Podcasts about Ahi

This episode breaks down the upcoming sleep testing code changes and why they matter for sleep labs, physicians, technologists, vendors, and health systems. The STT Crew discuss how the new structure changes home testing, professional review, reimbursement, and patient triage.They also explain why so many people in sleep care still do not realize these changes are coming, and what teams should be doing now before the January 2027 rollout.Key topicsIn this episode, the hosts explain that the current home sleep testing codes are set to sunset at the end of the year, with a new framework expected to launch January 1, 2027.The Crew lays out the new home testing tiers:Low complexity — 3 to 4 channels, CPT 95X18Moderate complexity — 5 to 10 channels, CPT 95X19High complexity — 11 plus channels, CPT 95X20, which includes home PSGTimestamps(00:00) Sponsor messages and episode setup(02:02) Introducing the new PSG code changes(02:59) Why most sleep professionals missed the coming changes(04:15) Fragmented communication in sleep care(05:42) Technical and professional billing are separating(06:42) Home PSG and the new high-acuity testing tier(08:16) Why physicians may need to review more than AHI(09:41) Why vendors cannot yet define the new channels(10:50) What sleep providers should do right now(11:20) Early reimbursement estimates and operational concerns(12:31) Derived channels, device selection, and policy updates(13:23) Payer contracts and vendor agreements may need revision(14:45) The three home testing complexity tiers(16:15) Why in-lab sleep testing is not going away(17:13) CMS, utilization control, and triage strategy(20:07) More data at home, more access to care(23:36) Hospital screening and inpatient sleep apnea risk(25:22) Population health outreach using AI and EHR data(27:57) Final takeaways on preparation, uncertainty, and timing(31:02) Important dates — comment period, November release, January 1 launchShare your opinion and comment on the codes here:https://aasm.org/new-unattended-sleep-testing-cpt-codes-cms-proposed-rule/ A huge thanks to our sponsors:Fisher & Paykel Healthcare  Discover how F&P full-face masks have led millions of people to a great night's sleep at https://www.fphcare.com/curiosityhttps://www.fphcare.com/us/homecare/sleep-apnea/Philips Healthcare   See how Philips is supporting you and your patients with meaningful innovation. Visit https://www.philips.com/matters Soliish https://www.soliish.com/React Health  https://www.reacthealth.com/More resources for clinicians can be found at Sleep Review Magazine  https://sleepreviewmag.com/Credits:Audio/ Video: Diego R Mannikarote; Music: Pierce G MannikaroteHosts: J. Emerson Kerr, Robert Miller, Gerald George MannikaroteCopyright: ⓒ 2026 SleepTech Talk ProductionsEpisode 131The views and opinions expressed by guests on SleepTech Talk are their own and do not necessarily reflect those of the podcast hosts or SleepTech Talk as a whole. This podcast is intended for educational and informational purposes only and should not be considered medical advice. Listeners are encouraged to consult with a qualified healthcare professional for any medical concerns or questions.

¡Ahi va la mugrosa pelagatos con sus fritangas!--¡Fíjese doña Patricia, dicen las malas lenguas que usa pura carne de gato!--¡Deberíamos hablarle al comandante, es mi compadre!-

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Sahil Chopra to discuss research challenging a fundamental assumption: that residual AHI measurements from PAP device downloads accurately reflect whether patients' sleep apnea is adequately treated. Sleep medicine clinicians routinely rely on residual AHI from PAP downloads to determine treatment success, typically targeting an AHI under 5. But what if this metric significantly underestimates untreated sleep apnea? Dr. Chopra's study comparing PAP-determined residual AHIs to cardiopulmonary coupling (CPC)-derived AHIs reveals striking discrepancies: mean residual AHI was 2.4 via PAP download versus 12.1 via objective testing. Even more concerning, 85% of nights showing residual AHI under 5 on PAP downloads had elevated AHI based on objective CPC measurement. Dr. Chopra explains why he chose cardiopulmonary coupling as the comparator metric, using a PPG-based wearable ring worn for 7-10 nights. He clarifies why PAP devices may systematically underestimate residual disease through mask leak, unstable breathing, and periodic breathing patterns. A particularly concerning finding involves residual hypoxia. Dr. Chopra discovered significant hypoxic burden in many patients considered "well-treated" by PAP standards—important since hypoxic burden, not just AHI, drives cardiovascular risk. Dr. Chopra's conclusion isn't that PAP-derived AHI is "bad"—rather, that it shouldn't be the sole metric for assessing treatment efficacy. Even patients with good symptoms may have significant residual respiratory events and hypoxia that PAP downloads fail to detect. Clinical applications are discussed, including when to pursue objective testing and what interventions to consider when objective testing reveals inadequate control despite acceptable AHI. Whether you rely on PAP downloads to assess treatment efficacy, manage patients with residual symptoms, or seek emerging objective metrics, this episode provides essential perspectives on optimizing PAP therapy. Join us for this important discussion that challenges current assumptions about measuring treatment success in sleep apnea.

This episode looks back at APSS Sleep 2026 with Dr. Gerald George Mannikarote, Emerson Kerr, and Robert Miller. The conversation focuses on how the conference reflected a shift in sleep medicine toward more options, more pharmaceutical involvement, and a stronger need for technologists to stay grounded in fundamentals.We discuss why the live conference experience still matters, how AI and automation are changing scoring and diagnosis, and why pharmacy, telehealth, oral appliances, and new reimbursement codes are reshaping the future of sleep care.Chapters1 - Welcome to the APSS Sleep 2026 annual review2 - Baltimore conference turnout and the return of large in-person meetings3 - Emerson hands off the AST presidency to Massey Arrington4 - Why fundamentals matter in an AI-driven sleep industry5 - Scoring, false positives, and the risk of trusting automation too much6 - Why technologists must keep learning beyond the basics7 - Pharma's growing footprint on the exhibit floor8 - Home PSG systems and the coming CPT code changes9 - Sleep apnea, GLP-1s, and the move toward precision therapy10 - Why the old CPAP-only pathway no longer fits every patient11 - Seven treatment options and the challenge of choosing the right one12 - Why failed protocols and failed home sleep tests need rethinking13 - Pharmacy as a new screening and referral gateway14 - Why more entry points could help more patients get treated15 - Where the future of sleep medicine is headed16 - Moving from AHI alone to why a patient has sleep-disordered breathing17 - Why mild OSA may benefit from earlier non-CPAP treatment18 - Oral appliance therapy education gaps and first-line use19 - A mild OSA patient who benefited from an oral appliance after CPAP struggle20 - Consumer tech, awareness, and the Rise of sleep telehealth referrals20 - Why local sleep conferences still matter for technologists21 - Sleep navigation, education, and where technologists fit in the new model22 - Future guests, new projects, and what to expect next from the showA huge thanks to our sponsors:Fisher & Paykel Healthcare  Discover how F&P full-face masks have led millions of people to a great night's sleep at https://www.fphcare.com/curiosityhttps://www.fphcare.com/us/homecare/sleep-apnea/Philips Healthcare  See how Philips is supporting you and your patients with meaningful innovation. Visit https://www.philips.com/matters Soliish https://www.soliish.com/React Health  https://www.reacthealth.com/myWaveshttps://mywaves.tech/More resources for clinicians can be found at Sleep Review Magazine  https://sleepreviewmag.com/Credits:Intro Music: Pierce G. MannikaroteAudio/ Video: Diego R. MannikaroteHosts: J. Emerson Kerr, Robert Miller, Gerald George MannikaroteCopyright: ⓒ 2026 SleepTech Talk ProductionsEpisode 130The views and opinions expressed by guests on SleepTech Talk are their own and do not necessarily reflect those of the podcast hosts or SleepTech Talk as a whole. This podcast is intended for educational and informational purposes only and should not be considered medical advice. Listeners are encouraged to consult with a qualified healthcare professional for any medical concerns or questions.Don't forget to Like, Share, and Comment! Subscribe for more conversations with leaders shaping the future of sleep medicine, sleep technology, and patient care.

The country's top restaurants have been crowned at this year's Cuisine Good Food Awards. Queenstown's Essence has taken restaurant of the year and is one of just six nationwide awarded the esteemed three hat rating. Auckland's Ahi, Cocoro, Tala, and Paris Butter, along with Hawke's Bay's Craggy Range were the other five, and Tala's founder and chef Henry Onesemo was named Chef of the Year. Cuisine Magazine Editor Kelli Brett told Mike Hosking it's an exciting time for hospitality, with the best yet to come. LISTEN ABOVE See omnystudio.com/listener for privacy information.

In this solo episode, Amy Wheeler explores the second yama, satyam (truthfulness), and its essential relationship to the first yama, ahiṃsā (non-harming). This conversation moves beyond simple definitions and into the lived complexity of speaking truth in real relationships, real bodies, and real moments.Drawing from personal reflection—including her own experience with illness and voice—Amy invites listeners into an honest inquiry:When do we speak too much, not enough, or avoid the truth altogether?In This EpisodeSatyam as Inner CoherenceSatyam is not simply “telling the truth.” It is the alignment between:PerceptionUnderstandingExpressionWhen these are out of sync, confusion and disconnection follow. When they align, communication becomes clear, steady, and trustworthy. Amy emphasizes that most misalignment comes from incomplete information (avidyā) and unexamined assumptions. As clarity improves, so does our ability to speak in a way that others can receive and trust.Ahiṃsā as the ContainerAhiṃsā is not just the absence of harm. It is the active cultivation of:SafetyCareStability in relationshipSatyam lives inside ahiṃsā. Truth must be expressed in a way that reduces harm and supports connection.This creates an ongoing inquiry:What am I saying that may cause harm?What am I avoiding that also creates harm?Avoidance and harshness are two sides of the same imbalance.The Role of RelationshipThe yamas are relational practices. They are not abstract ideals.Amy highlights that we refine truth through feedback:Honest, grounded relationships help us see clearlyMisaligned or dishonest environments distort our perceptionOver time, trustworthy relationships support the emergence of a deeper, more stable truth.Ṛtam: The Deeper TruthThe episode introduces ṛtam (cosmic order) as the underlying intelligence of reality.Ṛtam → what is (the larger truth)Satyam → how we align with and express that truthAmy describes this as learning to release control and personal agenda, allowing timing, context, and perspective to mature. Truth is not only about correctness—it is about alignment with something larger than the individual viewpoint. A Nervous System LensTruth is not just cognitive—it is physiological and relational.In sympathetic activation → truth can become sharp and reactiveIn withdrawal → truth can become suppressed or avoidedIn regulation → truth becomes attuned and constructiveInteroceptive awareness becomes a guide:Changes in breath, tension, or sensation signal misalignmentThe body often recognizes incoherence before the mind doesClinical and Practical ApplicationIn therapeutic settings, satyam is not blunt disclosure.Instead, it includes:Regulated presenceAttuned listeningReflective languageOften, simply reflecting a client's words allows truth to emerge without force. Truth becomes something discovered, not imposed.Key Reflection QuestionsAmy offers a simple but powerful framework:Is it true? (satyam)Is it kind? (ahiṃsā)Is it the right time, context, and relationship? (ṛtam)This triad supports more skillful communication and reduces unnecessary harm.Closing InsightTruthfulness is not a fixed achievement. It is a lifelong refinement.It asks for:Self-awarenessCourageRegulationWillingness to be wrongTrust in something larger than personal perspectiveAs Amy reminds us, this work unfolds over time, through relationships, and through the willingness to see ourselves clearly.Sanskrit Words of the EpisodeAhiṃsā – Non-harming; active care in relationshipSatyam – Truthfulness; inner and outer coherenceṚtam – Cosmic order; the deeper truth beyond personal perspectiveAvidyā – Misperception; incomplete or incorrect understandingSupport the PodcastJoin the Patreon communityExplore the Optimal State Mobile App (iPhone & Android)Pre-order Applications of Therapeutic Yoga in Integrative Health by Amy Wheeler & Marlisa Sullivanhttps://www.amazon.com/Applying-Therapeutic-Yoga-Integrative-Health/dp/1032888628/ref=sr_1_1?crid=1RFZ3L5MCCNPH&dib=eyJ2IjoiMSJ9.I7harQDOLulfRbd3dx2vVa5VUZa840PHcWB7dDiT3_bB2nravzO7_9Xs9shMhcy2Iwu0wtTA1PxeUG4TTugEQJuK_OEpvzQ-OyVvtsUkXsc.ViqLrL-EQPX7s09wZF6_2eCpLCimHa7Ohfbw-F7Yuk4&dib_tag=se&keywords=applications+in+therapeutic+yoga+wheeler&qid=1775224796&sprefix=applications+in+therapeutic+yoga+wheele%2Caps%2C153&sr=8-1

