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 she combed through half-a-million sleep records and looked at the predictive value of a sleep-onset REM period (SOREMP) on PSG for a future diagnosis of narcolepsy ..read more

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 the FDA as “medically necessary.” The scope of the recall is far larger than just consumer PAP devices. This impacts sleep diagnostics – including Alice polysomnography systems, home sleep apnea test platforms, and in-lab titration devices. Here to ..read more

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 but utilized Philips ASV devices. Those results have now been published and provide some insight into the use of peak-flow-triggered ASV for those with an ejection fraction of 45% or below. Dr. Douglas Bradley is here to share his results and to offer ..read more

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 identify biomarkers for obstructive sleep apnea. Her research involves analyzing sweat and she has found that there are specific markers for those with severe OSA and those without any OSA. Dr. David Gozal has been working in this field for many years ..read more

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 during sleep and its impact on sleep architecture. He describes how these devices work and how clinicians should approach them ..read more

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 patients transition off devices recalled by Philips Respironics. She also addresses concerns related to patients who have complex conditions such as chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome, and neuromuscular dis ..read more

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 complications than those with sickle cell disease who had a lower risk for OSA due to negative OSA screenings or exams. These complications seemed to be related to nocturnal hypoxia. Pain from a sickle crisis also can lead to sleep fragmentation. Dr. Sonal Malho ..read more

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 options, the risk of augmentation, potential impulsivity, and non-pharmacologic treatments ..read more

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 polysomnographic fingerprint? Should polysomnography be performed in those who are felt to be at higher risk of dementia? How can we, as sleep clinicians, potentially impact the course of dementia? Are there special considerations for our patients who have ..read more

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 100,000 live births in 2021. For black women, this was 69.9 deaths per 100,000 live births. The causes are severe bleeding, infections, and preeclampsia/eclampsia. The CDC indicates that 4/5 pregnancy-related deaths in the US are preventable. Dr. Ghada B ..read more