Sleep Matters

Welcome to our new SRN Blog - SLEEP MATTERS!

Check back weekly for new content pertaining to sleep medicine, from the SRN assembly Early Career Working Group! Suggestions? Email SRN Early Career Working Group co-chairs Lucas Donovan or Vaishnavi Kundel.

 

Sign up for the ATS SRN Mentoring Program Today! (March 2, 2020)

This is a great opportunity for early career professional and senior mentors to connect at the ATS 2020 meeting. Whether you are a senior mentor or mentee, sign up today! Deadline fast-approaching! [read more]

Apply Now for Sleep and Circadian Methods Workshop at the University of Pittsburgh. (February 25, 2020)

The University of Pittsburgh Center for Sleep and Circadian Science (CSCS) will host its inaugural Summer SWIM: Sleep and Circadian Workshop on Indispensable Methods, August 10-14, 2020. This one-week course features training on human and animal research methods including polysomnography, actigraphy, EEG, molecular, and cell methods. Apply by March 15th...[read more]

CPAP improves quality of life for patients with mild OSA. (January 21, 2019)

Most patients with obstructive sleep apnea have mild disease. There is little doubt that continuous positive airway pressure (CPAP) improves sleep related symptoms (e.g. excessive daytime sleepiness) among symptomatic patients with moderate to severe OSA. However, less attention has been paid to symptom improvement among those with mild disease...[read more]

Phrenic Nerve Stimulators for Central Sleep Apnea? (December 26, 2019)

Central sleep apnea treatment has been mostly limited to PAP despite conflicting data regarding their use. In the last decade several trials of the remedē System phrenic nerve stimulator have been conducted to evaluate its safety and efficacy...[read more]

What is the best treatment for Central Sleep Apnea and Cheyne-Stokes? (December 19, 2019)

There are a variety of potential treatments for central sleep apnea with Cheyne-Stokes respiration (CSA/CSR) including CPAP, adaptive servoventilation (ASV), and nocturnal oxygen therapy. The benefits of these therapies in CSA/CSR patients with comorbid heart failure (HF) has remained questionable. A recent network-meta-analysis published in the Journal of Clinical Sleep Medicine sheds light on this issue...[read more]

New Clinical Practice Guidelines for OSA and insomnia from the VA and DoD! (December 18, 2019)

The Departments of Veterans Affairs and Department of Defense recently released updated guidelines for the management of chronic insomnia and obstructive sleep apnea. They come with a helpful flowsheet and a summary for patients...[read more]

ATS SRN Apprenticeship and Mentoring Programs: Apply Now! (December 16, 2019)

Are you an early career investigator/junior member of the ATS Sleep and Respiratory Neurobiology (SRN) Assembly? Are you interested in getting more involved in the SRN Assembly? Then keep reading, and apply for the SRN Apprenticeship and Mentoring Programs now!

NIV and CPAP improve pulmonary pressures in OHS (December 3, 2019)

Obesity hypoventilation syndrome (OHS) is a particularly serious type of sleep disordered breathing characterized by awake hypercapnia. OHS is also associated with greater risk of cardiovascular morbidity, including pulmonary hypertension. The optimal treatment strategy of obesity hypoventilation syndrome (OHS) has long vexed sleep clinicians and researchers, especially among the 70% of patients with OHS and comorbid severe obstructive sleep apnea (OSA)... [read more]

Isolated REM Sleep Without Atonia (November 7, 2019)

How often have you encountered a handful of incidental epochs with increased chin EMG tone (>50%) while reading a PSG in a patient without clinical symptoms or concern for REM behavior disorder (RBD), and asked yourself any of the following questions: “How common is isolated REM sleep without atonia (RWSA)? Is this worth addressing in the final report?” If so, then keep reading, as this study by Feemster et.al. is hot off the press from SLEEP, and answers just these questions... [read more]

Hypoglossal nerve stimulator use is increasing, but what are the costs? (October 28, 2019)

Hypoglossal nerve stimulators (HGNS), approved by the FDA in 2014, are second line agents to treat OSA among patients who do not tolerate CPAP. As Dr. Rathi and colleagues report in JAMA Otolaryngology, sales of HGNS are rising. Using publicly available data from the U.S. Securities and exchange commission, the authors found 4,459 units have been sold since 2015, with sales increasing more than 7 fold increase since 2015. ...[read more]

The ATS abstract deadline is fast approaching! (October 10, 2019)

Just in case you missed the emails and other reminders, you have until October 30 at 5 pm E.S.T. to submit your ATS abstract! Get it in as soon as you can. Click here for a link.