Obstructive sleep apnea affects approximately one in four adults and is especially common among patients with neurologic disorders, including stroke, Parkinson disease, dementia, epilepsy, and neuromuscular conditions. In this episode, Dr. Stephanie Stahl discusses why neurologists should routinely screen for OSA, highlights key symptoms and risk factors, reviews important considerations when interpreting sleep studies, and outlines current treatment options beyond CPAP. Learn how recognizing and treating sleep apnea can improve quality of life, optimize management of neurologic disease, and reduce long-term health risks. In this episode, Aaron L. Berkowitz, MD, PhD, FAAN, speaks with Stephanie M. Stahl, MD, FAASM, author of the article "Obstructive Sleep Apnea" in the Continuum® August 2026 Sleep Neurology issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology in the Department of Neurology at the University of California, San Francisco, in San Francisco, California. Dr. Stahl is an Associate Professor of Clinical Medicine and Sleep Medicine Fellowship Program Director at Indiana University School of Medicine in Indianapolis, Indiana, where she also serves as Sleep Laboratory Medical Director in the Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine. Additional Resources Read the article: Obstructive Sleep Apnea Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz  Full episode transcript available here Dr Berkowitz: Obstructive sleep apnea is very common. It can cause or contribute to common neurologic symptoms, such as headache and impaired cognition, and it's a risk factor for stroke. And yet, if you're like me, you may not know too much more about sleep apnea than that. Today, I have the pleasure of talking to sleep expert Dr. Stephanie Stahl to learn what every neurologist should know about OSA.  Dr Jones:  This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Berkowitz: This is Dr. Aaron Berkowitz. Today I'm interviewing Dr. Stephanie Stahl about her article on obstructive sleep apnea. This article appears in the 2026 Continuum issue on Neurology of Sleep. Welcome to the podcast, Dr. Stahl, and could you please introduce yourself to our audience?  Dr Stahl: Yeah. Thank you for having me. I'm a sleep medicine physician and neurologist and medical director of the Indianapolis Sleep Lab at Indiana University Health. I serve as the director of the Sleep Medicine Fellowship program. I'm faculty advisor for our very first student interest group in sleep medicine at Indiana University School of Medicine. I'm also actively involved in some national leadership roles, including the incoming chair of the American Academy of Sleep Medicine's Education Committee and co-chair of the Academy's Inter-Scorer Reliability Gold Standard Panel. So, I really appreciate this opportunity. I look forward to our discussion.  Dr Berkowitz: Me too, and we appreciate the opportunity too to get to talk to you. You have so much expertise in this area, and I certainly encourage our listeners to look at your article, which is very comprehensive and up to date, and I learned a ton from it. I didn't get much exposure to sleep neurology as a trainee, and I've always worked in academic centers where we have a sleep group and we can refer patients there. So, I have to admit, sleep may probably be the area of neurology I know the least about, and felt like I was learning something new from pretty much every line of your article, and I know our readers will too. So, your article has a lot of excellent detail for our readers on the diagnosis and treatment of this very common condition. But I'd like to keep our interview relatively high level today and focus on the essentials for the practicing general neurologist. So, to start, can you just give us a sense of what obstructive sleep apnea is, and what every neurologist should know about it?  Dr Stahl: Yeah. So obstructive sleep apnea is characterized by either partial or full obstructions in the upper airway. That may sound pretty simple, but this leads to a whole bunch of issues. It leads to oxygen desaturations, arousals from sleep, leading to sleep fragmentation. This can then lead to sympathetic nervous system activation, cerebral hypoperfusion, leading to a whole bunch of symptoms or neurologic conditions.  Dr Berkowitz: Great. And you mentioned this in your article, but just to emphasize, how common is obstructive sleep apnea in the general population?  Dr Stahl: Yeah. So, about a quarter of the general population have obstructive sleep apnea. Much more common in many neurologic conditions.  Dr Berkowitz: Yeah, so very common disorder. We are seeing patients with it quite frequently, whether that's the reason they are seeing us in neurology or not. And this leads to my next question, which is what neurologic symptoms or presenting concerns of a patient should make us think about OSA and the differential diagnosis, and what factors based on the history or the exam or the context would make you suspicious for OSA as the cause of a neurologic symptom? In other words, the patient's presenting with classic symptoms of OSA, and that's why they're seeing a neurologist or seeing a primary care doctor, but is coming for evaluation of, say, headache or other symptoms. And what symptoms would make you think of wanting to consider OSA, and then what aspects of the history or otherwise would make you want to evaluate the patient for OSA?  Dr Stahl: I think a really important takeaway is for neurologists to know that obstructive sleep apnea is very common in neurologic conditions and has that potential to worsen a lot of these conditions or their associated symptoms. And so, it should be on our radar. There are certainly some basic questions and signs and symptoms that we can ask patients about or, or take a look at on exam. And so particular symptoms include snoring. Anybody that snores loudly or frequently, that's a strong risk factor for obstructive sleep apnea. If someone's seeing them stop breathing in their sleep, if they are waking up a lot throughout the night. There are some other symptoms that we may not necessarily attribute upfront to obstructive sleep apnea, such as nocturia, nocturnal reflux, night sweats. There are some daytime symptoms, of course, too, like unrefreshing sleep, daytime sleepiness, morning headaches, an important one in neurology. And then we take a look at the patient's exam. And so, some things that neurologists might want to be thinking about are people with obesity are certainly at a risk for obstructive sleep apnea. But it's also very important to know that someone does not need to have obesity in order to have obstructive sleep apnea. We look at neck size, other morphologic characteristics, such as how much that we can see in the back of their mouth. Can we see their uvula? Does their tongue size appear large in their mouth? And then some other risk factors too, such as male gender, older age, family history, post-menopausal state in women. All that being said, though, sometimes in neurologic conditions, we don't have all of those symptoms or risk factors to be thinking about. And so, in certain neurologic conditions such as stroke where obstructive sleep apnea is very common and has the potential to increase the risk of another stroke, we may need to be thinking about testing these patients even with minimal symptoms or other risk factors.  Dr Berkowitz: That's very helpful. So, you mentioned their headache might be the presenting symptom, right, to a neurologist, and we should certainly be thinking about obstructive sleep apnea as a potential diagnosis, even the cause of the patient's headache, particularly you said patients with morning headache. I often try to think about in patients presenting with, for memory loss, or other cognitive concerns, and that may be due more to inattention from poor sleep, so asking about sleep and symptoms of sleep apnea in those contexts. Are there any other presenting neurologic symptoms not particularly related to sleep? I'm thinking of headache, memory loss, other symptoms that would make you think, "Oh, I should actually screen this patient for sleep apnea also."  Dr Stahl: Yeah, other symptoms to think about in pediatrics, hyperactivity, people that have impaired vigilance, as you alluded to, that poor attention. Sometimes people get misdiagnosed with ADHD, and it's actually just a manifestation of obstructive sleep apnea.  Dr Berkowitz: You alluded to this, Dr. Stahl, that stroke, for example, patients are at higher risk of developing sleep apnea as a result of stroke, and it's also a risk factor for stroke. What other neurologic conditions, primary neurologic diseases, put patients at a higher risk of OSA? And again, similar to the last question I asked you, what are some clues that we should evaluate for? We might be following a patient for their post-stroke care over time and not necessarily thinking about diagnosing a separate condition in them since we're following them for their stroke or their degenerative disease. What are the conditions that put patients at a higher risk of OSA as a result of the condition, and then when would you think about screening them for it?  Dr Stahl: Some particular neurologic conditions where obstructive sleep apnea are very common, in addition to stroke and, and TIA, include Parkinson disease. It can worsen a lot of the motor, cognitive symptoms, sleep disruption that we can see in Parkinson disease. Very common in all causes of dementia, but in particular Alzheimer disease and Lewy body dementia. Very common in neuromuscular conditions. We should definitely have obstructive sleep apnea and all forms of sleep-disordered breathing high on our radar. In conditions like myotonic dystrophy. Charcot-Marie-Tooth is another one where obstructive sleep apnea is very common. Myasthenia gravis, it can worsen the symptoms of that. In particular, a pearl is if somebody has morning weakness in myasthenia gravis, obstructive sleep apnea should be high on your radar. And also, as you mentioned, any forms of headaches. There are some other things too. If somebody has poor seizure control, especially nocturnal seizures, you might have obstructive sleep apnea on your radar as well.  Dr Berkowitz: So, I think you've covered essentially every category of neurologic disease, right? We have cerebrovascular, movement, neurodegenerative, neuromuscular, epilepsy, all conditions where either the disorder itself, such as stroke or the, correct me if I'm wrong, the neurodegenerative disease puts the patient at risk. Or the patient may be at risk for exacerbations of their disease, as you mentioned in myasthenia. I love that pearl. Not fatiguable at the end of the day, but if the patient with myasthenia is telling you they're feeling weaker at the beginning of the day, then think about obstructive sleep apnea and that obstructive sleep apnea worsening control of epilepsy due to poor sleep. So really a lot of bidirectional interactions with this common condition. Okay, so if we're concerned about obstructive sleep apnea, again, myself, a general neurologist speaking perhaps on behalf of other general neurologists, we see a patient with headache or reporting memory loss that we find to be impaired attention, or we see exacerbation of their underlying primary neurologic disease. As you mentioned, we think, "Oh, I've listened to this podcast. I've read Dr. Stahl's article. I should probably be thinking about OSA in this patient, and I should order a sleep study." Now, I admit when I get the sleep study back, I scroll to the bottom, I see they do have obstructive sleep apnea, I'm going to send them over to a sleep specialist. But for the general neurologist, what are some high-yield pearls and some pitfalls to be aware of when we get sleep studies for obstructive sleep apnea, and we are looking at the results? Dr Stahl: The first thing is to understand that there are two main types of sleep studies: in-lab polysomnography and home sleep apnea test. In-lab studies are typically what we consider the more accurate type of study. Main reason for that is that we have EEG, so we can see if someone is awake versus asleep. Most home sleep apnea tests do not utilize EEG, and so when we're looking at respiratory events, apneas or hypopneas, we're looking at over the total recording time rather than the total sleep time. So, we know we're going to capture some time where a person is awake, where we don't have sleep apnea events, and that can be a big amount of time in people with insomnia, poor sleep efficiency. And as a result of that, it can lead to an underestimation of the apnea-hypopnea index. That's really important for people to understand that that means we can end up with a false negative home sleep apnea test, or it can put them in a category of lower severity than what they actually have. And so, if you get a home sleep study report back that's negative for sleep apnea and you remain concerned, you need to go on to do an in-lab study, where about twenty to fifty percent of people will go on to have a positive in-lab study. You can also get false positives with home sleep apnea tests too, and so ideally, we should only be doing home sleep apnea tests in people that are at high risk of having obstructive sleep apnea to decrease our chance of false positive study. When we get that sleep study report, what's important to take a look at? So the main number that we look at currently is the apnea-hypopnea index. The number of apneas, which are full obstructions in that upper airway, or hypopneas, partial obstructions in the upper airway where either there's an oxygen desaturation or an arousal associated with that. Less than five is considered to be normal. Anything five or more gives them a diagnosis of obstructive sleep apnea, and then we stratify them based on the AHI. But it's important to take a look at more than just the apnea-hypopnea index. And while my eyes too on various reports like echocardiograms want to jump to the impression, it is important to take a look at that full report, see what their oxygen levels averaged and what they dipped down to. The arousal index, which is how many times a patient may have woken up briefly throughout the night. Take a look at the histogram, usually an image at the bottom of their report that shows what sleep fragmentation may have been like so that you can take that all in and make that decision. How important are these study findings, and is this a person that would benefit from treatment?  Dr Berkowitz: That's a fantastic overview of sleep studies and some of the highlights to look out for, even if we won't be understanding every detail as you would to know most importantly the caveats about home sleep testing having a fairly high percentage of false negative and false positive results. So being wary if our suspicion is high, and that test is normal or inconclusive to get an in-lab sleep study. And if our suspicion is low or maybe we haven't ordered the test and the patient has had it done elsewhere, and the history doesn't really match up to know that there are false positives on the home studies as well, and again, an in-lab study to settle the diagnosis. Is that right?  Dr Stahl: Yes.  Dr Berkowitz: Okay. Now, for most neurologists, probably if we diagnose OSA, we will be referring the patient to a sleep specialist like yourself for treatment. I think we're all familiar with CPAP and patients being on CPAP. Your article mentions a number of treatment modalities I admit I have not heard of before or maybe heard of in passing, acknowledging most general neurologists are not going to be prescribing or knowing with the nuance that you do as an expert how to decide which treatment a patient would most benefit from or most qualify for. So, can you just give us a broad overview, again, for the general neurologist acknowledging we might see a patient whose past medical history says OSA being treated with fill in the blank. What are the different treatment modalities, and how do you think, just so we can learn from you in broad brush strokes, about particular treatments for particular patients?  Dr Stahl: As you mentioned, most people are familiar with positive airway pressure or PAP therapy, and that does remain our most efficacious treatment. The way I explain it to patients is why PAP therapy is the most effective treatment is it's the only treatment that can take all of the tissues of that upper airway and open them up. Whereas all of our other treatments, we're going to target smaller spaces of that upper airway. So, our first option is if we can get somebody on PAP therapy, we know that that's going to be the best option for the majority. PAP therapy works by basically acting as an air splint to open up the air tissues. Know that masks are not interchangeable. There are masks that cover the nose and go over the nose and mouth and under the nose. Full face masks that cover the nose and mouth, they do typically require higher pressures, also tend to be less comfortable for a lot of patients as well. In addition to different PAP masks, there's different modalities of positive airway pressure therapy too. There are machines that auto-adjust, some that provide fixed pressure, bi-level PAP that provides a higher inspiratory pressure, lower expiratory pressure. Then outside of PAP therapy, there are, as you alluded to, a lot of options and more, continuing to come down the pipeline as well. Mandibular advancement devices or a form of oral appliances has been around for a while. This is device that somebody wears in their mouth. It's preferably customized for their teeth and titratable, meaning that they can make adjustments that pulls their mandible forward in relation to the maxilla in order to pull those tongue tissues further away from the back of the upper airway. That's ideally managed by a qualified sleep dentist or someone that specializes in oral appliance management. Other treatments include surgical options, including hypoglossal nerve stimulation, which is an implanted device that causes the tongue to protrude repetitively throughout their sleep period to hopefully open up the airspace. There's some other surgical options too that open up various places of the upper airway. There's a daytime treatment of obstructive sleep apnea, transoral neuromuscular electrical stimulation that changes the muscle fiber type of the tongue. And then there's some adjunctive treatments that can be helpful too, such as positional therapy, oral facial myofunctional therapy that helps a person breathe better through their nose and may help train the upper airway muscles.  Dr Berkowitz: Great. Well, that's a very helpful overview, and again, I refer our listeners to your article, which talks about all of those modalities in very comprehensive detail. So, Dr. Stahl, as we wrap up our conversation, you have a captive audience of neurologists and neurology trainees here. What would you like to leave us with that every neurologist should know about obstructive sleep apnea?  Dr Stahl: The most important, again, is for neurologists to know that obstructive sleep apnea is so common in your patient population, and it can have a significant negative impact on quality of life and health, including many neurologic conditions. And at the same time, obstructive sleep apnea is very treatable. We have so many options nowadays that we can usually get someone onto adequate treatment. And treatment has that potential to improve several neurologic symptoms and disorders, even at times when you don't think that there's an opportunity to improve symptoms such as say in, headache. So, neurologists really should be screening for signs and symptoms of obstructive sleep apnea, as well as considering testing in high-risk, potentially asymptomatic or minimally symptomatic patients.  Dr Berkowitz: That's a fantastic overview of some of the many pearls that you shared with us today, as well as in your article. So, thank you so much again. Today, I've been interviewing Dr. Stephanie Stahl about her article on obstructive sleep apnea. This article appears in the August 2026 Continuum issue on neurology of sleep. Be sure to check out Continuum Audio episodes from this and other issues. And thank you so much to our listeners for joining today, and thank you again, Dr. Stahl.  Dr Stahl: Thank you again for having me.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.  

