Podcasts about Obstructive sleep apnea

Q-Bank: https://www.patreon.com/highyieldfamilymedicineIntro (0:35),Normal Sleep (1:38),Chronic Insomnia (2:48),Medications for Insomnia (4:44),Circadian Rhythm Disorders (6:21),Restless Legs Syndrome (7:58),Obstructive Sleep Apnea (9:40),Central Sleep Apnea (11:43),Sleepwalking (12:27),Sleep Terrors (13:05),Nightmares (13:58),REM Sleep Behavior Disorder (14:53),Sleep Paralysis (16:08),Narcolepsy (16:55),Practice Questions (18:34)

Snoring may be a nuisance, but for some people it can be a sign of obstructive sleep apnea, a common condition that disrupts breathing during sleep and can have serious health consequences if left untreated.In this episode of Health Matters, host Courtney Allison speaks with Dr. Ana Krieger, director of the Center for Sleep Medicine at NewYork-Presbyterian and Weill Cornell Medicine, about what causes snoring, how sleep apnea develops, and why so many people unknowingly live with the condition.Dr. Krieger explains how sleep affects virtually every system in the body, from the brain and cardiovascular system to memory and cognitive function. She discusses common symptoms of sleep apnea, risk factors such as age, weight changes, alcohol use, and menopause, and the importance of testing when symptoms arise.The conversation also explores treatment options ranging from CPAP therapy and dental devices to newer treatment approaches, while offering practical advice for improving sleep hygiene and building habits that support better sleep and long-term health.Chapters00:00 – Snoring, Sleep Apnea, and What Causes ThemWhat happens in the airway during sleep, why people snore, and how sleep apnea develops04:00 – Symptoms and Warning Signs of Sleep ApneaCommon symptoms, hidden signs, risk factors, and why many people don't realize they have sleep apnea06:30 – How Sleep Affects the Brain and BodyThe role of sleep in memory, cognitive function, cardiovascular health, and overall well-being10:45 – Sleep Apnea Treatments and Better Sleep HabitsCPAP therapy, dental devices, newer treatment options, and practical tips for improving sleep hygieneKey Topics CoveredSnoringSleep apneaObstructive sleep apneaSleep disordersSleep studiesSleep testingSleep healthCognitive healthMemory and sleepBrain healthCardiovascular healthAtrial fibrillationSleep deprivationSleep qualityCPAP therapyMandibular advancement devicesSleep apnea treatmentsSleep hygieneInsomnia and stressMenopause and sleep apneaAlcohol and sleepHealthy sleep habitsBreathing during sleepSleep medicineKey TakeawaySnoring is often harmless, but it can also be a sign of sleep apnea, a common condition that affects breathing, sleep quality, and overall health. Recognizing symptoms early, seeking evaluation when needed, and prioritizing healthy sleep habits can help improve sleep, protect brain and heart health, and enhance quality of life.Doctor BioDr. Ana Krieger is director of the Center for Sleep Medicine at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. She is a professor of clinical medicine in the Departments of Medicine, Neurology and Genetic Medicine and chief of the Sleep Neurology Division in the Department of Neurology at Weill Cornell Medicine. She is a board certified specialist in Sleep Medicine by the American Academy of Sleep Medicine.Dr. Krieger also holds board certifications in internal medicine and pulmonary medicine and has a master's degree in global public health with emphasis in healthcare policy and management. Over the past 25 years, Dr. Krieger has been actively involved in providing comprehensive patient care in sleep medicine, overseeing the Center for Sleep Medicine, a group practice that evaluates over 1,000 patients each month in New York City.She is also actively involved in medical and subspecialty education and research. As a clinician scientist, Dr. Krieger is the principal investigator in collaborative multidisciplinary research projects in sleep medicine and has published extensively in the field.Her current research is sponsored by the National Institutes of Health (NIH) and the National Science Foundation. She serves as Chair of the Mentored to Independence (MTI) K99/R00 grant review committee at the National Heart Lung and Blood Institute (NHLBI) at the NIH. Dr. Krieger is an active lecturer, regularly contributing to media efforts aiming at improving sleep health in the population. She is a Robert Wood Johnson Scholar, and Fellow of the New York Academy of Medicine, American College of Chest Physicians and American Academy of Sleep Medicine.

