Talking Sleep

Dr. Atul Malhotra, lead investigator of the SURMOUNT-OSA trial, joins specialists Dr. Radhika Breaden, Dr. Jeremy McConnell, and Dr. Rafael Sepulveda Acosta to discuss the groundbreaking FDA approval of tirzepatide for obstructive sleep apnea. They delve into its effectiveness beyond weight loss, practical implementation strategies for clinics, and the importance of managing associated conditions like obesity. The team addresses concerns about GLP-1 medications and emphasizes collaboration between sleep and obesity medicine to provide comprehensive care for patients.

Dr. Sanja Jelic, a prominent sleep medicine expert at Columbia University, and Dr. Daniel Gottlieb, an Associate Professor at Brigham and Women's Hospital, dive deep into the potential inflammatory effects of high-pressure PAP therapy for sleep apnea. They tackle eye-opening findings on how PAP settings might influence inflammatory markers and challenge existing beliefs about CPAP efficacy. Plus, they explore innovative alternatives like supplemental oxygen and advocate for personalized treatment to enhance cardiovascular health and overall outcomes in sleep medicine.

Barry Krakow, a sleep medicine physician known for work on treatment‑resistant insomnia and advanced PAP therapy, discusses measuring success in obstructive sleep apnea beyond simple numbers. He covers switching from CPAP to bilevel/ASV for flow limitation, links between sleep fragmentation and anxiety/PTSD, insurer negotiation for advanced devices, and behavioral tricks to improve PAP tolerance.

Dr. William Noah, founder of Sleep Centers of Middle Tennessee and KPAP inventor, joins Dr. David White, former AASM president and sleep research expert. They dive into KPAP therapy, a revolutionary approach to sleep apnea treatment that enhances comfort and efficacy over traditional CPAP. The duo discusses the innovative engineering behind the VECOM device, research studies on CO2 rebreathing, and how real-time pressure adjustments can significantly improve patient experience. Their insights offer a promising glimpse into the future of sleep therapy.

Matt Bianchi, a sleep medicine physician and research scientist on Apple’s Health Technologies team, discusses Apple Watch screening for moderate–severe sleep apnea. He explains how wrist accelerometry detects nightly breathing disturbances, the 30-day notification logic, the tradeoff favoring high specificity, and why the feature is screening-only and not a replacement for clinical testing.

Imran Iftikhar, associate professor and sleep physician who led the CPAP meta-analysis. Tavi Ioachimescu, sleep medicine researcher who coordinated industry–clinician discussions. Robert Thomas, Harvard sleep researcher focused on PAP waveforms and management. They discuss CPAP algorithm accuracy, device brand differences, when to inspect raw waveforms, and approaches for unstable breathing and high loop gain.

In this episode, host Dr. Seema Khosla welcomes Dr. Maya Schenker, a postdoctoral researcher from the University of Melbourne, who has dedicated her research to understanding the complex relationship between sleep and post-traumatic stress disorder (PTSD). With a focus on the bidirectional mechanisms linking sleep and trauma, Dr. Schenker explores how sleep can be a critical intervention point for managing and potentially preventing PTSD. Discover the latest insights into how sleep impacts trauma response, including the role of REM sleep, fear conditioning, and the neurological processes that contribute to PTSD development. The conversation delves into why women are more susceptible to PTSD, the potential of sleep interventions, and breakthrough research on preventing trauma-related sleep disorders. Whether you're a healthcare professional or interested in understanding the intricate connections between sleep and mental health, this episode offers valuable perspectives on trauma, sleep, and healing.

Dr. Danny J. Eckert, a leading sleep and respiratory physiologist and director at the Adelaide Institute for Sleep Health, discusses his groundbreaking work on OSA endotyping. He reveals that 70% of OSA patients suffer from non-anatomical causes, stressing the need for tailored treatment approaches. The chat covers innovative methodologies for assessing airway collapse and explores the significant impact of nasal obstruction on sleep quality. Eckert also highlights the potential of non-PAP treatments and new biomarkers for an improved understanding and management of obstructive sleep apnea.

In this episode of Talking Sleep, Drs. John Winkelman and Andy Berkowski discuss the updated AASM clinical practice guideline for the treatment of restless legs syndrome and periodic limb movement disorder.

There was a recent consensus statement from the Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology on the screening, diagnosis, and treatment of obstructive sleep apnea (OSA) in pregnancy. For too many, a sleep evaluation is deferred until the pregnancy is over, with the idea that pregnancy-related sleep disorders will resolve at the end of the pregnancy. This leaves so many with sleep disorders undiagnosed and untreated. Dr. Louise O’Brien has tried to bridge this gap. She works in the Division of Sleep Medicine in the Department of Neurology, as well as the Division of Maternal and Fetal Medicine in the Department of Obstetrics and Gynecology at the University of Michigan. She is here to share her experience locally, but also globally when it comes to sleep health during pregnancy.