Talking Sleep

In this episode, host Dr. Seema Khosla welcomes Dr. Danny J. Eckert, a sleep and respiratory physiologist and professor at Flinders University in Adelaide, Australia. Dr. Eckert is a leading expert in his field and the recipient of the 2023 European Respiratory Society Gold Medal in Sleep-Disordered Breathing. As the Director of the Adelaide Institute for Sleep Health, he discusses his groundbreaking work on OSA endotyping and the PALM classification system (Pcrit, Arousal threshold, Loop gain, and Muscle recovery).

Discover why 70% of OSA patients have non-anatomical causes and how understanding these distinct endotypes can revolutionize treatment approaches. The conversation delves into practical applications for clinical settings, examining the roles of obesity and nasal obstruction in sleep apnea while discussing targeted therapeutic strategies, including GABAergic medications.

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.

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 services. Changes to the Standards for Accreditation were also made to remove barriers and promote administrative and operational efficiencies in sleep practice management. In this episode, AASM Accreditation Committee Chair Dr. Fady Jamous and AASM Director of Accreditation Ray Anthonijsz help explain some upcoming changes to AASM accreditation programs.

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 pipeline and expanding access via telemedicine. He explains his model and discusses other behavioral interventions to consider for patients with sleep disorders.

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 respond to traditional CBT-I and behavioral intervention. Here today to explore this further are Dr. Leisha Cuddihy, Dr. Sara Nowakowski, and Dr. Michael Grandner. 

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 committee tasked with these questions. In this episode, we talk with committee members Dr. Margarita Oks and Matt Anastasi about a SWOT analysis on the use of AI-enabled technology in sleep medicine.

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 the wake-promoting medications that are available as treatment options.

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 Prakash Kolla discusses the impact of cannabis on sleep and its potential use to treat sleep disorders.

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 episode, we talk with committee members Drs. Shalini Paruthi and Sachin Shah about the latest sleep technology for insomnia.