This episode explores the critical role general dentists can play in identifying and managing obstructive sleep apnea. We discuss screening tools, signs to watch for, and how dental practices can contribute to overall health and wellness.Keywords:sleep apnea, dentistry, screening tools, oral health, sleep disorder, OSA, patient care, dental exam, sleep health, health screeningKey Topics:The importance of sleep apnea awareness among dentistsScreening tools like the Epworth Sleepiness Scale and the STOP-Bang questionnaireSigns of sleep apnea visible during dental examsThe significance of airway-related findings in oral health assessmentsReferral process to sleep specialists and diagnostic proceduresImpact of untreated sleep apnea on overall healthThe role of oral appliances in sleep apnea managementConnecting sleep quality with pain management in dentistry

Advances in sleep technology are transforming how neurologists identify and manage obstructive sleep apnea, a condition that affects up to 70% of patients with certain neurologic disorders and can negatively impact cognitive and neurologic outcomes if left untreated. In this episode, Dr. Joyce Lee-Iannotti discusses the growing role of wearable and nearable sleep-monitoring devices, when home sleep studies are appropriate, and how emerging technologies are expanding access to diagnosis and treatment. Learn practical strategies for screening patients, interpreting sleep data, and partnering with sleep specialists to improve long-term neurologic health through better sleep. In this episode, Casey S. Albin, MD, FAAN, speaks with Joyce K. Lee-Iannotti, MD, FAAN, FAASM, author of the article "Sleep Diagnostics and Monitoring Technology in Obstructive Sleep Apnea" in the Continuum® August 2026 Sleep Neurology issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Lee-Iannotti is a Professor of Neurology at the Barrow Neurological Institute, University of Arizona College of Medicine, and Creighton School of Medicine in Phoenix, Arizona. Additional Resources Read the article: Sleep Diagnostics and Monitoring Technology in 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: @caseyalbin Guest: @jleeiannotti Full episode transcript available here Dr Albin: Through the neurology of sleep issue, I think we have all been convinced that we all need better sleep, both for ourselves and for our patients. And fortunately, there is an abundance of new technology that can enable us to diagnose sleep problems, and then also make sure that our patients are getting the rest that's going to give them the best chance at a good cognitive recovery, and improve their cognitive function even if they are not currently suffering from a neurologic condition. Today, I am so excited to dive deeper into this topic.  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 Albin: Hello, this is Dr. Casey Albin. Today I'm interviewing Dr. Joyce Lee-Iannotti about her article on sleep diagnostics and monitoring technology in obstructive sleep apnea. This article appears in the August 2026 Continuum issue on neurology of sleep. Welcome to the podcast, I'd love to just start by having you introduce yourself to our audience.  Dr Lee-Iannotti: Sure. Thank you so much for having me, Dr. Albin. I'm Joyce Lee-Iannotti. I'm a professor of neurology at Barrow Neurological Institute. I am boarded in general neurology, stroke, and sleep, but I spend most of my time in the sleep world, so I jokingly say that I get more sleep doing sleep than I certainly did in stroke.  Dr Albin: Absolutely. I mean, wow, what a fascinating career, and I suspect that we're actually gonna get to some of how all of those pathophysiologies might overlap in the world of sleep. But you had the really exciting task of trying to distill this exciting, rapidly evolving field of sleep diagnostics, and I suspect it's relevant to many of the patients who end up in the neurology clinic, and I suspect that it's actually pretty relevant to many of our listeners who themselves might actually be wearing sleep tracking devices. And all of us probably wonder, well, how can we use that data to improve our own cognitive function and certainly make our patient's life even better? Before we even get into some of the meat and potatoes of this, I thought it would be really helpful for us to define some terms that come up in your article, one of which is wearables. We might figure that out, but the other is nearable. Walk us through what's a wearable, what's a nearable, how are they different?  Dr Lee-Iannotti: I'm happy to do that. First of all, the article is entitled Sleep Diagnostics and Monitoring Technology, and this was a super fun article for me to write because it's very practical, and it's generalizable to everybody. So, I'm going to start with a wearable, and a wearable is really a device that is simply worn on the body. And we're all familiar with wearables like smart watches, they're rings, they're patches, they're headbands, and the most validated form of a wearable that you've probably heard about is actigraphy, which we use in the sleep clinic.  Dr Albin: Tell us a little bit more. So, what is actigraphy? I've heard the word before, but don't actually know what it means.  