Nasal strips have been a fixture in pharmacy aisles and on athletes' faces for decades, sold on the promise of easier breathing, but the peer-reviewed evidence often tells a different story than the packaging does. We put nasal strips and internal dilators through the RCT wringer and sort out what these devices can and can't actually do, from your bedroom to the finish line. In this episode we will:Break down what the highest-quality evidence — a 2026 meta-analysis of 17 studies and nearly 500 patients — actually found for AHI, oxygen saturation, and sleep architecture across all nasal dilator typesSit with the placebo-strip finding out of the University of São Paulo, and what it reveals about the gap between subjective "I slept better" and objective, PSG-measured outcomesCompare internal dilators like Mute against external strips, and call out where manufacturer-cited stats diverge from the independent literatureHead onto the field and track: two competing systematic reviews on whether strips help runners and athletes, and why "very low certainty" evidence still shapes what gets marketed to youTo find out more about this week's podcast sponsor BreatheUp, please use the following link: https://breatheup.com/Original intro music Vigilanteology by Abhinav Singh (copyright 2026) Original outro music Vigilanteology (reprise) by Abhinav Singh (copyright 2026)Produced by: Maeve WinterMusic by: Dr. Abhinav Singh (@sleep_vigilante), all rights reservedMoreTwitter: @drchriswinterIG: @drchriwinterThreads: @drchriswinterBluesky: @drchriswinterThe Sleep Solution and The Rested ChildThanks for listening and sleep well!

#KAROLG #DRAKE #Ahí #Pop #Lain 2026 is here! That means Let's Talk About it: MUSIX REVIEWS S12 is here! A whole new approach this year long season is all about opening up and leaving behind the past. Join TK on a journey of funny off the wall pop reviews, hip-hop, Rnb and whole new variety content too! Of talking about trending news topics, video games and even maybe even talking about movies too! S12 is here! New episodes every single day! Join the wild ride of the SECOND YEAR LONG SEASON.Karol G, Drake, Ahi, Karol G Ahi, Drake Ahi, Karol G and Drake, Ahi Karol G, Karol G new song, Drake new song, Karol G music, Drake music, Latin music, Reggaeton, Latin trap, Karol G Drake collaboration, New music 2024, Official audio, Music video, Karol G hits, Drake hits

Most surgeons trained learning extracapsular tonsillectomies. What does the evidence say about intracapsular tonsillectomies? Two pediatric otolaryngologists explain why they made the switch and never looked back. On this episode of the BackTable ENT Podcast, hosts Dr. Ashley Agan and Dr. Gopi Shah sit down with pediatric otolaryngologists Dr. Stephen Chorney from UT Southwestern and Children's Health Dallas and Dr. Kevin Huoh from Children's of Orange County to examine post-operative complications after tonsillectomy and adenoidectomy, with a focus on coblation intracapsular tonsillectomy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Smith + Nephewhttps://www.smith-nephew.com/en/ --- Timestamps 00:00 - Introduction02:53 - Why Switch Techniques?07:58 - Risk Stratification and Patient Selection11:04 - Respiratory Complications and Management15:57 - Preop Screening21:35 - Risks for Post-op Bleeding and Counseling26:16 - Managing Post-op Bleeding31:56 - Surgical Tips to Prevent Bleeds and Management39:30 - Intracapsular Tonsillectomy in Older Kids43:44 - Post Op Pain Plan and Return To School48:33 - Use of Toradol & Readmission for Pain and Dehydration53:16 - Caution of Burn and Stenosis Injuries61:01 - Final Takeaways --- More about this episode Dr. Chorney and Dr. Huoh share why they each committed fully to the intracapsular technique and what that shift has meant in practice, from secondary hemorrhage rates hovering around 0.5–0.6% to fewer nursing line calls, readmissions for pain and dehydration, and faster returns to school and normal activity. They walk through their approach to patient risk stratification and admission criteria (age 30/ICU consideration) as well as how to manage the most common post-operative respiratory complications. The conversation also covers practical guidance for handling outside-ER bleed calls, the role of nebulized TXA, toradol considerations, and managing dehydration. They also share for navigating intracapsular coblation in older children, strategies to reduce burn injuries, and a closer look at the rare but serious risk of pharyngeal stenosis. Check out this episode to hear Dr. Chorney and Dr. Huoh discuss how intracapsular tonsillectomy doesn't just improve outcomes but can transform the recovery experience for patients and their families. --- Resources Extracapsular vs Intracapsular Tonsillectomy: Outcomes in Children with a Focus on Developmental Delayhttps://pubmed.ncbi.nlm.nih.gov/34839135/ Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United Stateshttps://pubmed.ncbi.nlm.nih.gov/32969500/ Dr. Chorney Episode 259 - Understanding Coblation Tonsillectomy https://www.backtable.com/shows/ent/podcasts/259/understanding-coblation-tonsillectomy-benefits-outcomes-techniques Dr. Huoh Episode 110 - Intracapsular Tonsillectomy in Childrenhttps://www.backtable.com/shows/ent/podcasts/110/intracapsular-tonsillectomy-in-children --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Is nasal obstruction the overlooked culprit behind CPAP intolerance? On this episode of BackTable ENT & Allergy, Dr. Gopi Shah interviews Dr. Atul Malhotra and Dr. Michael Hutz to examine the critical but often underappreciated role of the nose in obstructive sleep apnea management. They discuss how nasal obstruction can undermine CPAP adherence, why relying solely on AHI may miss key issues, and how identifying the true cause of intolerance can lead to more personalized and effective therapy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Aerin Medicalhttps://vivaer.com/ --- Timestamps 00:00 - Introduction04:05 - OSA Presentation and AHI Limitations08:13 - Understanding CPAP Intolerance and Nasal Obstruction15:24 - Evaluating Nasal Obstruction20:32 - Nasal Anatomy and Workup27:47 - DICE Technique and Assessing Dynamic Nasal Collapse32:51 - Medical and Non-Surgical Management37:29 - Surgical Options and VivAer43:39 - Nasal Procedures and CPAP Success51:57 - Nasal Surgery and Heart Outcomes55:23 - Beyond CPAP: Nasal Breathing, Myofunctional Therapy, and Collaborative Care01:04:51 - Wrap Up --- More about this episode The physicians review practical strategies for evaluating nasal obstruction, from targeted patient questionnaires, physical exams, nasal endoscopy, and selective imaging. The doctors also detail medical and surgical treatment options, from allergy management and nasal sprays to septoplasty, turbinate reduction, functional rhinoplasty, and temperature-controlled radiofrequency (VivAer). Throughout the episode, they highlight how comprehensive nasal evaluation and intervention can significantly improve CPAP comfort and adherence. --- Resources Dr. Atul Malhotra - https://providers.ucsd.edu/details/22362/sleep-medicine-pulmonology-(lung) Dr. Michael Hutz- https://doctors.rush.edu/details/19100 CPAP treatment persistence following nasal procedures in obstructive sleep apnea - https://www.tandfonline.com/doi/pdf/10.1080/13696998.2026.2671550 Design and rationale for treating Obstructive Sleep Apnea using Targeted Hypoglossal Nerve Stimulation trial - https://www.sciencedirect.com/science/article/pii/S1551714422001306 The Impact of Mouth-Taping in Mouth-Breathers with Mild Obstructive Sleep Apnea - https://pmc.ncbi.nlm.nih.gov/articles/PMC9498537/ VATRAC Trial of VivAer - https://aerinmedical.com/company/news-and-media/aerin-medical-announces-positive-two-year-outcomes-from-the-vatrac-trial-of-vivaer/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Sam Choy's years of cooking alongside his parents gave him the skills and inspiration to make Sam a Hawaiian celebrity chef. His exceptional creativity, love of good food, and aloha for guests propelled him to the status of an internationally recognized chef, Food Network personality, and James Beard award-winner. Choy's colorful personality and welcoming smile have drawn customers to his multiple restaurants over the last 30 years, but it is his award-winning cooking that keeps them coming back! He characterizes his cuisine as a "melting pot of the freshest ingredients from ever culture on the Hawaiian islands...true Hawaiian heritage cooking." Sam spent twenty plus years mastering his craft in the kitchens of noted hotels and resorts on the mainland and Hawai'i. Sam appears on his weekly cooking show, Cooking with Sam, on the Hawaiian Islands' NBC affiliate. He has authored 16 cookbooks and is often credited as the "Godfather of Poke" and the Culinary Ambassador of the Big Island. Send us Fan MailFirecracker Farm Small-batch Spicy Salt Family farm with a secret blend of Carolina Reaper, Ghost, and Trinidad Scorpion peppers.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show

The country's only two star Michelin chef has been left speechless over the achievement. Essence in Queenstown was the only New Zealand venue awarded two stars at last night's Michelin ceremony. Fourteen New Zealand restaurants received a single Michelin star including Kika in Wanaka, Ortega Fish Shack in Wellington, and Ahi at Auckland's Commercial Bay. Essence Head Chef Paul Froggatt told Mike Hosking it's a huge honour, and they'll still be striving for excellence. He says they're only as good as the last plate they served. LISTEN ABOVE See omnystudio.com/listener for privacy information.

Miguel Ángel González Suárez te presenta el Informativo de Primera Hora en 'El Remate', el programa matinal de La Diez Capital Radio que arranca tu día con: Las noticias más relevantes de Canarias, España y el mundo, analizadas con rigor y claridad. Una réplica de magnitud 4,6 sacude la zona devastada por los terremotos en Venezuela. Este nuevo temblor ha ocurrido cuando socorristas venezolanos y extranjeros trabajan contrarreloj para tratar de rescatar a personas con vida debajo de los escombros. Canarias activa la alerta por incendios forestales y calor extremo. El próximo día 2 y 3 de julio estaremos en directo desde el Hotel Coral Cotillo Beach. Hoy hace 3 años: La presidenta del Parlamento de Canarias propone a Clavijo como candidato para la investidura los días 11 y 12 de julio. La candidatura de Clavijo ya cuenta con el aval de 38 votos de los grupos Nacionalista, Popular, ASG y AHI. Hoy se cumplen 1.593 días de guerra entre Rusia y Ucrania. 4 años y 125 días. Hoy es martes 30 de junio de 2026. Día de las Redes Sociales. El Día de las Redes Sociales se celebra el 30 de junio. Su objetivo primordial es que las redes sociales sean una herramienta que permita a la población mundial una mayor y mejor comunicación, así como un medio para mantenerse informado, utilizando una plataforma globalizada como es Internet. 1862.- Se publican los últimos capítulos de "Los miserables", de Víctor Hugo. 1876.- Alfonso XII promulga la Constitución Española. 1948.- Los laboratorios Bell presentan el primer transistor. 1997.- Último día en que Hong Kong pertenece al Reino Unido. 2002.- Brasil gana por quinta vez la Copa del Mundo de fútbol al vencer a Alemania en Yokohama (Japón). 2005.- El Congreso de los Diputados aprueba la ley de matrimonio entre personas del mismo sexo. Patrocinio del santo de cada día por gentileza de la Casa de las Imágenes, en la calle Obispo Perez Cáceres, 17 en Candelaria. El santoral católico completo de hoy, 30 de junio: San Ladislao de Hungría San Adolfo de Osnabrück San Alpiniano de Limoges El Gobierno eleva en cuatro décimas el crecimiento económico para este año y lo sitúa en el 2,6%. Feijóo acusa a Sánchez de "ingeniería electoral" y "fabricar votantes" nacionalizándolos con la Ley de Nietos. La secretaria de Zapatero se niega a declarar en la comisión del Senado sobre las presuntas irregularidades en la SEPI. Carmen Pano insiste en que la abogada de Koldo trató de sobornala para que negara que había llevado dinero a Ferraz. El Gobierno anuncia un "importante" paquete de medidas que "pueda lograr un gran acuerdo" sobre vivienda en el Congreso. El precio de la vivienda se dispara en los barrios populares de Canarias: por qué sube el doble que en los ‘ricos'. El informe “Evolución del precio de la vivienda en los barrios populares de Canarias” analiza en profundidad de qué forma aumenta el precio de la vivienda en el Archipiélago. Ya es oficial: Canarias prorroga el IGIC cero a los combustibles hasta septiembre para contener el precio de la gasolina. El Gobierno mantiene también la devolución extraordinaria del impuesto sobre combustibles para agricultores y transportistas, aunque las medidas podrán retirarse antes si bajan los precios. La economía canaria pierde vigor y continúa amenazada por la baja productividad. La patronal de Las Palmas presenta su informe del año 2025, en el que advierte de los problemas que acechan al crecimiento del Archipiélago. El 30 de junio de 1986 se publica este disco de MADONNA - ‘True Blue'.

