Podcast terbaik Sleep Talking (2024)

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RLS Clinical Practice Guideline Update 54:40

3d ago54:40

54:40

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.Oleh AASM

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Should PAP be a Tool for the Obstetrician? 45:43

17d ago45:43

45:43

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 sl…

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A new era of AASM accreditation 46:52

1M ago46:52

46:52

The AASM is introducing a new service-based accreditation model and updated Standards for Accreditation, which will take effect in January 2025. Based on feedback from members and accredited programs, this accreditation model provides greater flexibility to accommodate all practice types, making it easier to manage, add, and remove accredited servi…

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Behavioral therapy for sleep disorders: CBT-I and beyond 53:29

2M ago53:29

53:29

Dr. Richard Blackburn is a sleep psychologist who is attempting to improve access to cognitive behavioral therapy for insomnia (CBT-I) and other behavioral therapies for sleep disorders. He has a psychologist training program as well as a telemedicine practice, and he hopes to increase the availability of sleep behavioral therapy by increasing the …

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Sleep-related anxiety and new onset insomnia 50:28

2M ago50:28

50:28

We have long known about the bi-directional relationship between anxiety and insomnia. When I was a fellow, we were taught that treating the anxiety would treat the insomnia. Since that time, more data has emerged on the importance of treating insomnia. More recently, our guests have noticed a pattern of anxiety about insomnia that doesn’t always r…

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AI SWOT Analysis 50:01

2M ago50:01

50:01

AI is popping up everywhere — when we open a PDF, use an AI scribe, or look something up with Chat GPT. We all interface with AI daily and may not even realize it. This can become very complex and somewhat mysterious. How can we use AI in a sleep medicine practice? Is it trustworthy? Will we all be replaced by AI someday? The AASM has an AI committ…

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Silent and sleepy: The use of wake-promoting medications in well-treated OSA 54:46

3M ago54:46

54:46

Excessive daytime sleepiness is a significant problem for many people who have obstructive sleep apnea (OSA), and persistent sleepiness occurs in some patients despite effective treatment of OSA. Dr. Kingman Strohl and Dr. Lucas Donovan discuss this common clinical scenario, provide tips for the evaluation of persistent sleepiness, and talk about t…

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Cutting Through the Haze - the Use of Cannabis for Sleep and Sleep Apnea 30:20

3M ago30:20

30:20

There are currently 40 states with legalized medical marijuana. Twenty-four of these also have legalized recreational marijuana. Many people report using cannabis to help them to initiate and maintain sleep. Is there any data to support this? Is cannabis safer than prescription sleep aids? What should we know about cannabis and sleep? Dr. Bhanu Pra…

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Sleep technology for insomnia 40:36

4M ago40:36

40:36

As technology continues to permeate every aspect of our lives, the subset of sleep-related technology continues to expand. The AASM Emerging Technology committee continues to assess both clinical and consumer sleep technology. We have previously discussed consumer and clinical sleep technology that largely centered around snoring and OSA. In this e…

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Key Considerations When Implementing an RPM program 40:18

4M ago40:18

40:18

Remote patient monitoring codes have been active for a number of years. These have largely been used to monitor blood glucose levels via a continuous glucose monitor or to adjust heart failure medications via a connected digital scale. Dr. Charles Bae and Dr. Gabriela de Bruin discuss whether sleep medicine professionals should also use remote phys…

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Reimbursement and clinical use of actigraphy 30:53

5M ago30:53

30:53

The Actiwatch is a popular actigraphy device that is no longer sold or supported by Philips. Its discontinuation coincided with the launch of the AASM’s “Act on Actigraphy” campaign, which highlights the importance of actigraphy testing for sleep disorders and urges payers to reimburse health care professionals for this medical service. Dr. Paul Ra…

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Hiding in plain sight: The importance of a SOREMP on PSG 49:43

5M ago49:43

49:43

Despite having more treatment options than ever before, narcolepsy remains significantly underdiagnosed. Is there a potential clue on the polysomnogram (PSG) that we are overlooking? Dr. Alyssa Cairns and her team are exploring the biophysiological phenotypes of sleep disorders, specifically central disorders of hypersomnolence. She discussed how s…

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The Philips consent decree and the path forward 53:34

6M ago53:34

53:34

After nearly three years, the Department of Justice and the Food and Drug Administration have finally agreed to the terms of a consent decree with Philips. It states that Philips Respironics cannot manufacture or distribute new sleep and respiratory care devices in the U.S. market until certain criteria are met, unless the devices are classified by…