Dr Lee-Iannotti: Actigraphy has been a tool that we've used in the sleep clinic for a really long time. Traditionally, we used it to monitor circadian rhythm patterns in people who are night owls or morning larks. And then more currently, we actually use it to track sleep patterns in people with suspected narcolepsy. So, before they come in for a sleep study, we actually have them wear an actigraphy for about a week just to get a sense of their sleep duration and their circadian pattern.  Dr Albin: Got it. And what is it monitoring? Our movement or the patterns that we may or may not make?  Dr Lee-Iannotti: It's really based on movement. You're exactly right.  Dr Albin: Cool. Okay, so most of this is based on gold standard monitoring with actigraphy. What other things can be incorporated into these wearable devices?  Dr Lee-Iannotti: Yeah, the technology is really advanced, and every day it changes, which is super exciting. So, on top of movement, these wearables can look at temperature. They can look at even EEG, like limited EEG, heart rate variability, and a really big word that we like to use in sleep technology, which is PPG, or photoplethysmography data, and that's really looking at heart rate variability and oxygenation, saturations, and following those levels as well.  Dr Albin: Wow, so you basically can get most of the data that you might have historically needed to go to a sleep lab to get.  Dr Lee-Iannotti: Most of them. They're still a surrogate. You'll hear me emphasize in the article as well that the gold standard remains the in-lab polysomnogram, but these are good surrogate markers that patients can wear long term to look at trends and patterns.  Dr Albin: Absolutely. And we're gonna unpack a little bit about who specifically those are best for and, really what it gives you in the clinic. But before we jump into that, what's a nearable, and how is that different?  Dr Lee-Iannotti: Yeah. Nearables are really exciting too. So, these are devices that monitor sleep but don't require direct contact on the body. So, these are devices that our patients will use, but it'll be at the bedside table. They're devices that actually go underneath the mattress, or they can be in, like, the ambient environment to detect sleep patterns.  Dr Albin: Oh my gosh. How is it doing that if it's not actually something you're wearing? Dr Lee-Iannotti: I know. It seems a little Big Brother-ish, doesn't it?  Dr Albin: Yes.  Dr Lee-Iannotti: So, they use a technology called radio frequency signals, sometimes radar, sometimes sonar, pressure sensors, even microphones, and they're picking up things like respiration, movement, snoring, and that's how they can decipher sleep patterns.  Dr Albin: Crazy. I mean, I guess the benefit of that is that it's less disruptive to the user 'cause it's not actually on them and having contact with them, and I suspect there's probably some downsides in terms of just it's a more limited data set you're getting.  Dr Lee-Iannotti: Absolutely. Yeah, you're exactly right. It's more convenient because it's not touching them, so, in theory, they're gonna sleep more comfortably. But I would like to think that the most validated forms of devices that we use to track sleep have to have some form of contact with the body, and this technology is new and probably needs a few layers of more sophistication to be as accurate as the wearables.  Dr Albin: Absolutely. I feel like we're going to have this conversation in five, maybe even less than that, years, and this data will have become like, oh, we all have something in our room that's monitoring everything. The world is crazy. All right. One of the places where your article really stood out to me is that sleep diagnostics have really taken off, particularly when we're thinking about obstructive sleep apnea. And I think we all might sort of scratch our heads and be like, "This is a neurology podcast. Why should I, as a neurologist, care about obstructive sleep apnea?" But I think you laid out a very convincing argument in the article. Walk us through why we should care about this.  Dr Lee-Iannotti: Absolutely. So, for neurologists, sleep matters, and I hope that my article translates that. Obstructive sleep apnea, which I'm gonna call OSA, is incredibly common in all of our neurologic patients, whether you see epilepsy, Parkinson's, stroke, Alzheimer's, neuromuscular, or even chronic headache patients. The prevalence of sleep apnea is as high as 70% in these patients.  Dr Albin: Wow. That's incredible. That is an incredibly high number.  Dr Lee-Iannotti: And if I can add, Dr. Albin, there's growing literature in multiple studies across the literature that show that untreated sleep apnea negatively impacts neurologic outcomes in our patients. So, it is really important to ask the question about sleep, and if the red flags pop up, to then screen for sleep apnea in particular.  