New Zealand restaurants are getting their sparkle back, thanks to some joining elite ranks. More than 100 venues have been recognised by the Michelin Guide, with 14 awarded a single star, including Auckland's Ahi and Wanaka's Kika. Essence in Queenstown was the only venue to receive a coveted two stars. Restaurant Association CEO Nicola Waldren told Ryan Bridge the country wasn't guaranteed any stars, so securing 16 stars on the first try is huge. She says this is a stunning achievement for a little country like ours, with such a special hospitality industry. LISTEN ABOVE See omnystudio.com/listener for privacy information.

Sleep, Airway and Mouth Breathing: An ENT's Guide for Dentists Could a “normal” sleep study still be missing your patient's airway problem? Why do women and children with real symptoms keep scoring “mild”? Should a mouth-breathing child see a myofunctional therapist — or an ENT first? And which four questions screen a child for sleep problems in under a minute? The roof of the mouth is the floor of the nose — so ENT and dentistry should be in constant dialogue. In practice, they rarely are. In this one, Dr David McIntosh — an Australian ear, nose and throat surgeon with a deep niche in sleep-disordered breathing — makes the case for why that has to change, and gives dentists practical ways to screen and refer. He is direct, analogy-rich and doesn't mince words; expect a few positions that cut against the grain of how sleep apnoea is usually handled. https://youtu.be/QVEc0ocxTCc Watch PDP272 on YouTube Protrusive Dental Pearl: When the Numbers Mislead Dentists love data — the AHI, the cut-offs (over 5 is mild, over 30 is severe). But take those numbers with a pinch of salt: the thresholds are arbitrary, and a single score tells you nothing about why a patient has the problem. They don't account for individual variability — especially in women and children, where a mild score can sit right alongside significant symptoms. Read the number with the anatomy and the phenotype — the clinical signs and the airway assessment — never instead of them. What You'll Take From This Episode This conversation reframes sleep-disordered breathing from a number on a report into something you can localise and refer.  A sleep study tells you IF, not WHY — sleep-disordered breathing is the whole spectrum; a normal study doesn't mean normal breathing. Phenotyping the airway — map the individual anatomical causes instead of trusting a single score. Why women get missed — the gender bias built into standard adult screening tools, and what to ask instead. The four-question filter for children — snore, mouth breathe, stop breathing, wake up tired: any ‘yes' means refer. Treat the cause before the function — why myofunctional therapy comes after the obstruction is cleared, not before, and how expansion and surgery are matched to the anatomy. Highlights of This Episode 00:00  Teaser 01:00  Why ENT and Dentistry Should Be Talking 02:51  Protrusive Dental Pearl: When Sleep Data Misleads You 03:46  Meet the ENT Who Works With Dentists 06:00  Sleep Physician, ENT or Dentist: Who Should Lead? 07:26  Why Children and Adults Are Completely Different 08:58  Sleep-Disordered Breathing Is Not the Same as Sleep Apnoea 09:39  Why a Normal Sleep Study Doesn't Mean Normal Breathing 10:01  Same AHI, Different Cause: A Tale of Two Patients 12:54  Why One Night's Sleep Study Isn't Enough 13:44  Where the AHI Cut-Off Numbers Really Came From 15:27  CPAP Explained: A Bridge, Not a Cure 18:27  When Snoring Hides Something Serious 19:10  What Phenotyping the Airway Actually Means 20:27  Splint, CPAP, or Both? 21:33  Why a CBCT Can Miss a Deviated Septum 25:32  Is STOP-Bang Enough to Screen for Sleep Apnoea? 26:06  Why the Epworth Sleepiness Scale Is a Blunt Tool 26:50  Why STOP-Bang Is Biased Against Women 31:17  Sleep Apnoea in Women: Mild on Paper, Severe in Life 32:05  Midroll 36:56  The Triad: Airway, TMD and Orthodontics 37:12  The Three Most Common Causes of Night-Time Grinding 39:41  The Four Questions That Screen a Child for Sleep Problems 41:03  Tired vs Not Tired: The Sign That Changes Everything 43:36  Should You Refer to Myofunctional Therapy Before an ENT? 45:58  The Hidden Dangers of Forcing Nasal Breathing 52:28  Maxillary Expansion vs Surgery: Which One Fixes It? 54:51  How Dentists Can Assess Adenoids 56:25  Save the Child First: The Drowning Analogy 57:56  Where Dentistry and ENT Go From Here 1:00:05  Outro – New-Look Premium Notes & CPD Outro From the Guest Dr David McIntosh is an ear, nose and throat surgeon (MBBS, FRACS, PhD) with a special interest in sleep-disordered breathing and airway obstruction. A self-described compulsive educator, he is the author of several books on Amazon — including dENTal health, on the connection between ENT and dental disease, and Snored to Death, on the lesser-recognised causes of obstructive sleep apnoea in adults. References & Further Reading Sources discussed in this episode: Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine, 2000;1(1):21–32. The 22-item PSQ; a score above 0.33 suggests sleep-disordered breathing. Loved This Episode? Try Next Airway Dentistry with Jeff Rouse – PDP229 Listen, Subscribe, Earn CPD This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology (Sleep medicine) #PDPMainEpisodes #OralSurgeryandOralMedicine Aim & Learning Outcomes Aim: To help dental practitioners recognise sleep-disordered breathing across the whole airway, screen adults and children appropriately, and refer at the right time and to the right clinician. Learning Outcomes — by the end of this episode, dentists will be able to: Differentiate sleep-disordered breathing from obstructive sleep apnoea, and explain why a normal sleep study does not exclude clinically significant breathing problems. Apply a structured screening approach for adults and children, including recognising why standard adult tools under-detect sleep-disordered breathing in women and children. Evaluate when to refer for specialist airway assessment, and articulate why addressing anatomical obstruction should precede functional (myofunctional) therapy.

Sleep, Airway and Mouth Breathing: An ENT's Guide for Dentists Could a “normal” sleep study still be missing your patient's airway problem? Why do women and children with real symptoms keep scoring “mild”? Should a mouth-breathing child see a myofunctional therapist — or an ENT first? And which four questions screen a child for sleep problems in under a minute? The roof of the mouth is the floor of the nose — so ENT and dentistry should be in constant dialogue. In practice, they rarely are. In this one, Dr David McIntosh — an Australian ear, nose and throat surgeon with a deep niche in sleep-disordered breathing — makes the case for why that has to change, and gives dentists practical ways to screen and refer. He is direct, analogy-rich and doesn't mince words; expect a few positions that cut against the grain of how sleep apnoea is usually handled. https://youtu.be/QVEc0ocxTCc Watch PDP272 on YouTube Protrusive Dental Pearl: When the Numbers Mislead Dentists love data — the AHI, the cut-offs (over 5 is mild, over 30 is severe). But take those numbers with a pinch of salt: the thresholds are arbitrary, and a single score tells you nothing about why a patient has the problem. They don't account for individual variability — especially in women and children, where a mild score can sit right alongside significant symptoms. Read the number with the anatomy and the phenotype — the clinical signs and the airway assessment — never instead of them. What You'll Take From This Episode This conversation reframes sleep-disordered breathing from a number on a report into something you can localise and refer.  A sleep study tells you IF, not WHY — sleep-disordered breathing is the whole spectrum; a normal study doesn't mean normal breathing. Phenotyping the airway — map the individual anatomical causes instead of trusting a single score. Why women get missed — the gender bias built into standard adult screening tools, and what to ask instead. The four-question filter for children — snore, mouth breathe, stop breathing, wake up tired: any ‘yes' means refer. Treat the cause before the function — why myofunctional therapy comes after the obstruction is cleared, not before, and how expansion and surgery are matched to the anatomy. Highlights of This Episode 00:00  Teaser 01:00  Why ENT and Dentistry Should Be Talking 02:51  Protrusive Dental Pearl: When Sleep Data Misleads You 03:46  Meet the ENT Who Works With Dentists 06:00  Sleep Physician, ENT or Dentist: Who Should Lead? 07:26  Why Children and Adults Are Completely Different 08:58  Sleep-Disordered Breathing Is Not the Same as Sleep Apnoea 09:39  Why a Normal Sleep Study Doesn't Mean Normal Breathing 10:01  Same AHI, Different Cause: A Tale of Two Patients 12:54  Why One Night's Sleep Study Isn't Enough 13:44  Where the AHI Cut-Off Numbers Really Came From 15:27  CPAP Explained: A Bridge, Not a Cure 18:27  When Snoring Hides Something Serious 19:10  What Phenotyping the Airway Actually Means 20:27  Splint, CPAP, or Both? 21:33  Why a CBCT Can Miss a Deviated Septum 25:32  Is STOP-Bang Enough to Screen for Sleep Apnoea? 26:06  Why the Epworth Sleepiness Scale Is a Blunt Tool 26:50  Why STOP-Bang Is Biased Against Women 31:17  Sleep Apnoea in Women: Mild on Paper, Severe in Life 32:05  Midroll 36:56  The Triad: Airway, TMD and Orthodontics 37:12  The Three Most Common Causes of Night-Time Grinding 39:41  The Four Questions That Screen a Child for Sleep Problems 41:03  Tired vs Not Tired: The Sign That Changes Everything 43:36  Should You Refer to Myofunctional Therapy Before an ENT? 45:58  The Hidden Dangers of Forcing Nasal Breathing 52:28  Maxillary Expansion vs Surgery: Which One Fixes It? 54:51  How Dentists Can Assess Adenoids 56:25  Save the Child First: The Drowning Analogy 57:56  Where Dentistry and ENT Go From Here 1:00:05  Outro – New-Look Premium Notes & CPD Outro From the Guest Dr David McIntosh is an ear, nose and throat surgeon (MBBS, FRACS, PhD) with a special interest in sleep-disordered breathing and airway obstruction. A self-described compulsive educator, he is the author of several books on Amazon — including dENTal health, on the connection between ENT and dental disease, and Snored to Death, on the lesser-recognised causes of obstructive sleep apnoea in adults. References & Further Reading Sources discussed in this episode: Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Medicine, 2000;1(1):21–32. The 22-item PSQ; a score above 0.33 suggests sleep-disordered breathing. Loved This Episode? Try Next Airway Dentistry with Jeff Rouse – PDP229 Listen, Subscribe, Earn CPD This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes C AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology (Sleep medicine) #PDPMainEpisodes #OralSurgeryandOralMedicine Aim & Learning Outcomes Aim: To help dental practitioners recognise sleep-disordered breathing across the whole airway, screen adults and children appropriately, and refer at the right time and to the right clinician. Learning Outcomes — by the end of this episode, dentists will be able to: Differentiate sleep-disordered breathing from obstructive sleep apnoea, and explain why a normal sleep study does not exclude clinically significant breathing problems. Apply a structured screening approach for adults and children, including recognising why standard adult tools under-detect sleep-disordered breathing in women and children. Evaluate when to refer for specialist airway assessment, and articulate why addressing anatomical obstruction should precede functional (myofunctional) therapy.

Canadian Folk Music Award winner AHI performed his new song, Chosen, on stage at the FIFA World Cup 2026 countdown concert in Toronto. And if that moment wasn't special enough for the lifelong soccer fan, he got to do it with one of his idols, Wyclef Jean. AHI stopped by the studio to chat with guest host Angeline Tetteh-Wayoe about what it was like collaborating with the Fugees rapper.