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ADVENT-HF trial 37:07

6M ago37:07

37:07

The world of sleep medicine has had several large recent disruptions with COVID-19 and the Philips Respironics recall. These haven’t been the only ones. If we look back almost a decade, sleep medicine was disrupted by the SERVE-HF results and field safety notice for ResMed ASV devices. Another trial was conducted around the same time as SERVE-HF bu…

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OSA proteomics and metabolomics 43:13

7M ago43:13

43:13

We know that there are a billion people in the world with undiagnosed obstructive sleep apnea (OSA) and that it simply isn’t practical to have every person undergo a sleep study. Are there other methods that might be more efficient identifying those at the highest risk of OSA? Dr. Laura Castillo is a chemist who has studied biological matrices to i…

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Acoustic stimulation for improving sleep 39:00

7M ago39:00

39:00

There are a handful of direct-to-consumer devices that claim to improve the quality of our sleep by using acoustic stimulation. What is the science behind these devices? Dr. Roneil Malkani is an associate professor of neurology in the Feinberg School of Medicine at Northwestern University. He collaborates with others to study acoustic stimulation d…

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NIV and other considerations for the Philips Respironics PAP device recall 42:19

8M ago42:19

42:19

While CPAP devices are similar across manufacturers, there are more significant differences in the advanced modalities of ventilatory support. Dr. Lisa Wolfe is well known for her granular knowledge of mechanical ventilation, including noninvasive ventilation (NIV). She discusses some aspects of NIV that may become pertinent as both sleep labs and …

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Neurotransmitters, insomnia pharmacotherapy and mental health 55:15

8M ago55:15

55:15

We know that CBT-I is the gold standard treatment for insomnia, but it remains inaccessible for many due to cost or the limited availability of trained professionals. For patients with comorbid mental health disorders, insomnia treatment may improve their sleep and mental health, but sleep restriction therapy may not be the most appropriate modalit…

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Sleep, OSA and sickle cell disease 34:10

9M ago34:10

34:10

While sleep disorders are associated with numerous health complications, one area that doesn’t receive much attention is the impact of sleep and sleep disorders on those with sickle cell anemia. A study published in Sleep and Breathing found that children with sickle cell disease and comorbid obstructive sleep apnea had 47% more health complication…

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A Practical Approach to Treating RLS 47:26

9M ago47:26

47:26

Johns Hopkins colleagues Dr. Rachel Salas and Dr. Sara Benjamin discuss the basics of treating restless legs syndrome (RLS), focusing on an updated algorithm published in the Mayo Clinic Proceedings in 2021 by the Scientific and Medical Advisory Board of the Restless Legs Syndrome Foundation. Topics of discussion include pharmacological treatment o…

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Sleep and Alzheimer’s disease 41:40

10M ago41:40

41:40

We routinely see patients with dementia in our sleep clinics but often do not meet them until they present with a sleep complaint such as insomnia or obstructive sleep apnea. We know that sleep and dementia have a bidirectional relationship. Is there a way to identify those who are at higher risk of dementia and intervene earlier? Is there a polyso…

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Sleep as an Opportunity to Improve Maternal Mortality 47:47

10M ago47:47

47:47

We wanted to start the new year by examining that time in our lives when we welcome new lives into this world. We often think about pregnancy as a joyful time. But, for too many women in the US, pregnancy leads to significant morbidity and mortality. Our US maternal mortality rate increased from 20.1 per 100,000 live births in 2019 to 32.9 per 100,…

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Keeping Up with the Changes to the Scoring Manual 32:07

11M ago32:07

32:07

The AASM released an update to the scoring manual earlier this year. Some of the changes were minor and others more significant. Adhering to the AASM scoring manual is a mandate of accreditation. Dr. Matt Troester, Dr. Alcibiades Rodriguez and Dr. Rich Berry are here to review these changes and highlight the most clinically pertinent information fr…

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Sleep and ADHD in Adolescents 34:09

12M ago34:09

34:09

We have seen data associating attention-deficit/hyperactivity disorder with sleep disorders, and many experts believe that a sleep assessment should be performed routinely in these patients. Is it all about insufficient sleep and sleep patterns? Or are there polysomnographic differences that may identify those who are at risk for ADHD? Can poor sle…

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Medications To Manage Central Disorders Of Hypersomnolence 37:21

12M ago37:21

37:21

In the last few years, more medications have been available to treat central disorders of hypersomnolence. While treatments for narcolepsy and idiopathic hypersomnia are similar, there are some specific considerations when trying to determine which combination of medications is most appropriate for a patient. Significant payor coverage and formular…

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Legal Issues in a Sleep Medicine Practice 46:02