Dr Albin: I think that that's a great point for us to drill down on, and obviously you're a sleep neurologist. You're very used to screening people in the clinic. But say someone comes in, and I'm gonna have you put your former stroke hat on, and say someone comes into the stroke clinic, and you're just making sure that they're optimized on their aspirin or dual antiplatelet therapy, and you're doing secondary risk modification. How would screening for OSA fit into that?  Dr Lee-Iannotti: It would be a part of that screening process to look at preventative ways to prevent strokes, whether it be primary or secondary prevention. So, we did a survey a while back, and it actually showed that 17% of stroke neurologists are screening for sleep apnea. It has quadrupled, fortunately, in the last few years due to public awareness and a lot of education that the AAN has done, in fact. So, at this point, I would say not asking about sleep apnea to a stroke patient is similar to not asking about diabetes.  Dr Albin: So, we really have to be cognizant and conscious about saying, you know, "Do you snore at night? Do you have episodes of apnea, or does someone witness you stop?" Are there things that you ask that maybe I wouldn't be aware and thinking of?  Dr Lee-Iannotti: Those are the right questions, and then very practically, very easy questionnaires to implement that literally take a minute that your nurses or medical assistants can administer to the patient, and the most commonly one that is used in stroke patients is called the STOP BANG, S-T-O-P B-A-N-G, which is a validated questionnaire to screen for symptoms.  Dr Albin: Absolutely. So okay, so this is easy to do. We should all be doing this. If you're not, now's the time. And I suspect if they screen positive, next steps, it can be hard to get into a sleep lab, and we're gonna talk about some workarounds, but I think some of our listeners may never have spent time in the actual sleep lab. So, let's say you refer a patient and you actually can get them in for a gold standard in-lab sleep study. What's gonna happen in that sleep study?  Dr Lee-Iannotti: Yeah. And I just want to preface this by saying that my article hopefully highlights that we've come a long way where we understand that there are many neurologic populations then that can undergo home ambulatory sleep studies with just as much accuracy as an in-lab polysomnogram. But with that, I wanna say an in-lab polysomnogram is actually a highly sophisticated physiologic recording overnight, typically, unless somebody is a day sleeper. So, if I could take a minute to kinda describe the data that we're monitoring throughout the night. There is a limited EEG. We concentrate on frontal, central, occipital leads to look at sleep staging. We have eye leads. We have EMG leads on the chin and the leg. We look at EKG, flow monitors, belt, and then we also do pulse oximetry, snoring mics, and even body position sensors. So, a lot is going on.  Dr Albin: This is incredible. Yeah, it truly is. I mean, this is like... I'm a neurointensivist, and so I think that you have just really outdone what I consider multimodal monitoring in your sleep study patients. I'm not even sure our neuro ICU patients accumulate that much data. All right, so tell me, they go through, and they can get this. But like you said, there's actually a lot of data that you've presented that, you know, not everyone needs to go to the in-lab sleep study. So how do you decide who actually needs to be in a sleep lab versus who can do this at home? And then how do you set them up with getting this done at home?  Dr Lee-Iannotti: Yeah. The home sleep studies are really more accessible ways for us to assess for sleep apnea in our neurologic patients, especially patients who live in very rural areas and don't have access or have very long wait times for an in-lab polysomnogram. With that being said, though, Dr. Albin, I will say that there are a subset of patients who have to go into the lab, and those are patients where you suspect a sleep disorder other than obstructive sleep apnea, so like parasomnias or central sleep apnea, patients with severe cognitive or physical debilitation, like our stroke patients who are hemiplegic and won't be able to apply the home sleep study. But for the most part, I do feel like a home sleep study is a good beginner study to screen the patient. And if there are red flags, then you can always get the in-lab afterwards.  Dr Albin: That's super helpful. And just from a pragmatic standpoint, will insurance cover the home sleep study?  Dr Lee-Iannotti: They will, yes, and it's all about documenting. So, if I could get really practical, for neurologists, it really just requires documenting snoring, for one, whether it's noted by the patient or by their bed partner, and then any form of hypersomnia, which is daytime sleepiness or even a sense of fatigue, having low energy or napping during the day.  Dr Albin: I suspect so many of our patients meet those criterias. That seems, like, wildly simple to do.  Dr Lee-Iannotti: Yes. And if you wanna be the favorite referral person to your sleep neurologist or your sleep specialist, then take another step and do that STOP-Bang. And if you record a score greater than three, that automatically gets them at least a home sleep study.  