As I mentioned in the podcast I want to make sure you have solid references/resources to access to expand your study.  The first is related to treaties/covenants in the ancient near east.  I did a podcast on the Ark of the Covenant that is key to this lesson.  Here's the link to that Bible study - https://lightofmenorah.podbean.com/e/exodus-63-exod-2510-16-the-ark-of-the-covenant/ Here are three links as regards ancient treaties/covenants. Link 1 … https://en.wikipedia.org/wiki/Tablets_of_Stone Link 2 … https://biblehub.com/q/Why_stone_tablets_for_commandments.htm Link 3 … https://www.tarsus.ie/resources/Wisdom-Lit.-/ANET-PDF.pdf In this lesson I stated that Israel, also known as Jacob, entered Egypt with the family in 1876 B.C.  How did I come up with this exact year?  I didn't come up with it but real scholars using solid archaeology give us the dates in the Bible of Exodus, the times of Joseph and his father Jacob, and even the dates when Abraham entered Canaan.  Here's the link to the critical lesson of these dates and how we know they are real and exact … Exodus 5 Part 1 - https://youtu.be/8XHvXUSAdRY?si=rWzmXx7drVmL8eou Exodus 5 Part 2 - https://youtu.be/hgFM23lLmDo?si=Mr_Gt_ZPXkxttPk3 Who is the Egyptian goddess Ma'at?  And, she has 42 commandments.  Huh?  How is this all related to the Ten Commandments?  To expand your study check out the links below. WHO IS THIS GODDESS MA'AT?? https://ancientegyptonline.co.uk/maat/ MA'AT's COMMANDMENTS …  https://www.worldhistory.org/The_Negative_Confession/ GOTQUESTIONS.ORF – MA'AT'S LAWS AND THE TEN COMMANDMENTS - https://www.gotquestions.org/forty-two-precepts-of-Maat.html Shown below are the 42 commandments of Ma'at.  I made the connection to the Ten Commandments  indicated with a TC# followed by the number.  42 Negative Confessions found in the Papyrus of Ani 42 Negative Confessions (Papyrus of Ani) The negative confessions one would make after death could be individualized, that is, vary from person to person. These were the confessions found in the Papyrus of Ani. Hail, Usekh-nemmt, who comest forth from Anu, I have not committed sin. Hail, Hept-khet, who comest forth from Kher-aha, I have not committed robbery with violence. TC #8 Hail, Fenti, who comest forth from Khemenu, I have not stolen. TC #8 Hail, Am-khaibit, who comest forth from Qernet, I have not slain men and women. TC #6 Hail, Neha-her, who comest forth from Rasta, I have not stolen grain. TC #8 Hail, Ruruti, who comest forth from Heaven, I have not purloined offerings. TC #8 Hail, Arfi-em-khet, who comest forth from Suat, I have not stolen the property of God. TC #3?? Hail, Neba, who comest and goest, I have not uttered lies.TC #9 Hail, Set-qesu, who comest forth from Hensu, I have not carried away food. TC #8 Hail, Utu-nesert, who comest forth from Het-ka-Ptah, I have not uttered curses. Hail, Qerrti, who comest forth from Amentet, I have not committed adultery. TC #7 Hail, Hraf-haf, who comest forth from thy cavern, I have made none to weep. Hail, Basti, who comest forth from Bast, I have not eaten the heart. Hail, Ta-retiu, who comest forth from the night, I have not attacked any man. TC #6 Hail, Unem-snef, who comest forth from the execution chamber, I am not a man of deceit. TC #9 Hail, Unem-besek, who comest forth from Mabit, I have not stolen cultivated land. TC #8 Hail, Neb-Maat, who comest forth from Maati, I have not been an eavesdropper. Hail, Tenemiu, who comest forth from Bast, I have not slandered anyone. Hail, Sertiu, who comest forth from Anu, I have not been angry without just cause. Hail, Tutu, who comest forth from Ati, I have not debauched the wife of any man. TC #7 Hail, Uamenti, who comest forth from the Khebt chamber, I have not debauched the wives of other men. Hail, Maa-antuf, who comest forth from Per-Menu, I have not polluted myself. Hail, Her-uru, who comest forth from Nehatu, I have terrorized none. Hail, Khemiu, who comest forth from Kaui, I have not transgressed the law. TC #'S 4-10 Hail, Shet-kheru, who comest forth from Urit, I have not been angry. Hail, Nekhenu, who comest forth from Heqat, I have not shut my ears to the words of truth. Hail, Kenemti, who comest forth from Kenmet, I have not blasphemed. TC #3 Hail, An-hetep-f, who comest forth from Sau, I am not a man of violence. TC #6 Hail, Sera-kheru, who comest forth from Unaset, I have not been a stirrer up of strife. Hail, Neb-heru, who comest forth from Netchfet, I have not acted with undue haste. Hail, Sekhriu, who comest forth from Uten, I have not pried into other's matters. Hail, Neb-abui, who comest forth from Sauti, I have not multiplied my words in speaking. Hail, Nefer-Tem, who comest forth from Het-ka-Ptah, I have wronged none, I have done no evil. Hail, Tem-Sepu, who comest forth from Tetu, I have not worked witchcraft against the king. Hail, Ari-em-ab-f, who comest forth from Tebu, I have never stopped the flow of water of a neighbor. Hail, Ahi, who comest forth from Nu, I have never raised my voice. Hail, Uatch-rekhit, who comest forth from Sau, I have not cursed God. TC #3 Hail, Neheb-ka, who comest forth from thy cavern, I have not acted with arrogance. Hail, Neheb-nefert, who comest forth from thy cavern, I have not stolen the bread of the gods. TC #3?? Hail, Tcheser-tep, who comest forth from the shrine, I have not carried away the khenfu cakes from the spirits of the dead. TC #8 Hail, An-af, who comest forth from Maati, I have not snatched away the bread of the child, nor treated with contempt the god of my city. TC #8 AND TC #3 Hail, Hetch-abhu, who comest forth from Ta-she, I have not slain the cattle belonging to the god. Finally I made the connection between the 3000 that died at Sinai, the Mountain of God, and the 3000 who were saved on Pentecost in Jerusalem, also the Mountain of God.  My teacher, Ray Vander Laan and others put together this awesome correlation between the Mountains of God and the Covenants.  Check it out.  THE MOUNTAINS OF GOD AT SHAVUOT AMAZING CONNECTIONS Both events occurred on mountains known as "the mountain of God." Exo 24:13 So Moses arose with Joshua his servant, and Moses went up to the mountain of God. (Ex. 24:13; Isa. 2:3). Isa 2:3 And many peoples will come and say, "Come, let us go up to the mountain of the LORD, To the house of the God of Jacob; That He may teach us concerning His ways And that we may walk in His paths." For the law will go forth from Zion And the word of the LORD from Jerusalem. Both events happened on day 50. They arrived at Sinai in the third month on the very day (Ex. 19:1).  Exo 19:1 In the third month after the sons of Israel had gone out of the land of Egypt, on that very day they came into the wilderness of Sinai. Hebrew “on that very day” means they arrived on the third day of the third month exactly 50 days after their first Passover meal in Egypt. The feast of Shavuot is to happen on the 50th day after the weekly sabbath during Passover and Unleavened Bread (Lev. 23:15-16). Both involved similar sounds and symbols, such as wind, fire, and voices (Ex. 19:16-19; Acts 2:1-3). Note that the Hebrew for "thunder" (kolot) means "voices" (Acts 2:4). Jewish tradition said that the Israelites heard God speak in 70 languages or, to translate direct from the Hebrew, God spoke in tongues! Both events involved the presence of God (Ex. 19:18,20; Acts 2:4). About 3,000 people died because of their sin when Moses received the Torah (Ex. 32:28). About 3,000 people believed (were born again into new life) when the Spirit came (Acts 2:41). At Mount Sinai, God wrote his revelation on stone tablets (Ex. 31:18). On the fulfillment of Pentecost, God wrote his law on people's hearts as he had promised He would (2 Cor. 3:3; Jer. 31:33). Torah means "teaching." The Spirit, given on Shavuot, also became the "Teacher" of the new community of Jesus' followers (John 14:26) Many Jews from all over the world heard their own language from a bunch of kids, young men and women, who only knew Aramaic, Greek and Hebrew. The whole world heard the Gospel!! It was as if it was SINAI REPEATED!! Both events were times when God's people entered a NEW covenant with the Lord. Israel became a new nation, a nation of priests, and nation that would be the light of the world (Ex. 19:6, Isa. 49:6).  And, for us, we have entered a NEW covenant with the Lord as we take the cup of Messiah in His Last Seder meal (Luke 22:20).  We too become a new people, a new nation, a royal priesthood (1 Pet. 2:9-10).  We to are to be the light of the world (Mat.5:14, Acts 1:7-8).  But, this time, this covenant is the covenant to restore all people to Himself as our sins our totally cleansed and forgiven.  This is the final covenant for Jew and Gentile to become one flock with one shepherd, the Good Shepherd, the Messiah Jesus (John 10:14-16). On Shavuot there is a special sacrifice. Amazingly it uses two loaves of LEAVENED BREAD (Lev. 23:17). Is God giving us a picture that Jew and Gentile are a new people, a new culture, a holy nation, His two flocks coming together as ONE permeated and saturated with His Holy Spirit dwelling in us and through us? Is God helping us see that His Bible is ONE book, about ONE God, about ONE Gospel, ONE Baptism, and ONE Savor of all – Yeshua!   Who is this guy, Rev. Ferret?  (Ferret - teaching at the archaeological site of Herod's temple he built for Augustus at Omrit Israel) What's his background?  Why should we take time to listen to him?  Here's a link to check out his background - https://www.dropbox.com/s/ortnret3oxcicu4/BackgrndTeacher%20mar%2025%202020.pdf?dl=0  

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Abhishek Goyal, Professor and Head of Respiratory Medicine in Dehradoon, India, and Dr. Prakhar Agarwal, a pulmonologist in private practice in Bhopal, India, to discuss their research comparing fixed CPAP versus auto-titrating CPAP (APAP) on blood pressure control and autonomic nervous system response. For years, difficult-to-treat hypertension has been recognized as an indication for sleep studies, reflecting the assumption that treating sleep apnea improves blood pressure. But does the method of PAP therapy matter? Beyond achieving a residual AHI under 5, are there treatment nuances that could optimize cardiovascular outcomes? Dr. Goyal and Dr. Agarwal's research addresses these questions, building on landmark work by Dr. Pepin examining fixed versus auto-titrating PAP therapy. The motivation includes both clinical and economic considerations. A 2021 Portuguese study examined cost implications, and similar economic pressures exist in India where APAP is significantly more expensive than fixed CPAP. The study used a crossover design comparing fixed CPAP to APAP, measuring blood pressure dipping patterns and autonomic response to assess cardiovascular effects. The results have prompted Dr. Goyal to reconsider his clinical practice regarding pressure selection, raising important questions: If fixed CPAP offers superior blood pressure outcomes, should the standard practice of prescribing APAP devices be reconsidered? This challenges assumptions about adaptive algorithms and raises questions about prioritizing cardiovascular outcomes beyond AHI reduction. The episode contextualizes these findings within India's unique healthcare landscape, exploring surprising OSA incidence data and examining whether craniofacial anatomy or arousal patterns differ from Western populations. Dr. Agarwal discusses how pressures are typically determined and the practical differences between APAP 4-20 versus narrow-range settings. Whether you're prescribing PAP therapy for hypertension, optimizing cardiovascular outcomes, or seeking evidence-based approaches to pressure selection, this episode provides important international perspectives. Join us for this discussion that may prompt reconsideration of how we set PAP pressures and what outcomes we should prioritize.

In this episode, we chat to acclaimed Canadian artist, AHI. We discuss the power of storytelling in folk music and how personal experiences shape the songs we connect with most deeply. We also touch on AHI's journey as an artist, the role of vulnerability in songwriting, and how he's learned to channel criticism into creativity and growth throughout his career.Be sure to catch AHI live on his upcoming tour and connect with him on Instagram, Facebook and on his website.About AHIWith an unmistakable voice like “gravel on silk”, and a colourful landscape of tightly-crafted lyrics, driving rhythms and uplifting melodies, Canadian singer-songwriter  AHI (pronounced “eye”) is creating folk music the whole world can sing to. From charting on Spotify, Apple Music, and Amazon, to delivering captivating performances on CBS & NPR Tiny Desk and touring internationally with Mandy Moore, Lauren Daigle and Milow, AHI has earned over 100 Million streams worldwide, propelling him to the forefront of today's Folk/Roots music scene.On the international stage, AHI has received glowing reviews from Billboard (US) and Rolling Stone (Germany), and his voice has been featured by Starbucks, Ralph Lauren, IKEA, and many more. Meanwhile, back home in Canada, AHI has earned multiple JUNO Award nominations and been recognized by the prestigious Polaris Prize, establishing him as one of Canada's most exciting new voices.______________Tune in to the latest episodes of Refolkus, featuring latest music releases from Folk Canada members and Refolkus guests, now broadcasting on CKCU FM 93.1 in Ottawa, CKUW 95.9 FM in Winnipeg and CFBX 92.5 FM in Kamloops.Presented by Folk CanadaHosted by Rosalyn DennettProduced by Kayla Nezon and Rosalyn DennettMixed by Jordan Moore of The Pod CabinTheme music “Amsterdam” by King CardiacArtwork by Jaymie Karn

Whitly, un bucólico pueblo del norte de Inglaterra, fue el destino en 1890 de Bran Stoker, el mítico autor de Drácula. Ahí encontró las historias que le sirvieron de inspiración para su mítica obra, que apareció siete años después. El lugar lo conoce a la perfección Miriam del Río, conocida en redes sociales como Darkladybcn y autora del libro Turismo Dark (Luciánada).

Send us Fan MailS6 E130 - New FDA Pill: Weight Loss vs. Sleep Apnea (The Truth About Foundayo & GLP-1s)

Mi hobby es rediseñar toda la ciudad limitándome a sus estúpidas leyes de urbanizaciónECDQEMSD podcast episodio 6294 I Love PowerPointConducen: El Pirata y El Sr. Lagartija https://canaltrans.comNoticias del Mundo: Trump y la I.A. - Crisis del Rial - México reconoce ayuda de Washington - Hipopótamos colombianos a la India - De Ice a Nice - El billete de Trump - Premio para Patti Smith - Un tigre en XochimilcoHistorias Desintegradas: Extraños entretenimientos - Ahi te voy Seattle - Apartamentos y casas - Jericallas y Cantaritos - Preparando al baby - Sakura es el bueno - Dónde está VEVO - Cuestión de limitaciones - Día internacional del Jazz - Lo falso de lo falso - Día del Niño en México - Álvaro Obregón, José Vasconcelos - Seamos honestos  y más...En Caso De Que El Mundo Se Desintegre - Podcast no tiene publicidad, sponsors ni organizaciones que aporten para mantenerlo al aire. Solo el sistema cooperativo de los que aportan a través de las suscripciones hacen posible que todo esto siga siendo una realidad. Gracias Dragones Dorados!!NO AI: ECDQEMSD Podcast no utiliza ninguna inteligencia artificial de manera directa para su realización. Diseño, guionado, música, edición y voces son de  nuestra completa intervención humana.

