The Problem We’re Solving

Silent respiratory decline is one of the most dangerous and least recognized risks in home care. Families can be doing everything right — watching closely, checking vitals, following routines — and still miss the moments that matter most. Research shows that 20–40% of patients with respiratory illness experience silent hypoxia: dangerously low oxygen levels with no outward signs. Many don’t feel breathless, don’t look distressed, and don’t trigger alarms.

Even more striking, in one study, 50% of discharge‑ready patients developed hypoxia during a simple six‑minute walk test — with no symptoms at all. And while remote monitoring tools exist, a major review found weak and inconsistent evidence that they reliably prevent deterioration or hospitalization.

But the risk isn’t limited to adults with respiratory disease. It affects multiple vulnerable groups:

  • Down Syndrome: Children with Down Syndrome have extremely high rates of obstructive sleep apnea — 30–97%. Adults face even higher prevalence, with up to 90% developing OSA. These events often include silent desaturation spells that caregivers never see.

  • Infants: Premature and medically fragile infants frequently experience sudden oxygen drops during sleep, feeding, or illness. Their respiratory systems are immature, and they cannot signal distress. Silent hypoxia in infants is both common and dangerous.

  • COPD: COPD patients often experience unrecognized desaturation during daily activity, sleep, and illness. Many develop hypoxia without dyspnea, and CO₂ retention can escalate quietly — a major driver of emergency visits and readmissions.

Across all these groups, the pattern is the same:

Families are left to bridge the gap with instinct, vigilance, and hope. Clinicians are left without visibility into what happens between visits. And the home remains the most vulnerable point in respiratory care.

And the cost of this gap is staggering

Respiratory hospitalizations and readmissions tied to silent decline cost the U.S. an estimated $3.4 billion every year — not because families aren’t trying, but because the tools they have aren’t enough.

This is the problem Pigeon is built to solve.

Why the Home Is the Blind Spot

Patients spend almost all of their lives outside the clinic — 99% of their time, according to recent home‑care analyses. That means the most critical changes in respiratory status don’t happen during appointments, tests, or follow‑up calls. They happen in bedrooms, living rooms, school commutes, and quiet moments when no one is watching.

Clinicians do their best with scheduled touchpoints — a call at 48–72 hours, a home visit if needed, and a clinic appointment weeks later. But between those interactions, care teams have limited objective information about how recovery or decline is unfolding. Families are left to notice subtle changes, interpret symptoms, and decide when something is wrong — often without tools that can see what they can’t.

And the problem is bigger than missed symptoms:

  • Changes often develop between scheduled interactions. Oxygenation can decline, respiration rate can rise, activity can drop — and these shifts may persist for days before anyone realizes something is wrong.

  • Patients frequently under‑report symptoms. Fatigue, medication effects, fear of being a burden, or uncertainty about what’s “normal” all lead to under‑reporting.

  • Single measurements rarely tell the whole story. Without knowing a patient’s baseline, a single pulse ox reading or symptom report is almost impossible to interpret.

  • Home monitoring tools are inconsistent. Even the American Thoracic Society notes major knowledge gaps and inconsistent performance in home spirometry and pulse oximetry for chronic lung disease.

The result is a perfect storm:

Caregivers are vigilant, but they’re human. Clinicians are skilled, but they’re distant. And the home — where respiratory decline actually happens — remains the least monitored and least understood environment in the entire care pathway.

This is the blind spot Pigeon is designed to illuminate.

How Pigeon Closes the Blind Spot —The Ecosystem That Sees What Families Can’t

TThe blind spot in home respiratory care won’t be solved by a single device. It will be solved by a connected ecosystem that continuously watches, interprets, and communicates the moments caregivers can’t see. Pigeon is being built to deliver exactly that — a future where families have real‑time visibility, clinicians have meaningful data, and silent respiratory decline no longer goes unnoticed.

Pigeon’s ecosystem is designed to create a continuous, intelligent signal path from the body → to the sensor → to the processor → to the caregiver. Each component will play a specific role, and together they will form a safety net the home has never had.

Feather & Pin Feather — Wearable Sensors for Real Life

Feather (adult) and Pin Feather (infant/premie) will be soft, wireless nanotextile sensors designed for everyday movement, sleep, feeding, and recovery. They will capture SpO₂, pulse, and tcCO₂, along with:

  • skin contact

  • optical signals

  • motion

Their job will be simple: see the moment it happens, including the silent ones.

Pearch

Perch will be its own sensor, giving families another way to see what’s happening — not as a backup, but as a second, equally important window into respiratory status.

Nest — The Intelligence Layer

Nest will be the processing hub where your proprietary algorithms live. It will interpret SpO₂, pulse, and tcCO₂ signals and perform:

  • melanin‑bias correction

  • motion artifact filtering

  • waveform smoothing

  • CO₂‑risk pattern recognition

  • alert threshold logic

  • battery telemetry

  • safety logic

Nest will transform raw signals into actionable insight, closing the blind spot by recognizing patterns caregivers cannot detect on their own.

Coo — The Caregiver Interface

Coo will deliver real‑time readings and alerts directly to the caregiver’s handset. It will be simple and designed for daily life — no apps, no pairing, no phone dependency.

Coo will provide both audible and visual alarms, ensuring caregivers are alerted immediately when Nest detects a concerning pattern. It can be muted when needed, but by default, Coo will speak up.

Coo will be the voice of the ecosystem — the part that says, “Something is changing. Look here.”

PAM — The Partner Assist Module

PAM will provide gentle wrist‑based vibration alerts when Nest detects concerning respiratory patterns.

PAM will give partners a silent, immediate cue that something needs attention, without startling the CPAP/BiPAP user or disrupting sleep with loud alarms.

Over time, PAM will also support:

  • caregivers who need discreet alerts

  • individuals who prefer haptic notifications

  • shared nighttime monitoring without noise

PAM will be the tap on the wrist that keeps partners connected, informed, and supported — especially in the moments when CPAP/BiPAP users cannot sense their own decline.

Ducket — The Charging & Safety System

Ducket will manage charging logic and enforce the dual‑unit safety rule:

  • sensors will never be charged while attached

  • one unit will stay on the patient

  • one unit will charge

  • monitoring will remain continuous

  • LiPo risk will be prevented

Ducket will be the guardian of the ecosystem.

Together, They Will Close the Blind Spot

Feather, Pin Feather, and Perch will capture SpO₂, pulse, and tcCO₂. Nest will interpret SpO₂, pulse, and tcCO₂. Coo and PAM will deliver the insight. Ducket will protect the system.

And families will finally have what the home has always lacked:

A future where silent respiratory decline is no longer silent. A future where caregivers are supported, not stretched. A future where the home is no longer the blind spot.