Dr Albin: It's amazing. And then when you get this data, again, this is really practical, pragmatic stuff, how do you get the report? Does it integrate in your electronic medical record? Does the patient bring it in? How do you get that data back?  Dr Lee-Iannotti: Yeah, so this is where technology is amazing, Dr. Albin. Now we have disposable devices. Sometimes they sync to the WatchPat, or the greater Wi-Fi. So we can get them all through password-protected internet forums that transmits the data, so sometimes the patients don't even have to come back to give us the data. And then we have different forms where we can actually relay the results as well, either through the electronic medical record or through systems themselves to relay those results directly to the patient.  Dr Albin: Yeah, and your article really laid out in beautiful tables, like, all the different devices that are available to patients, and it's honestly mind-blowing how many of these companies and devices exist. So, seems like the world is your oyster in terms of picking from them.  Dr Lee-Iannotti: Absolutely. I think there's... The last time I counted, there was over 20 different home sleep study devices for obstructive sleep apnea. And it's a great thing to have, but sometimes too many choices can be a little bit confusing. So that's where I do say partner with your sleep specialist close by, and they will find the right type of home sleep study device for your particular patient.  Dr Albin: Drilling down a little further, let's say your patient does get diagnosed with OSA. One of the things that really stuck out to me is that there's a whole range of now devices that are new that make this treatment easy so that we can actually prevent and treat neurological conditions by just improving patient sleep. So, walk us through a little bit about how that landscape has changed.  Dr Lee-Iannotti: Sure. And I'll start with the gold standard of treatment, which is still CPAP, which is continuous positive airway pressure. Not only can we monitor the pressure, look at adherence, change the humidification for the patient all remotely through, again, password-protected internet forums, but we can even change the pressure with patients 300-plus miles away.  Dr Albin: Wow.  Dr Lee-Iannotti: It's really cool, right? It prevents patients, especially with significant neurologic debilitation, from having to come into the office for adjustments. The other thing I wanted to mention, Dr. Albin, is for patients, a lot of patients like positive feedback on a daily basis. And a lot of these companies, if you are on CPAP, have come up with a smartphone app that you can look at how many hours you used your CPAP device. They give you a score, and they even tell you how many times you had stoppage of breathing that night.  Dr Albin: I think that this is what's really exciting about where we are in neurology and, like, neurologic care, is we have gotten so much better at getting patients their own data and allowing people to really see that data, integrate lifestyle changes, and see how it impacts them. And that positive feedback loop, I think, is a really powerful tool for our patients to say, "Look, this makes me better," or, "Oh, this makes me worse." I'm just really excited by how much data we can give directly to our patients.  Dr Lee-Iannotti: I agree. It's so empowering. You know, as a CPAP user myself, you want that positive affirmation that all of your efforts at night and cleaning your mask and your machine paid off, and everybody likes to see an A+ on their report card.  Dr Albin: I love that. Now I'm going to ask you on the flip side, I imagine, and I myself am a sleep tracker, like I have my little device and I look at, you know, the score in the morning and I kind of perseverate on like what makes it better, what makes it worse, and I can imagine that sometimes in sleep clinic, people are coming in to you and they have just pages and pages and, you know, they're flipping through all their data from the last year. And I imagine that's pretty overwhelming when you have just the insane amount of data that these devices can generate. So, from another pragmatic, practical standpoint, how are you integrating all that data when someone comes in for a sleep visit?  Dr Lee-Iannotti: I love that question. So first of all, I will say myself, and I think a lot of my sleep colleagues, we love objective data, right? Because it's something that we can see. We can see whether it matches their subject's symptoms. Sometimes it can be a lot of reassurance that, "Look, you actually got more sleep than you thought you did." But sometimes patients will bring in like a month's worth, and that's really hard to analyze, you know, in a 30 or 60-minute visit. So oftentimes what I do is I look at like the last week or last two weeks, and I look at trends. And I think a lot of the apps for whatever device you decide to use have done a really good job in terms of visual graphics to show how much sleep on average you're getting, how much deep sleep or REM sleep or wake-up times that you have. So, I, again, I feel like the technology has really helped us consolidate a lot of data, but also be efficient with the messaging that we relay to our patients.  