Confusion and controversy are growing around the intelligence community's handling of Havana Syndrome. This is what the government refers to as Anomalous Health Incidents, or AHIs. The mysterious health condition has left a group of American spies, diplomats, and service members with serious brain injuries. Many believe Russia's hand is at play. But an intelligence community assessment from 2023 said most agencies concluded it is “very unlikely” a foreign adversary was behind the affliction. It hasn't changed its stance despite new details coming to light. As Sasha first reported, the US government bought and has been testing a weapon that some scientists believe is likely the cause of these brain injuries. Sasha reached out to the CIA, which declined to comment then and declines to comment now. Accusations of a cover-up have been mounting, from inside the House Intelligence Committee to journalists covering AHI. Reporter Michael Weiss is part of a team that uncovered new information. Subscribe to Sasha's Substack, HUMINT, to get more intelligence stories: https://sashaingber.substack.com/ For more information about the International Spy Museum, visit:  https://www.spymuseum.org/ And if you have feedback or want to hear about a particular topic,  you can reach us by email at spycast@spymuseum.org. This show is brought to you by N2K Networks, Goat Rodeo, and the International Spy Museum in Washington, DC. This episode was produced by Flora Warshaw and the team at Goat Rodeo. At the International Spy Museum, Mike Mincey and Memphis Vaughan III are our video editors. Emily Rens is our graphic designer. Joshua Troemel runs our SPY social media. Amanda Ohlke is our Director of Adult Education and Mira Cohen is the Vice President of Programs.

You've spotted the signs—wear, scalloping, fragmentation, maybe even a low AHI—but what does that really mean? When the data doesn't match the symptoms, how do you move forward? And how do you integrate airway into full mouth rehab without compromising function, stability, or predictability? In this episode, Jaz is joined by Dr. Aston Parmar to explore the real-world application of airway dentistry. They discuss how to help patients own their problem, why sleep testing matters, and how airway influences diagnosis, treatment planning, and long-term outcomes. https://youtu.be/-zVV1FAT0NI Watch PDP263 on YouTube Protrusive Dental Pearl Nasal Breathing and Simple Screening Nasal airflow can be a major limiting factor in sleep quality. Simple test: flare nostrils → if breathing improves, nasal resistance may be present. Nasal dilators can be a cheap, low-risk intervention for selected patients. Not all patients need mandibular advancement — sometimes the issue is nasal. Second pearl: test snoring improvement by advancing the mandible. If forward positioning reduces snoring sound → mandibular advancement may help. Key Takeaways Patients must own their problem before accepting treatment Airway dentistry is about risk reduction, not cure Apnea-Hypopnea Index (AHI) has limitations—context and patterns matter more than raw scores Upper Airway Resistance Syndrome (UARS) is common but underdiagnosed Sleep fragmentation can exist even with low AHI scores Myofunctional therapy improves compliance and outcomes Multi-night sleep testing provides more accurate insights Collaboration with ENT specialists improves diagnostic accuracy Airway is the bookend of full mouth rehab (start and end) Dentistry should be airway-sympathetic, not just tooth-focused Mandibular advancement devices are effective but require careful titration Morning occlusal guides help reduce bite changes from appliances Not all patients need the same pathway—risk stratification is key Predictability in dentistry depends on understanding the whole system The environment (airway, function, biology) matters more than the teeth Highlights of this episode: 00:00 – Introduction to Upper Airway Resistance Syndrome 02:08 – Pearl: Nasal Breathing and Simple Screening 07:43 – Recap: Myofunctional Therapy and Indications 08:30 – Role of Myofunctional Therapy in Treatment Planning 09:40 – Patient Communication and Case Acceptance 23:20 – Sleep-Disordered Breathing Spectrum 23:50 – Apnea vs Hypopnea and Apnea-Hypopnea Index (AHI) Limitations 30:00 – Upper Airway Resistance Syndrome (UARS) 35:43 – Management of UARS 37:00 – Mandibular Advancement Devices (MAD) 39:00 – Maxillary Expansion and Surgical Options 41:00 – Treatment Pathway and ENT Involvement 44:00 – Risk Assessment in Full Mouth Rehab 59:30 – Airway-Sympathetic Dentistry 01:02:00 – Treatment Philosophy and Case Selection 01:07:00 – Airway as Bookends of Treatment 01:09:00 – Managing Side Effects of MAD 01:12:00 – Career Insight and Final Reflections Want to learn more? Watch part 1 of this episode: PDP262 – Implementing Sleep, Airway and Myo to Restorative Dentistry Part 1 Also, check out Stop Blaming Bruxism with Dr. Sandra Hulac – PDP142

You've spotted the signs—wear, scalloping, fragmentation, maybe even a low AHI—but what does that really mean? When the data doesn't match the symptoms, how do you move forward? And how do you integrate airway into full mouth rehab without compromising function, stability, or predictability? In this episode, Jaz is joined by Dr. Aston Parmar to explore the real-world application of airway dentistry. They discuss how to help patients own their problem, why sleep testing matters, and how airway influences diagnosis, treatment planning, and long-term outcomes. https://youtu.be/-zVV1FAT0NI Watch PDP263 on YouTube Protrusive Dental Pearl Nasal Breathing and Simple Screening Nasal airflow can be a major limiting factor in sleep quality. Simple test: flare nostrils → if breathing improves, nasal resistance may be present. Nasal dilators can be a cheap, low-risk intervention for selected patients. Not all patients need mandibular advancement — sometimes the issue is nasal. Second pearl: test snoring improvement by advancing the mandible. If forward positioning reduces snoring sound → mandibular advancement may help. Key Takeaways Patients must own their problem before accepting treatment Airway dentistry is about risk reduction, not cure Apnea-Hypopnea Index (AHI) has limitations—context and patterns matter more than raw scores Upper Airway Resistance Syndrome (UARS) is common but underdiagnosed Sleep fragmentation can exist even with low AHI scores Myofunctional therapy improves compliance and outcomes Multi-night sleep testing provides more accurate insights Collaboration with ENT specialists improves diagnostic accuracy Airway is the bookend of full mouth rehab (start and end) Dentistry should be airway-sympathetic, not just tooth-focused Mandibular advancement devices are effective but require careful titration Morning occlusal guides help reduce bite changes from appliances Not all patients need the same pathway—risk stratification is key Predictability in dentistry depends on understanding the whole system The environment (airway, function, biology) matters more than the teeth Highlights of this episode: 00:00 – Introduction to Upper Airway Resistance Syndrome 02:08 – Pearl: Nasal Breathing and Simple Screening 07:43 – Recap: Myofunctional Therapy and Indications 08:30 – Role of Myofunctional Therapy in Treatment Planning 09:40 – Patient Communication and Case Acceptance 23:20 – Sleep-Disordered Breathing Spectrum 23:50 – Apnea vs Hypopnea and Apnea-Hypopnea Index (AHI) Limitations 30:00 – Upper Airway Resistance Syndrome (UARS) 35:43 – Management of UARS 37:00 – Mandibular Advancement Devices (MAD) 39:00 – Maxillary Expansion and Surgical Options 41:00 – Treatment Pathway and ENT Involvement 44:00 – Risk Assessment in Full Mouth Rehab 59:30 – Airway-Sympathetic Dentistry 01:02:00 – Treatment Philosophy and Case Selection 01:07:00 – Airway as Bookends of Treatment 01:09:00 – Managing Side Effects of MAD 01:12:00 – Career Insight and Final Reflections Want to learn more? Watch part 1 of this episode: PDP262 – Implementing Sleep, Airway and Myo to Restorative Dentistry Part 1 Also, check out Stop Blaming Bruxism with Dr. Sandra Hulac – PDP142

Anfang Januar 2026 häuften sich Berichte in der Presse: Angeblich soll die Biden-Administration in ihrer letzten Phase ein Exemplar jener Strahlenwaffe erworben haben, die für das sogenannte Havanna-Syndrom verantwortlich gemacht wird. Im Rahmen einer geheimen Operation der Homeland Security Investigations soll die Waffe für 15 Millionen US-Dollar von russischen Kriminellen gekauft worden sein. Das Erstaunliche daran? Sie soll in einen Rucksack passen und damit nahezu überall einsetzbar sein. Doch was steckt wirklich hinter diesen Geschichten? Gibt es belastbare Beweise? Oder bewegen wir uns immer noch im Reich der Spekulation? Wir haben uns zum dritten Mal auf die Spur des Havanna-Syndroms gemacht. Wie man uns unterstützen kann, könnt ihr hier nachlesen. Zum HOAXILLA Merchandise geht es hier QR-Code für Überweisung: QUELLEN: Story der Woche: Gab es das Pedoskop? Thema der Woche: Das Havanna-Syndrom in der dt. wikipedia Der Standard: "Havanna-Syndrom": Russlands unheimliche Mikrowellen-Waffe, erklärt CBS News - 60 Minutes: U.S. military tested device that may be tied to Havana Syndrome on rats, sheep, confidential sources say Der Startpunkt für die neuen Berichte CNN: Pentagon bought device through undercover operation some investigators suspect is linked to Havana Syndrome Die Historie bei CNN CNN: US intelligence community report says ‘pulsed electromagnetic energy’ could cause Havana Syndrome CNN: Exclusive: Dozens of CIA officers accuse intel agency of soft-pedaling its ‘Havana Syndrome’ investigation CNN: US intelligence community cannot link ‘Havana Syndrome’ cases to a foreign adversary Deutsche Gesellschaft für Neurologie: Havanna-Syndrom: Zu wenig wissenschaftliche Daten, um die Ursache klar benennen zu können Washington Post: Researcher skeptical of ‘Havana syndrome’ tested secret weapon on himself Deutscher Reservistenverband: Strahlende Flugabwehr Defensecoop: Pentagon eyes ‘treatments and countermeasures’ as it reshapes AHI cross-functional team

Well folks, 60 Minutes just confirmed that a classified U.S. intelligence mission recovered an actual directed-energy weapon — concealable, portable, silent, programmable, remote-operated, penetrates walls — and they tested it on animals in a military lab for over a year. It does what the victims said it does. So that's fun.Remember when these diplomats and spies with top-secret clearances and zero psychiatric history were told they were delusional? The FBI's early assessment was “mass hysteria.” The 2023 intelligence community report — still officially standing — says it's “very unlikely” a foreign adversary was responsible. There is now a weapon in a lab that says otherwise. Whoopsie.A former CIA officer in the Anomalous Health Incidents unit — speaking publicly for the first time — describes being told the goal was to prove it was psychosomatic and environmental. He watched a senior AHI officer mock victims by simulating a stroke at a unit happy hour. That's your tax dollars funding workplace comedy about brain injuries. Incredible.Now here's where it gets interesting for us. MKUltra didn't pick subjects randomly. CIA started with their own people — hi Frank Olson — then military subjects at Edgewood Arsenal, then systematically pivoted to populations whose testimony would be automatically discredited. Psychiatric patients. Prisoners. Addicts at the Lexington Narcotic Farm. Sex workers at Operation Midnight Climax. The selection logic wasn't random. It was about deniability.Map that onto our population. Four hundred episodes of testimony. People institutionalized as adolescents. Boarding school kids. People flagged through giftedness testing — programs that sometimes trace back to federal or military funding pipelines. Musicians — internationally traveling, high sensory sensitivity, unusual venue-exposure profiles. Joni Mitchell talked about this and got demolished. Charles Holman, musician, MRF-connected, dead. Roy Houchin, musician, MRF board. Barbara Mandrell, musician. That's not random. That's a selection signature.And “delusional parasitosis” does to this population exactly what “delusional” did to those intelligence officers. It's both the effect and the cover. Self-sealing.The CDC's 2012 Kaiser Permanente study did the same thing as the 2023 intelligence assessment: produce an official finding, foreclose inquiry, move on. Same playbook, different decade, different agency.Now — the archive we've built here is the only dataset that isn't compromised or locked in a university vault. Speaking of which: Oklahoma State University, the MRF patient registry of 12,000 families is still missing. Open records request 26-100, filed February 23rd. No substantive response. If you donated data, money, or samples to the Morgellons Research Foundation or Randy Wymore at OSU, maybe give them a call.And speaking of foreign actors — next episode we're opening the Shanghai thread. Early Wayback captures of morgellons.org linked to a personal site documenting roughly ten cases in Shanghai, built by the husband of a woman with initials H.L. He worked at Ansoft Corporation — a Pittsburgh electromagnetic field simulation software company with offices in China — and used his Ansoft work email. They reportedly funded research at Fudan University into her case. Pittsburgh to Shanghai to Fudan. We're going to verify every piece of it transparently.The government closed their investigation. We didn't. Stay tuned.