Image of the day: RBD or pseudo-RBD? (October 6, 2019)

A 65-year-old man presents from his primary physician’s office out of concern for possible obstructive sleep apnea. He describes relatively good sleep quality, but endorses loud, disruptive snoring and witnessed apneas. Physical exam is significant for oropharyngeal crowding and obesity. A home sleep apnea test is initially ordered. On the way out of the room, the patient notes offhandedly that he also fights in his sleep, and that he frequently acts out his dreams. ... [read more]

Does treating insomnia reduce suicidal ideation? (October 4, 2019)

Suicide rates have increased steadily over the last 15 years by 12.5-15.0 per 100,000 individuals, and reducing suicide risk will be a task of enormous importance in the coming years. Both insomnia and the medications used to treat insomnia are associated with increased suicide risk, but the nature of these associations are unclear. Does insomnia lead to greater suicidal ideation and risk? Do the sedating and often disinhibiting medications used to treat insomnia lead to suicidal behaviors? ... [read more]

OSA and Resistant Hypertension (September 24, 2019)

It has been observed that OSA is associated with resistant hypertension (RH), but there are surprisingly few studies on the characteristics of OSA in patients with RH. This multicenter, prospective cohort study by Sapina-Beltran et al. was recently published ahead of print in the Annals of ATS. The authors aimed to describe the prevalence of OSA in patients with RH, as well as assess for an association between blood pressure (BP) control and OSA. ... [read more]

The Evaluation and Management of Obesity Hypoventilation Syndrome (OHS), 2019 Guidelines (September 2, 2019)

New guidelines have been released for OHS management. OHS is defined by the combination of obesity (BMI > 30 kg/m2), sleep disordered breathing (SDB), and awake daytime hypercapnia (awake resting PaCO2 > 45 mm Hg), after excluding other causes for hypoventilation. It can lead to serious sequelae, including increased rates of mortality and hospitalization due to acute-on-chronic hypercapnic respiratory failure, among others. The purpose of this guideline ... [read more]

Sleep and Immune Regulation: Sleep it Off? (September 1, 2019)

What is the relationship between sleep and our immune system? In a fantastic new review of the subject by Dr. Michael Irwin, MD (Professor of Psychiatry and Behavioral Sciences, Professor of Psychology, and Director of the Cousins Center for Psychoneuroimmunology at the Semel Institute for Neuroscience), the beneficial crosstalk between sleep and host defense mechanisms is explored, as are the potential host-immune consequences that may result from misalignment of the two. ... [read more]

Alternate Care Provider Management for Patients with Severe OSA (August 28, 2019)

The lack of available sleep specialists is a major problem facing sleep medicine. Incorporating non-specialists into the role of delivering OSA care may improve access to care. Recently, Pendharkar et al. published the results of their randomized control trial assessing non-inferiority of OSA care delivered by alternate care providers (ACPs) relative to sleep specialists. ... [read more]

Undiagnosed OSA and risk for perioperative complications (August 16, 2019)

Is undiagnosed OSA a risk factor for perioperative complications? Prior retrospective cohorts have been mixed in their results, with some studies demonstrating an association of OSA with greater risk of perioperative complications and others not showing this association.  However, given the administrative nature of these cohorts, many were unable to reliably assess undiagnosed OSA.

Chan et al. recently performed a rigorous prospective cohort study ... [read more]

National sleep apnea awareness day (April 3, 2019)

Did you know that April 18 is Sleep Apnea Awareness Day? It’s an important day, not just because it allows us to advocate for the health of our patients, but also because it celebrates a milestone in OSA history. On April 18, 1981, Sullivan and colleagues published a case series of five patients who had OSA successfully treated by way of nasal CPAP. ... [read more]

The long and short of respiratory events in OSA (April 1, 2019)

AHI. It’s often the only number that practitioners use to characterize sleep apnea severity, which is kind of amazing when you think about it, since polysomnograms and even home sleep apnea tests record huge amounts of data. At our institution, even the report summarizing a polysomnogram is eight pages long, and yet ... [read more]

ATS news (March 30, 2019)

Did you know that the program for ATS 2019 is available online?
http://conference.thoracic.org/program/index.php ... [read more]

Revisiting oxygen for hypertension in OSA (March 29, 2019)

Ah, summer 2014. Seems like just yesterday that Sam Smith was hitting the high notes on “Stay With Me,” and John Legend was letting us know how much of him loved us (hint: all). But a hugely influential paper in sleep medicine also came out in the New England Journal of Medicine in June 2014, “CPAP versus Oxygen in Obstructive Sleep Apnea.” In this paper, Gottlieb and colleagues ... [read more]

Melatonin works better than you'd think in kids (March 26, 2019)

Melatonin is the neurohormone that serves as the major regulator of the circadian drive for wakefulness. It’s released primarily by the pineal gland, resulting from light stimulus to the retina, via the retinohypothalamic tract, the suprachiasmatic nucleus, and the superior cervical ganglion. Melatonin isn’t regulated by the FDA; instead it’s considered a supplement. It is probably one of the most widely used substances for sleep in the United States ... [read more]