1y ago46:02

46:02

Drowsy driving accidents are just one of the many ways in which health care can interface with the legal system. Our guest for this episode is Dr. Ramesh Sachdeva, a sleep medicine and pediatric critical care physician who decided to go to law school several years ago and has previously served as an adjunct professor of law. He has a unique interes…

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Medications to Treat Obstructive Sleep Apnea 33:12

1y ago33:12

33:12

We have long known that CPAP therapy isn’t meant for everyone who has obstructive sleep apnea. There are plenty of non-PAP treatment options, including oral appliance therapy and hypoglossal nerve stimulation. Pharmacotherapy has been used as an adjunct therapy to treat persistent hypersomnolence despite well-treated OSA or to assist with PAP accli…

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Management of Obesity Hypoventilation Syndrome 47:54

1y ago47:54

47:54

Obesity hypoventilation syndrome can be challenging to manage. Obtaining the appropriate device for each patient is often complicated by insurance requirements and endless red tape. Previous guidelines have indicated that CPAP may be as effective as bi-level PAP; however, this doesn’t apply to all patients. How can we identify patients who may requ…

1
Insufficient Sleep, Circadian Disruption and Cardiometabolic Health 37:57

1y ago37:57

37:57

We frequently discuss how insufficient sleep may be harmful to cardiometabolic health, but is this the whole story? How does circadian rhythm misalignment contribute to this relationship? Could a behavioral sleep intervention possibly improve cardiometabolic health? Dr. Chris Depner investigates how insufficient sleep and circadian disruption contr…

1
DREAM-IT: Insomnia Management in Adolescents 36:25

1y ago36:25

36:25

As students go back to school, many adolescents will have to advance their sleep phase in order to start classes early in the morning. While delayed sleep phase syndrome is common during adolescence, insomnia symptomatology may be underrecognized. It may be attributed to excessive screen time, social jet lag, or too much caffeine. We try to provide…

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Obesity Management for Sleep Clinicians 42:26

1y ago42:26

42:26

We have long known that obesity is a risk factor for OSA, but most sleep clinicians don’t manage obesity. Is this something we should consider? How complicated is it? How should we navigate insurance hurdles? Do we need to employ a dietician? Is managing obesity feasible for a typical sleep medicine practice? Here to explore this further on today's…

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Embracing Alternative Practice Models 46:27

1+ y ago46:27

46:27

The practice of sleep medicine is extremely diverse. While there are many who are a part of academic institutions, others have chosen private practice. One option that is becoming more popular is a direct-to-consumer, self-pay model. Here to give us a better understanding of some of these practice models are Dr. Sahil Chopra and Dr. Andy Berkowski.…

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Navigating the Ethics of Disclosure in RBD 44:56

1+ y ago44:56

44:56

In this episode of Talking Sleep our guest, Dr. Alon Avidan, helps us better understand the ethics of disclosure in REM sleep behavior disorder. A big part of this disorder's overall management includes disclosing potential neurodegenerative sequelae. While prescribing medications can be fairly straightforward, the discussion of a potentially life-…

1
SleepHouse Rock: How a CPT Code is Made 48:01

1+ y ago48:01

48:01

As sleep technology continues to advance, we are sometimes left to try to figure out which billing code to use. There are level 2 studies that have a g-code and some novel HSAT devices that are creating new metrics that don’t always fit into a current CPT code. Navigating this can be tricky. Here to help us understand how a CPT code is made is Dr. …

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Bringing Sleep to the Neighborhood- The Mobile Sleep Lab Model 35:29

1+ y ago35:29

35:29

A few years ago, the AASM held a competition challenging us to reimagine sleep care. The Mobile Sleep Lab was a model that was submitted as a contender in this challenge. Here to tell us more about this are Dr. Mark Boulos, Dr. Luqi Chi and Dr. Oleg Chernyshev.Oleh AASM

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More Than Chin Music: How a New Signal Can Assess Sleep-Disordered Breathing 28:55

1+ y ago28:55

28:55

In today’s episode of Talking Sleep, we are joined by Dr. Jean-Louis Pépin and Dr. Atul Malhotra, who talk about how the signal derived from mandibular jaw movements during sleep can be an alternative measurement of respiratory effort in patients being evaluated for suspected sleep apnea. We will focus on the scientific basis and clinical implicati…

1
Predicting HGNS Treatment Success 37:20

1+ y ago37:20

37:20

In today’s episode of Talking Sleep, Dr. Raj Dedhia joins us to talk about hypoglossal nerve stimulation, which was first approved by the FDA in 2014 to treat a subset of patients with moderate to severe obstructive sleep apnea. Now, nearly a decade later, the treatment has evolved, and we have a better understanding of its nuances. Visualizing the…

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The Nose and OSA: Why the Nose Always Seems to Know 32:37