En el episodio del 12/03/26 hablamos de: ¡TIEMBLEN PARTIDOS! Ahí viene el PLAN B de la Reforma Electoral

Israel has launched waves of airstrikes in retaliation for a barrage of Hezbollah rockets and missiles. Hezbollah is still believed to have thousands of missiles. Charlie D'Agata reports. Some airports are warning travelers to allow extra time as TSA experiences staffing shortages again due to a spike in sick calls. It's the first pay period TSA officers will not get a paycheck due to the partial government shutdown. Kris Van Cleave reports. For years, the U.S. government has doubted the stories of those suffering from AHI, commonly called Havana Syndrome. Now, victims hope that reports of a newly discovered weapon will finally vindicate them. A plaque honoring police officers who responded to the Capitol on Jan. 6 went up over the weekend, three years after a federal law mandated it be displayed. Scott MacFarlane reports on the years of pushback by some of President Trump's supporters. New data from AARP reveals nearly one in 10 adults over the age of 50 has experienced an online romance that ultimately led to a request for money or encouragement to invest in crypto currency. Candace Dellacona, an estates and trusts lawyer, explains steps to take to protect your loved ones. Daryl Hannah, who dated John F. Kennedy Jr. in the 1990s, criticized the series "Love Story" and its portrayal of her. The FX series is about JFK Jr. and Carolyn Bessette, focusing on their courtship and marriage, which began after Kennedy's relationship with Hannah. In The New York Times, Hannah said the portrayal of her is "not even remotely accurate." Texas state Rep. James Talarico, who won the Democratic primary for Senate last week, tells "CBS Mornings" "people across the political spectrum are deeply worried about another forever war in the Middle East" as strikes continue in the Iran war. He speaks about the war's potential impacts and what he thinks voters in Texas are looking for this November. In this week's "Beg-Knows America," CBS News contributor David Begnaud highlights three inspiring stories of everyday Americans: a priest who has found a second calling as a repairman, a cancer survivor who surprised his donor in-person on his wedding day and two former waitresses who are working to show their appreciation for the service industry. Matthew Fox, who starred in the hit series "Lost," talks about being part of the cast for the new Paramount+ show "The Madison." He describes how he relates to his character, why he decided to return to Hollywood and working with Kurt Russell again. David Pogue, an author and correspondent for "CBS Sunday Morning," talks about covering the rise of Apple over his career as the company is set to turn 50 next month, and his new book, "Apple: The First 50 Years." To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

¡Ave Emili! Nuestro latinista tuitero, Emilio del Río, nos trae su particular espacio, Verba Volant. Una sección de NEUDC de las clásicas: llena de humor, curiosidades, música, conexiones con el Olimpo —cuando la cobertura divina lo permite— y latinismos. Verba Volant, un clásico de los clásicos de la radiodifusión de nuestros tiempos (no tan clásicos) … ¡Ahi, vademecum tango, ad usum Delphini!Escuchar audio

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Mark Boulos, Dr. Khullar, and Dr. Mak for an in‑depth discussion on a topic that has challenged clinicians for decades: Are hypnotics safe for patients with untreated obstructive sleep apnea (OSA)? As new therapeutic options emerge and our understanding of comorbid insomnia and sleep apnea (COMISA) evolves, clinicians are increasingly confronted with nuanced decisions about when—and whether—to use hypnotic medications. The guests unpack the latest evidence and share insights from recent studies, including research evaluating dual orexin receptor antagonists (DORAs) such as lemborexant in individuals with sleep apnea. The conversation begins with a review of hypnotic medication classes and explores which agents may be safer in untreated OSA, and which still raise concerns. The panel discusses a recent lemborexant study, its design, population characteristics (including BMI and OSA severity considerations), and whether industry sponsorship played a role. They clarify that while the study did not focus specifically on COMISA, it sheds light on how DORAs perform in people with sleep apnea—particularly in terms of respiratory metrics. Returning from the break, the experts tackle the practical clinical dilemma of treatment sequencing in COMISA: Should clinicians begin with cognitive behavioral therapy for insomnia (CBT‑I), initiate PAP therapy, or consider medications first? They walk through what is known about how different hypnotic classes—including z‑drugs, GABAergic agents, trazodone, and DORAs—affect respiratory drive and sleep architecture. The discussion extends to special circumstances such as REM‑related OSA, where increased REM sleep induced by certain medications may have unique implications. The episode also considers broader emerging questions: Do DORAs improve apnea–hypopnea index (AHI) even without PAP? Can hypnotics be used strategically to improve sleep continuity without worsening respiratory parameters? And will future insomnia care rely on identifying phenotypes that respond differently to GABA‑based medications or wakefulness‑impairment targets? Throughout the conversation, the guests emphasize evidence-based takeaways, including the central finding that DORAs do not appear to worsen OSA‑related metrics, offering reassurance for clinicians navigating complex COMISA treatment plans. Whether you regularly see patients with comorbid insomnia and untreated sleep apnea or simply want clarity on the evolving role of hypnotics in this population, this episode offers practical, research-grounded guidance for clinical decisionmaking. Join us for this important discussion on how hypnotics can be used safely and thoughtfully in patients with untreated OSA.

AĞAR'IN TORBACISI YELDANA'NIN AHI

In this season 8 premiere of Talking Sleep, host Dr. Seema Khosla welcomes three members of the AASM guideline committee—Dr. Rami Khayat, Professor and Division Chief of Pulmonary, Allergy & Critical Care Medicine and Director of Penn State Health Sleep Services; Dr. Shirine Allam, Professor of Medicine at Emory University and Program Director for the Pulmonary and Critical Care Fellowship at the Atlanta VA Medical Center; and Dr. Christine Won, Medical Director of Yale Centers for Sleep Medicine and Professor of Medicine at Yale University—to discuss the newly released AASM clinical practice guidelines for central sleep apnea treatment. The conversation begins with the rigorous process behind guideline development, clarifying the distinction between evidence-based recommendations and expert opinion. The panel systematically walks through each recommendation, addressing CPAP use across various CSA etiologies including primary CSA, heart failure-related CSA, medication-induced CSA, treatment-emergent CSA, and CSA due to medical conditions. A surprising recommendation against BPAP without backup rate generates discussion about why backup rates matter and why heart failure patients are excluded from certain BPAP recommendations. The experts tackle the controversial topic of adaptive servo-ventilation (ASV), explaining why it's now conditionally recommended even for heart failure patients despite SERVE-HF trial concerns. They clarify that newer ASV algorithms differ from devices used in that study and emphasize the importance of patient-provider shared decision-making and treatment at experienced centers. Practical implementation guidance covers oxygen therapy for heart failure and high-altitude CSA, including insurance coverage challenges. The panel discusses acetazolamide use across multiple CSA etiologies, providing concrete advice on prescribing and follow-up protocols. Transvenous phrenic nerve stimulation receives attention as an option for select patients, with candid discussion about its invasive nature, accessibility limitations, and high costs. The episode addresses the shift toward viewing CSA treatment as chronic disease management, including billing code G211 implications. The experts emphasize that guidelines guide but don't constrain clinical judgment, stressing the importance of monitoring beyond AHI—including patient symptoms and quality of life improvements. Whether you're treating complex central sleep apnea, navigating insurance coverage, or seeking clarity on when ASV is appropriate, this review provides essential guidance for implementing evidence-based CSA treatment. Join us for this season premiere that translates complex guidelines into practical clinical applications.

Can adults really expand their maxilla? Is treating sleep apnea with a CPAP or mandibular advancement device only MASKING the problem? How does craniofacial anatomy influence airway health, and what should dentists look for? Dr. Dave Singh joins us to dive into CranioFacial Sleep Medicine. He breaks down how structural issues—like a narrow maxilla, high-arched palate, or limited tongue space—can be root causes of sleep-disordered breathing, rather than just treating symptoms.  The episode also touches on controversies in orthodontics and presents evidence supporting interventions once thought impossible in adults. https://youtu.be/WUyeOjKquJU Watch PDP253 on Youtube Protrusive Dental Pearl: Obstructive Sleep Apnea is NOT just a “fat old man disease.” If you're not screening every patient for sleep and airway issues, you're missing a huge piece of their overall health. Snoring, bruxism, and craniofacial anatomy are all connected, and understanding these links can transform the way you approach patient care. Key Takeaways: Mandibular advancement appliances are not a universal solution. While effective for some patients, they often fail to address the underlying causes of airway collapse. Craniofacial sleep medicine focuses on airway etiology, not just symptom control, by identifying why the mandible, tongue, and airway behave as they do during sleep. The cranial base plays a foundational role in facial growth, jaw position, and airway size, directly influencing sleep apnea risk. A retruded mandible is frequently due to developmental and epigenetic factors, rather than being an isolated mandibular issue. Sleep apnea has multiple endotypes—including craniofacial, neurologic, metabolic, and myopathic—requiring individualized treatment planning. Bruxism is not a reliable airway-opening mechanism and may be a primitive physiological response to hypoxia rather than a protective behavior. Tooth wear can be an early indicator of sleep-disordered breathing, and should prompt clinicians to screen beyond restorative concerns. Upper Airway Resistance Syndrome (UARS) can occur even when the apnea-hypopnea index (AHI) is low, particularly in non-obese patients with fatigue, pain, and poor sleep quality. Palatal expansion should be understood as a 3D craniofacial intervention, aimed at improving nasal airflow and airway function—not merely widening the dental arch. Effective care depends on an integrated, multidisciplinary approach, involving dentists, orthodontists, sleep physicians, ENTs, and myofunctional therapists. Youtube Highlights: 00:00 Teaser 01:01 Introduction 02:56 Pearl: Debunking Myths About Sleep Apnea 04:27 Interview with Professor Dave Singh: Journey and Insights 13:23 Craniofacial Development 18:53 Epigenetics and Orthodontic Controversies 25:52 Diagnosis and Treatment of Sleep Apnea 32:49 Understanding Upper Airway Resistance Syndrome 34:17 Midroll 37:38 Understanding Upper Airway Resistance Syndrome 39:45 Diagnosing Sleep Disorders and Treatment Modalities 43:58 Exploring Bruxism and Its Hypotheses 45:19 CPAP and Alternative Treatments for Sleep Apnea 48:12 Managing Upper Airway Resistance Syndrome 55:11 Integrative Approach to Sleep Disorder Management 57:17 Diagnostic Protocols and Imaging Techniques 01:02:25 The Importance of Proper Device Fit and Function 01:07:16 Upcoming Events and Further Learning Opportunities 01:09:56 Outro ✨ Don't Miss Out: Practical, anatomy-based approaches to sleep and airway management for dentists and specialists

Can adults really expand their maxilla? Is treating sleep apnea with a CPAP or mandibular advancement device only MASKING the problem? How does craniofacial anatomy influence airway health, and what should dentists look for? Dr. Dave Singh joins us to dive into CranioFacial Sleep Medicine. He breaks down how structural issues—like a narrow maxilla, high-arched palate, or limited tongue space—can be root causes of sleep-disordered breathing, rather than just treating symptoms.  The episode also touches on controversies in orthodontics and presents evidence supporting interventions once thought impossible in adults. https://youtu.be/WUyeOjKquJU Watch PDP253 on Youtube Protrusive Dental Pearl: Obstructive Sleep Apnea is NOT just a “fat old man disease.” If you're not screening every patient for sleep and airway issues, you're missing a huge piece of their overall health. Snoring, bruxism, and craniofacial anatomy are all connected, and understanding these links can transform the way you approach patient care. Key Takeaways: Mandibular advancement appliances are not a universal solution. While effective for some patients, they often fail to address the underlying causes of airway collapse. Craniofacial sleep medicine focuses on airway etiology, not just symptom control, by identifying why the mandible, tongue, and airway behave as they do during sleep. The cranial base plays a foundational role in facial growth, jaw position, and airway size, directly influencing sleep apnea risk. A retruded mandible is frequently due to developmental and epigenetic factors, rather than being an isolated mandibular issue. Sleep apnea has multiple endotypes—including craniofacial, neurologic, metabolic, and myopathic—requiring individualized treatment planning. Bruxism is not a reliable airway-opening mechanism and may be a primitive physiological response to hypoxia rather than a protective behavior. Tooth wear can be an early indicator of sleep-disordered breathing, and should prompt clinicians to screen beyond restorative concerns. Upper Airway Resistance Syndrome (UARS) can occur even when the apnea-hypopnea index (AHI) is low, particularly in non-obese patients with fatigue, pain, and poor sleep quality. Palatal expansion should be understood as a 3D craniofacial intervention, aimed at improving nasal airflow and airway function—not merely widening the dental arch. Effective care depends on an integrated, multidisciplinary approach, involving dentists, orthodontists, sleep physicians, ENTs, and myofunctional therapists. Youtube Highlights: 00:00 Teaser 01:01 Introduction 02:56 Pearl: Debunking Myths About Sleep Apnea 04:27 Interview with Professor Dave Singh: Journey and Insights 13:23 Craniofacial Development 18:53 Epigenetics and Orthodontic Controversies 25:52 Diagnosis and Treatment of Sleep Apnea 32:49 Understanding Upper Airway Resistance Syndrome 34:17 Midroll 37:38 Understanding Upper Airway Resistance Syndrome 39:45 Diagnosing Sleep Disorders and Treatment Modalities 43:58 Exploring Bruxism and Its Hypotheses 45:19 CPAP and Alternative Treatments for Sleep Apnea 48:12 Managing Upper Airway Resistance Syndrome 55:11 Integrative Approach to Sleep Disorder Management 57:17 Diagnostic Protocols and Imaging Techniques 01:02:25 The Importance of Proper Device Fit and Function 01:07:16 Upcoming Events and Further Learning Opportunities 01:09:56 Outro ✨ Don't Miss Out: Practical, anatomy-based approaches to sleep and airway management for dentists and specialists

