

And then once that is done, and our residents are starting to drift off to sleep. That's when music starts to  become less effective. Because our ears and our brains are always listening and when we are listening to music as we're starting to drift to sleep and are asleep, it actually synchronizes our brain to the rhythm and changes and variations in the music.

So it's not a full resting brain state. What we're trying to do is leverage sound to do the best it can for the various stages of sleep. So music's a great introduction. Then once the listener is drifting off to sleep, we switch over very gradually dovetail into what's called pink noise.

This is that frequency response I was talking about before, and we've actually developed a variation on pink noise with a couple sort of secret sauce elements there that we've studied and found to be very effective. But pink noise at its basis has been known to do two things really good.

 It's a frequency that actually older adults hear fairly well, considering [00:10:00] the older adult hearing profile. Generally, we lose some of the high frequencies. The T's the S's all the sort of very high things that we hear. We aren't able to pick those up as easily. So pink noise fits in that sort of warmer middle to low range. It fits their hearing profile really well. And it's also been well understood, not just in our research, but other published research that it can go a long way in inducing deep way of sleep better, higher quality rest and adding a 3rd benefit there, it acts as a sound masking environmental element. So what I mean by that is, in congregate living and in hospital settings, the number 1 reason for sleep disturbance is environmental noise. People doing their job in the middle of the night.

Other residents up and about needing care. These things will arouse the brain and our response system and wake us out of our sleep. By employing pink noise at the right volume for that resident's room, we can actually take away a lot of the distracting qualities of those intermittent noises through the night.

Great for sleep. Great for your ears for being exposed to for a long period of time and goes a long way and taking all that interrupted sleep elements out of the environment. 

Amber Bardon: I was just woken up the other night by snow plows. I was staying at one of our communities in Montana and they were snow plowing the road at midnight and woke me up. Not sure how that went over with the residents either.

Jeff, I know that Composure has had some published research in memory care. Can you talk a little bit about what did you find out from that research? What have you learned? I 

Jeff McSpadden: think the number one most surprising thing we learned was exactly how impactful better sleep is on the quality of life for people living with dementia.

 If you know this population well, first of all, over 70 percent of people living with this degenerative disease experience regular sleep issues. as we all can attest to in our own lives, when you don't sleep well, you don't perform your best the next day. Now, imagine that in the context of already having lowered coping thresholds, lowered cognition as the disease progresses, you start to become nonverbal.

There's a lot of things that just add complexity to your day. So what we found was by focusing in on improving sleep, we saw a number of behavioral outcomes during the day improve. And I think that was what kind of gave us the big aha moment. It seems like a nice thing to improve somebody's quality of sleep.

Isn't that nice and cozy? And, you feel good. But actually where the rubber hits the road in a health care context is that if you improve a person's sleep, you actually give them a cognitive boost. The next day, you actually give them a physical performance boost. The next day, meaning potential for less falls, we saw increase in appetite  and eating performance.

We saw all the activities of daily living start to improve, like bathing and dressing and, eating and all of those essentials. And what we were most proud of is we ended up having two statistically significant outcomes in this study. By contrast, this is just anecdotal, but a lot of file pharma companies that go out and do research on their new drugs and so forth never reached statistical significance.

So we're really excited about these outcomes. And what those 2 were a major reduction in daytime drowsiness. So that makes sense, right? We're actually impacting the quality of sleep at night. So you feel less drowsy during the day. But what it really means, if you unpack that is they're more alert, oriented and engaged during the day.

Let's say a community has invested heavily in their activities program, and they've got a lot of enrichment going on through the day. But if you've got a population that is just exhausted and would rather take a nap every time they sit  in a chair. Then, how good is that? So we found that, better sleep at night lets them take advantage of a full quality of life during the day.

There's also another part of that I think McKnight's published an article last April about a relevance between excessive daytime napping and early end of life care considerations. So there's a deterioration that comes from excessive daytime napping. So we're excited about that measure being so drastically improved. But the next 1 that we hit statistical significance on had to do with cooperation with care. This is a big one for staff, right? And staff burnout ratios and those kinds of things, right? If you can improve the sort of relationship and the moments of caregiving in a memory care context that's huge, you're seeing less aggression, you're seeing less expressions of unmet needs or behaviors as some people call them, right?

Yeah. But when we looked at the data, it actually was interesting. What it said was, the people who in our study that [00:15:00] got the best rest And that saw the most improvements in their sleep were more likely to not accept care because they were feeling more independent.