1+ y ago32:37

32:37

Obstructive sleep apnea is regularly linked to the posterior oropharynx and the tongue, but its relationship with the nose is often overlooked. Recent research suggests that the assessment of the nose plays an important role in the physiology of sleep. Nasal obstruction is common in sleep apnea and contributes greatly to the development of OSA. Her…

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The Microbiome and Sleep Apnea– A Bidirectional Relationship 31:22

1+ y ago31:22

31:22

Recent evidence and data has highlighted important associations between obstructive sleep apnea and the microbiome. Here to help us learn more about how sleep and the gut microbiome impact our heath is Dr. Andrew Goldberg.Oleh AASM

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Clinical Considerations for Novel Sleep Technology 42:46

1+ y ago42:46

42:46

The sleep field is intertwined with technological advances. Innovative devices are being developed every day, some of which are crossing over into the clinical realm. In this episode of Talking Sleep, Dr. Scott Ryals and Dr. Steven Holfinger describe how some novel home sleep apnea test devices work and explain how clinicians should approach them.…

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Permanent Standard Time Advocacy 20:05

1+ y ago20:05

20:05

It's that time of year again when we spring forward and set our clocks ahead one hour. Whether we should continue to change our clocks twice per year is an ongoing topic of debate, and legislation has been introduced in the U.S. Senate and House of Representatives to make daylight saving time permanent. Here to give more insight on the science of c…

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Comorbid Insomnia and Sleep Apnea (COMISA) 34:17

1+ y ago34:17

34:17

An article was published in the ERJ demonstrating that CBT for Insomnia reduced the severity of obstructive sleep apnea. Our guest, Dr. Alexander Sweetman, is here to tell us more.Oleh AASM

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New AASM Clinical Practice Guideline: Management of REM Sleep Behavior Disorder 38:11

2y ago38:11

38:11

The AASM recently released a new clinical practice guideline which provides necessary recommendations for adults with REM Sleep Behavior disorder. The guideline provides clinicians with insight on how best to prevent sleep-related injury and how to provide patients with a risk assessment for neurological disease. Here to tell us more about this is …

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Improving Patient Understanding of Sleep Apnea 43:06

2y ago43:06

43:06

In today’s episode of Talking Sleep, we talk about the importance of patient communication. Dr. Rebecca Robbins and Dr. Suzanne Bertisch of Harvard Medical School and Brigham and Women’s Hospital share their insights into existing patient education materials for obstructive sleep apnea and offer tips on how to make it easier to understand. Listen n…

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Sleep Age with Dr. Mignot 45:27

2y ago45:27

45:27

In today’s episode of Talking Sleep our guest, Dr. Emmanuel Mignot, talks with us about sleep age and the importance of the EEG collected during polysomnography. As the interest in sleep grows, more attention is being paid to how sleep is related to morbidity and mortality. While there is much discussion about obstructive sleep apnea and cardiovasc…

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College, Transgender Students and Sleep 29:52

2y ago29:52

29:52

In today’s episode of Talking Sleep, we discuss how insufficient sleep and other factors are negatively impacting college students’ health. Our guest, Dr. Shelley Hershner, is an associate professor of neurology at the University of Michigan. Through her research, she has found that there are certain populations of students, such as transgender stu…

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Sleep Technologist Education 41:34

2y ago41:34

41:34

In today’s episode of Talking Sleep, we discuss sleep technologist education. Our guests Karen Rowe, Debbie Guerrero and Dr. Brad Vaughn, who are part of the CoA PSG program, talk about the increasing demand for sleep technologist across the country and explain the pathway to becoming a certified sleep tech.…

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Melatonin 35:46

2y ago35:46

35:46

In today’s episode of Talking Sleep, we discuss the use of melatonin in both children and adults. Our guests Dr. Abby Strang and Dr. Gautam Ganguly, talk about the AASM’s recent health advisory for the appropriate use of melatonin in children and the importance of understanding how melatonin works. Listen now…

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Spotlighting Central Sleep Apnea 39:27

2y ago39:27

39:27

In today’s episode of Talking Sleep, we discuss the complexities of central sleep apnea. Our guest, Dr. Safwan Badr, describes the multiple pathways that can cause different forms of central sleep apnea and how the disorder is more similar to obstructive sleep apnea than we think.Oleh AASM

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CPAP in Pediatric Patients 35:04

2y ago35:04

35:04

In today’s episode of Talking Sleep, we discuss safe and effective CPAP use in pediatric patients with obstructive sleep apnea. Drs. Louella Amos and Robin Lloyd join us to share information about the AASM’s recent position statement on age and weight requirements for PAP therapy in pediatric patients and the importance of appropriate management of…

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