The future of healthcare starts at home

Today, most people see a doctor only after symptoms have become noticeable. But what if healthcare could identify the earliest signs of Alzheimer's disease, Parkinson's disease or psychiatric disorders long before symptoms begin to affect daily life?

Researchers at Aarhus University have spent years developing a technology that could make that possible. The device resembles a pair of ordinary in-ear headphones, but instead records brain activity while people sleep in their own beds. Known as ear-EEG, the technology was designed to make advanced brain monitoring simpler, less intrusive and more accessible.

And perhaps most importantly, the technology is already being used in clinical studies where researchers track patients' sleep over extended periods to investigate whether diseases can be detected earlier than is possible today.

"We have spent many years developing and refining the technology," says Professor Preben Kidmose from the Department of Electrical and Computer Engineering at Aarhus University, where he leads the Centre for Ear-EEG.

"Today, the challenge is no longer primarily technological. We have reached a point where measurements that once required specialised equipment and hospital visits can be performed in people's homes. The next step is building the workflows, infrastructure and healthcare services needed to use the technology in practice."

One example is an ongoing collaboration between Aarhus University, Rigshospitalet and the Danish company Cebreo Medical in a project supported by Innovation Fund Denmark. Researchers are following patients' sleep patterns over time to investigate whether sleep signatures associated with Parkinson's disease can be identified years before a clinical diagnosis is made.

Participants perform measurements at regular intervals over a period of up to two years. The goal is both to demonstrate that these characteristic sleep changes can be detected early and to show that the technology can track disease progression over time.

"Studies like these become possible when measurements move out of the clinic and into people's everyday lives," says Preben Kidmose.

"We can follow individuals over long periods and observe changes that are extremely difficult to capture through traditional sleep studies conducted in specialised clinics."

Ear-EEG is far from the only health technology approaching clinical implementation. Across healthcare, researchers are developing digital solutions that move diagnostics and monitoring closer to patients. But ear-EEG provides a particularly clear example of both the opportunities and the challenges that lie ahead.

Sleep may reveal disease long before symptoms appear

The technology is based on a simple principle: the brain continuously produces electrical signals even during sleep. By analysing these signals alongside measurements such as body temperature, movement patterns, breathing and heart sounds, researchers can identify patterns associated with specific diseases.

What makes this especially interesting is that many neurological diseases begin affecting sleep very early in their progression, often years before patients notice any symptoms.

"We know that changes in sleep can be among the earliest signs of neurodegenerative diseases," says Professor and Consultant Neurologist Poul Jørgen Jennum from the Danish Center for Sleep Medicine, Copenhagen University Hospital.

"If we can monitor these changes continuously over long periods, we may be able to identify disease much earlier than we do today."

Traditionally, such investigations require patients to spend nights in specialised sleep clinics connected to electrodes, wires and extensive monitoring equipment. The researchers' ambition is to move those measurements from hospitals into people's homes.

"Our goal is to make monitoring simple enough for people to perform themselves over days, weeks or even months," says Preben Kidmose.

"Many of the biological changes we are looking for develop gradually and can be difficult to detect in a single measurement. When we can follow people over extended periods in their normal environment, we gain access to patterns and changes that would otherwise remain invisible."

A healthcare system centred on the patient

The technology also raises a broader question: Is the healthcare system ready for patients to play a more active role in collecting health data?

This debate is becoming increasingly relevant as digital health technologies mature. Denmark's healthcare reform places greater emphasis on treatment closer to home, digital health services and remote monitoring. At the same time, new national initiatives aim to strengthen the digital infrastructure that connects health data and healthcare services.

"We know that many more people could benefit from sleep assessment than we currently reach," says Poul Jørgen Jennum.

"If we want to reach them, we cannot simply do more of what we are already doing. We need to change the way we work."

For Preben Kidmose, the transformation is about culture as much as technology.

"We are used to a healthcare system where people travel to hospitals for examinations. In the future, many more measurements will take place in people's homes. That requires patients to become more involved in managing their own health."

He emphasises that the technology is not intended to replace clinicians.

"This is not about leaving people alone with an app or a device. It is about providing clinicians with better data and enabling earlier intervention. Ultimately, it is about finding people who are on the path to disease much earlier than we do today."

A major problem of underdiagnosis

For Poul Jørgen Jennum, the need for new solutions is becoming increasingly urgent.

Sleep disorders play a role in a wide range of diseases, yet many people who could benefit from sleep assessment are never evaluated.

"We are massively underdiagnosing," he says.

"There are many people who would benefit from sleep investigations but are never examined. Not because we don't know how to do it, but because we simply do not have the capacity to evaluate everyone who should be assessed using today's technologies."

The problem is not only one of capacity.

"Many sleep assessments today are based on measurements collected over one or a few nights. That provides valuable information, but fundamentally it is only a snapshot," he says.

"Many of the diseases we hope to identify earlier develop over years and appear as subtle changes in sleep patterns over time. We therefore need methods that allow us to monitor people unobtrusively in their everyday lives for extended periods."

Current approaches also require specialised equipment, trained staff and often visits to dedicated sleep clinics.

"The system works well for the patients we are able to assess, but it was never designed to reach everyone who might benefit from evaluation. If we want to identify more patients earlier in the course of disease, we need investigations that are simpler, less resource-intensive and more accessible."

Technology is no longer the bottleneck

Denmark is in a unique position. Significant investments are being made in digital healthcare solutions, home-based care and new ways of organising healthcare delivery.

For the researchers, ear-EEG demonstrates that many of the necessary tools already exist.

The technology has been developed through more than a decade of research and innovation projects involving universities, hospitals and industry partners. Today, commercial versions of the technology are being used in clinical studies designed to demonstrate its value in future healthcare systems.

According to Poul Jørgen Jennum, the greatest challenge is not the patients healthcare providers already know about.

"The real challenge is all the people we have not yet found," he says.

"If we are serious about earlier detection of disease, we need both to evaluate more people and to follow them over longer periods of time. Traditional sleep assessments alone cannot support that ambition. That is why we need new technologies such as ear-EEG."

If successful, the benefits could be substantial, not only through earlier diagnosis and treatment, but also by enabling a more preventive and targeted healthcare system.

For Preben Kidmose, the implications extend far beyond a single technology.

"Ear-EEG is one example of a broader transformation taking place across healthcare. We are gaining new opportunities to move monitoring and diagnostics closer to citizens. That allows healthcare systems to intervene earlier and use resources more effectively. The technology is almost ready. Now we need to make the healthcare system ready to use it."

And perhaps that transformation begins in the last place most people would expect:

In the ear.