They were feeling more able. They were feeling like I understand what you're asking me to do. I'll do it. I got it from here and that was really exciting. It's interesting to know how these cognitive boosts and cognitive reserves that sleek afford you express themselves.

And then we saw improvements and falls. The setting where we did our study was a very high performing setting, both on the resident side and the staff side during our study. So there was a very low incident count of falls to begin with but even within that, we saw a lowering in falls during our study.

 It was a small one site study. And we're excited for the results we got. And we're looking towards other additional opportunities, expand our understanding with another broader study. 

Amber Bardon: Yeah, it makes complete sense. We've all suffered from sleep deprivation and we all know intuitively that we don't perform at our best and we have  brain fog and things like that, but I'm sure that's really exciting to you to see the actual scientific data back that up.

And let you actually see the impact that you're having on community. So if a senior living community is interested in working with composure, what do they need to know. 

Jeff McSpadden: That prioritizing sleep for your residents is a vital part of fall prevention strategy or a prevention care strategy just in general.

 We've talked to a lot of people in the space and what we've generally found is when you talk about sleep and where the sort of downstream negative impacts are. And when we say what are you doing about it? It falls in three buckets.

One is medications, and everybody winces a little bit when they talk about it, because we all know that's not a great approach. And so reducing that medication use is something that people seem to be very interested in. The other thing is Remote patient monitoring which I think is an amazing  advancement in technology.

 It really enables staff to stay more alert and aware of situations. But I don't see it yet being a super effective prevention technology. It's more of a detection and analytics. And then there's the kind of You know, do it yourself approach, which is, we know our residents really well, we know their personal preferences.

We know that certain things work for, Helen as opposed to John. But even those things are kind of staff intensive resource intensive sometimes. And, what works 1 night might not work another. So it's a hit or miss. So working with us, we found that we can be a really needed relief in the market because we've devised a system that not only deploys sound, which it does no harm.

There is no side effects. There are no downsides. There have been very little evidence of, what do you call like a negative response to what we're doing. And we're doing it and deploying it in a sort of technological way that  we're not overburdening staff. The staff don't have to do anything.

It's a basically kind of a set it and forget it proposition. And it only gets better. With the regularity of the time schedule per resident for getting these sounds at night. And regular repeat exposure over time, it actually reinforces the benefits. So we've been trying to make it as easy to deploy and set up and use on a regular basis.

Amber Bardon: I really learned a lot from this conversation. So I'm really glad that we found each other and we're able to get you on the show and talk about composure. And I learned a lot of interesting information today. Where can our listeners find out more? 

Jeff McSpadden: Visit our website.

It's Composure.Care. And I'm on LinkedIn. Composure is also on LinkedIn. If you want to find me there. And actually one thing I'm really excited about coming up is I've been invited to pitch at the senior living 100 conference at the end of March.

They're doing their very first shark tank like pitch session. Composure will be one of six companies invited to be there. So if anyone in your audience Plans on being at the conference.  Come check us out Sunday, March 24th. 

Awesome. Good luck to you.

Thank you. I'm excited and thank you for inviting me on. This has been great. I'm really intrigued by what Parasol is doing and the much needed benefits. I know one thing I didn't really talk about earlier is the tech. Sort of infrastructure that we look to align within our client base.

It's not strenuous what we need, but there are certain sort of baseline requirements and I'm super glad you guys are out there helping people understand the importance of those things. 

Amber Bardon: Really, we're here to help build that infrastructure and backbone so that innovators and entrepreneurs like yourself and others out there can bring this technology to communities. 

Jeff McSpadden: Yeah, I definitely think, you guys recognize as well as we do that COVID changed what's a priority in senior living. This sort of boon in recognizing technology is a very useful thing. A very empowering thing for these caregivers and environments. It's a really exciting time right now. 

Amber Bardon: It is an exciting time. And I said that in other episodes and I'll continue to say that I think senior living technology is the most exciting technology industry right now because there's so much change coming.

 Thank you so much for being on the podcast today. 

Jeff McSpadden: Thank you, Amber. I'm glad we could get together. 

Amber Bardon: You can find us online at RaisingTechPodcast.com where you can see all of our episodes and contact us to provide feedback or submit an episode idea. We are on social media everywhere at Raising Tech Podcast. If you enjoy Raising Tech, please leave us a review and share with a friend. Music is an original production by Tim Resig, one of our very own Parasol Alliance employees.

As always, thank you for listening.