Emma is joined by Professor Vik Veer, a leading ENT surgeon based in the UK, who serves as Head of Sleep Surgery at the Royal National Ear, Nose, and Throat Hospital in central London. He also practices at Queen's Hospital, Romford. Vik has a popular YouTube channel where he discusses sleep apnea/apnoea along with other ENT topics.In this episode:* Prof. Veer discusses how he began his YouTube channel during the pandemic.* When people with sleep apnea should see an ear, nose, and throat surgeon.* The drug-induced sleep endoscopy (DISE) procedure and why Vik finds it so helpful to find exactly how and why a patient's airway is collapsing or becoming blocked.* The challenge of finding a skilled ENT who specializes in sleep surgery.* Hypoglossal nerve stimulator implants and the differences between Inspire and Genio implant options. The new, smaller hypoglossal nerve stimulator implants being developed by Restera.* Vik discusses why he wanted to invent his new "Side Sleeping Pro" pillow - for people with positional obstructive sleep apnea.* The importance of working as part of a multi-disciplinary team with a range of specialists to work out the best treatment option/s for specific patients with obstructive sleep apnea.* The apnea-hypopnea index (AHI) and issues arising from putting too much emphasis on using one number to assess the severity of OSA.* Moving away from a one-size-fits-all treatment option and towards choosing the right treatment or combination of treatments for each individual patient.Connect with Vik Veer:https://www.consultant-surgeon.co.uk/Free Sleep Questionnaires⁠https://form.jotform.com/vikveer/sleep-questionnaires⁠Newsletter⁠https://cheerful-knitter-8774.kit.com/35648c37b6⁠Tonsillectomy book⁠https://cheerful-knitter-8774.kit.com/f629b09fa4⁠YouTube⁠https://www.youtube.com/c/VikVeerENTSurgeon⁠Side Sleeping Pro⁠https://www.iwantgreatsleep.com/⁠>>Download Project Sleep's PDF toolkit on Sleep Apnea Treatment Options: https://project-sleep.com/sleep-apnea-treatment-options/Join Project Sleep's Sleep Apnea Squad by signing up for e-updates here: https://project-sleep.com/sleep-apnea-squad/>>Connect with Emma:⁠⁠⁠Instagram⁠https://www.instagram.com/sleepapneastories⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Email Emma at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠sleepapneastories@gmail.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.sleepapneastories.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Disclaimer: This podcast episode includes people with sleep apnea discussing their experiences with medical procedures and devices.  This is for information purposes only and you should consult with your medical professionals before starting or stopping any medication or treatment.

What if the tumor you're treating is already yesterday's news? In this riveting episode of Metabolic Matters, Dr. Nasha Winters sits down with Dr. John A. Catanzaro, NMD, PhD—Co-Founder and CEO of Neo7Bioscience and one of the leading innovators in personalized peptide therapeutics and molecular surveillance. With over 25 years at the intersection of clinical medicine, molecular biology, and translational research, Dr. Catanzaro specializes in understanding the real-time biology driving cancer, autoimmunity, chronic inflammation, degenerative disease, and mRNA-related injuries. His proprietary PBIMA® and REViSS® platforms analyze genomics, transcriptomics, proteomics, and AHI-driven analytics to design patient-specific peptide sequences tailored to each individual's molecular signature.Connect with Dr. John: WebsiteDr. John's XNeoScience XFacebookSubstack Dr. John LinkedInNeoScience LinkedInNeoScience YoutubeAbout Your HostI'm Dr. Nasha Winters, a global healthcare authority, best-selling author, and educator in the emerging field of integrative oncology and terrain-based cancer care. I host Metabolic Matters to explore the intersections between metabolism, medicine, and meaning.Subscribe, Share & ReviewIf you loved this conversation, please subscribe, rate, and share with a friend or clinician who needs to hear it.Support & Resources:Support Patient Grants: www.mtih.orgBook: The Metabolic Approach to CancerEducation Programs: www.metabolicregen.comSupplements: mitovida.comFollow on SocialsDr. Nasha on InstagramMetabolic Matters InstagramFacebookLinkedInTikTokYouTube Hosted on Acast. See acast.com/privacy for more information.

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Dave Singh, a sleep dentist with expertise spanning decades in dental sleep medicine, a PhD in craniofacial cleft palate development, and a third PhD in orthodontics. As founder of REMA Sleep based in North Carolina, Dr. Singh introduces the concept of craniofacial sleep medicine—an etiology-based approach to treating obstructive sleep apnea guided by anthropomorphic features rather than solely AHI severity metrics. Craniofacial sleep medicine represents a paradigm shift from license-based treatment allocation to collaborative, anatomy-driven care where dentists, surgeons, and sleep physicians work together to determine the most appropriate interventions based on individual structural characteristics. Dr. Singh explains why understanding craniofacial structures is crucial for personalizing OSA treatment, including why Asian populations show high OSA prevalence despite lower obesity rates. The conversation provides a comprehensive crash course in assessing craniofacial anatomy: What is retrognathia and what causes it? How can clinicians alter jaw position by adjusting cranial base morphology? Dr. Singh explains the classification system for dental occlusion (Class I, II, and III bites), midface assessment techniques, and the palate evaluation method Dr. Guilleminault taught fellows. He discusses critical anatomical considerations including tongue positioning at rest and during sleep, lateral pharyngeal wall collapse, and cervical vertebrae influence on airway patency. The episode explores both preventive approaches in children and interventions for adults, addressing whether craniofacial modifications require surgery or can be achieved through other means. Dr. Singh discusses palatal expansion, tongue traction techniques, and the physiological components that remain addressable even after skeletal maturity. He also explains age-related changes including loss of muscle tone, bone volume reduction, and maxillary drift that progressively narrow the airway. Intriguing topics include the mechanisms behind why didgeridoo playing and conch shell blowing improve sleep apnea, the role of oromyofunctional therapy as a viable treatment option, evolutionary changes in human dentition that impact airway anatomy, and even the dental stem cell implications for regenerative approaches. Dr. Singh also clarifies surprising facts, such as why mouthguards in contact sports serve purposes beyond tooth protection. Whether you're seeking to understand anatomical contributors to OSA beyond obesity, interested in multidisciplinary treatment approaches, or curious about how craniofacial structure influences treatment selection, this episode provides essential insights into personalized, anatomy-based sleep apnea management. Join us for this fascinating exploration of how form determines function in the upper airway and how understanding craniofacial anatomy can revolutionize OSA treatment strategies. 

There's excitement among Kiwi food experts and hospo giants about what the Michelin Guide's arrival could do for tourism. Tourism New Zealand is investing $6.3 million to bring the guide to New Zealand, and it's estimated 36,000 more international visitors could be drawn in as a result. Executive chef at Ahi and New Zealand Food Story host Ben Bayly says this move will give the nation's food sector more credibility. "Let's face it, gastronomic tourism right now is huge, people are travelling all over the world to eat food - that is their main driver for coming to countries now." LISTEN ABOVESee omnystudio.com/listener for privacy information.

In this special episode of Talking Sleep, host Dr. Seema Khosla offers an exclusive preview of the upcoming SleepMedicine Disruptors course, taking place November 14-15 in Austin, Texas. She speaks with Steve Van Hout, executive director of the AASM, and Dr. David White, professor of medicine part time at Harvard Medical School, about the groundbreaking innovations reshaping sleep medicine. Steve Van Hout explains what makes the Disruptors conference unique compared to other AASM meetings like Trends and the annual SLEEP conference. Designed to bring together clinicians, researchers, technology innovators,and venture capitalists, Disruptors aims to foster cross-industry collaboration and encourage investment in sleep medicine innovations. The conference features innovation award presentations similar to Shark Tank pitches with the audience voting on their favorites, keynote speakers, and discussions about emerging technologies that promise to transform how we diagnose and treat sleep disorders. Dr. White provides an in-depth preview of his presentation on pharmacotherapy for obstructive sleep apnea, sharing exciting developments in multiple drug candidates. He discusses Apnimed's AD-109, a combination of atomoxetine and R-oxybutynin, which has completed two phase three studies showing approximately 50% reduction in AHI across six-month and one-year trials involving over 650 patients each. With FDA submission planned for early 2026, this medication could reach the market by late 2026. The conversation explores other promising agents including Incannex's combination of dronabinol and acetazolamide, carbonic anhydrase inhibitors like sulthiame (recently licensed by Apnimed), and innovative potassium channelantagonists that could be delivered via nasal spray for localized upper airway effects with minimal systemic absorption. Dr. White discusses the potential for poly therapy approaches, combining medications with devices like mandibular advancement devices or positional therapy, drawing parallels to how hypertension and diabetes are managed with multiple treatments. The episode tackles important questions about the future of sleep medicine: Will pharmacotherapy replace PAP therapy, or will hybrid approaches become standard? What AHI reduction is clinically meaningful for cardiovascularprotection and symptom improvement? How will pricing and insurance coverage affect accessibility? They emphasize that while these medications may not replace CPAP entirely, they offer promising options for patients who struggle with existing therapies. Whether you're a sleep medicine practitioner interested in emerging treatments, an entrepreneur exploring innovation opportunities, or simply curious about the future of sleep disorder management, this episode provides essential insights into the rapidly evolving landscape of sleep medicine. Join us for this forward-looking conversation about innovation, investment, and the technologies poised to disrupt traditional sleep medicine practice.

Part 2 of 2. Anomalous Health Incidents. AHI's. That is what the intelligence community refers to it as, but you likely know it as “The Havana Syndrome.” People reported feeling sick, dizzy, or even worse after experiencing a loud sonic-like wave in and around the U.S. Embassy in Cuba. The U.S. Intelligence Community says there is no evidence of any deliberate actions by a foreign actor. Is there more to the story?

Anomalous Health Incidents. AHI's. That is what the intelligence community refers to it as, but you likely know it as “The Havana Syndrome.” People reported feeling sick, dizzy, or even worse after experiencing a loud sonic-like wave in and around the U.S. Embassy in Cuba. The U.S. Intelligence Community says there is no evidence of any deliberate actions by a foreign actor. Is there more to the story?

When Ahi moved into a grand, century-old mansion in the Twin Cities, he expected peace, not a paranormal encounter. Staying rent-free in his aunt's historic home—complete with stained glass windows, ballroom, and hand-carved woodwork—seemed like a dream. But one foggy night on the fourth floor, Ahi woke to find a shadowy man in a top hat silently watching from the foot of his bed. Was it fear? Depression? Or the lingering spirit of the home's original owner? If you have a real ghost story or supernatural event to report, please write into our show or call 1-855-853-4802! If you like the show, please help keep us on the air and support the show by becoming a Premium Subscriber.  Subscribe here: http://www.ghostpodcast.com/?page_id=118 or at or at http://www.patreon.com/realghoststories Watch more at: http://www.realghoststoriesonline.com/ Follow Tony: Instagram: HTTP://www.instagram.com/tonybrueski TikToc: https://www.tiktok.com/@tonybrueski Facebook: https://www.facebook.com/tony.brueski 

You never know who you might meet at a Canadian gas station. Back in March, AHI sat down with Tom Power to tell us how a chance encounter at a truck stop in Thunder Bay inspired him to pursue music full-time. He also sets up a song off his new album, “The Light Behind the Sun.”

Story at-a-glance Sleep apnea, especially during rapid eye movement (REM) sleep, causes oxygen drops that damage small brain vessels and raise dementia risk, often before cognitive symptoms become noticeable New research links REM-specific oxygen loss to white matter lesions and entorhinal cortex thinning, two key markers of early neurodegeneration in aging and Alzheimer's disease Standard apnea scores like apnea-hypopnea index (AHI) often miss these deeper risks because they don't measure oxygen depth or track when during sleep the damage occurs Long-term studies confirm that even mild, untreated apnea accelerates brain aging and disproportionately increases dementia risk in women compared to men Treatments like breathing machines, oral devices, and lifestyle changes reduce apnea severity and help preserve brain health by ensuring proper oxygen delivery during sleep  

Jim talks with Anders Indset about his book The Singularity Paradox: Bridging the Gap Between Humanity and AI, co-authored with Florian Neutkart. They discuss the "final narcissistic injury of humankind," Freud's three historical narcissistic injuries, machine consciousness vs human consciousness, the "undead" state, human cognitive limitations, game theory dynamics & multipolar traps, Artificial Human Intelligence vs AGI/ASI approaches, consciousness preservation, chess AI & human cognition, coevolutionary dynamics between AHI & AGI/ASI, "playing to win" vs "playing to become," organizational design for anticipatory leadership, trust & friction as progress drivers, the three pillars of forging & investment & efficiency, reactive vs reflective societies, technical hygiene, "zombie apocalypse" scenarios, the role of agency, questions of identity & authenticity in an AI world, and much more. Episode Transcript Wild Knowledge: Outthink the Revolution, by Anders Indset The Quantum Economy: Saving the Mensch with Humanistic Capitalism, by Anders Indset The Viking Code: The Art and Science of Norwegian Success, by Anders Indset Ex Machina: The God Experiment, by Anders Indset and Florian Neukart The Singularity Paradox: Bridging the Gap Between Humanity and AI, by Anders Indset and Florian Neukart Against Empathy: The Case for Rational Compassion, by Paul Bloom The Beginning of Infinity, by David Deutsch Anders Indset is a business philosopher and author of four Spiegel bestsellers, with works translated into over ten languages. He has been recognized by Thinkers50 as one of the most influential thinkers in technology, economy, and leadership. In addition to writing books including The Quantum Economy, Ex Machina, and his newest title, The Singularity Paradox, the Norwegian-born polymath is also Chairman of the Njordis Group, a driving force behind initiatives like the Quantum Economy, and a deep-tech investor. He is a sought-after speaker at conferences such as the World Economic Forum, the Global HR Summit, and the Mobile World Congress.

Chef, TV presenter and proud champion of Kiwi kai, Ben Bayly is back on our screens tonight with the fourth season of A New Zealand Food Story. The series has taken him all around the motu on a mission to answer the question "what is New Zealand food?".