Dr Albin: Absolutely. And I know personally, at least for the sleep tracker I wear, it also allows you to diary. So, you can say like, "Oh, last night I had a glass of wine," or, "Yesterday I had a really hard workout," or, "I stayed out late with friends," or, "I was on call." Turns out call is really, really bad for my sleep. But it does allow you to sort of track what behaviors, and I wonder how much of that informs what you're counseling patients to do in terms of trying to notice the things that either improve their sleep performance or their subjective feeling of restlessness or restfulness, and how all of that plays into what you're doing in the clinic.  Dr Lee-Iannotti: I love all of those comments. It is validation for the patient. Again, it's empowering for them to look at, what did I do last night to get more REM sleep than the night prior? I want to mention that the best people who do this so well are professional athletes, and they look at, how am I going to cater my day to make sure that I'm sleeping well, that I reduce my risk of injury and concussion and increase my reaction time? And I feel like all of us should do that. That's such a great philosophy, to analyze how we can do things better.  Dr Albin: I love that. This whole issue, but this article in particular, really emphasized to me that sleep, again, it's not a passive time that we're taking a nap. It's a really active form of sort of neurologic healing. There's important removal of toxins through the lymphatics. And like there's a lot happening in sleep, and there are so many more tools that allow us to unpack that sort of peak performance of sleep, which again, sort of is that athletic mentality of like, how can I make this better? Not just to treat a neurologic condition, but also really importantly, to prevent one.  Dr Lee-Iannotti: I often refer to sleep as icing on the cake. With our patients, when you're doing everything right, for example, a multiple sclerosis patient, they're on the right medications, they are exercising, they're participating in rehab, their mood is good, but they're just not getting to the quality-of-life metric that they want to be, it usually is sleep. And if you can add that as a neurologist to your piece of the algorithm to help your patient, it really does improve their quality of life and ultimately their neurologic outcome. I'm a true believer of that.  Dr Albin: I was a true believer. I've been made even more of a true believer through your article and getting to talk to you. I always like to close by asking the person I'm interviewing, what's one really exciting thing in this field? What are you kind of most looking forward to as you think about sleep medicine and its impact in neurology in the next five or 10 years?  Dr Lee-Iannotti: Oh, I love that question, too. So, the thing I'm most excited about in the field of sleep, and specifically sleep neurology, is the power of preventative care. When I did a lot of stroke, I would see young people, older people, healthy people, people with a lot of genetic risk factors come in, and one minute they were totally normal. The second minute, they're paralyzed and can't speak. And for a lot of these patients, I would ask, "Why am I seeing you now? Why couldn't I have seen you 10 years earlier, worked on risk factors, and prevented this outcome?" And I truly believe that is exactly where sleep lies. If you work on sleep, whether you're an adolescent, 20 year old, 30, et cetera, you are ultimately going to prevent horrible cardiovascular, cerebrovascular, neurologic diseases in the long run.  Dr Albin: So important. I really want to direct our listeners back to your article because all of the articles are really practical, but this one in particular looks at how do you do this? What are your options? How do you get this to patients? It really is sort of a step-by-step guidebook on like, A, why this is important, how you should screen, what you should do if someone screens positive for needing to have a sleep study.There's so much more technology that allows really anyone anywhere to have access to the testing that they need to get the right diagnosis, to improve their sleep, to improve their cognitive outcomes, to improve their neurologic health. It's pretty amazing.  Dr Lee-Iannotti: It is amazing. And in the article, I do allude to certain devices and then websites that are very helpful. If I can announce, Dr. Albin, I'm super excited about this. Through work with the American Academy of Sleep Medicine, endorsement with the AAN, we are coming out with a new clinical guideline specifically on home sleep study devices and looking at the validation studies. So, I think that's going to be very helpful. But I hope that everybody after listening to this picks up the phone, call your friendly sleep specialist, and align with them and partner with them. And this will ultimately help your patients, I guarantee it.  Dr Albin: Again, today I've been interviewing Dr. Joyce Lee-Iannotti about her article on sleep diagnostics and monitoring technology in 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 to our listeners, and thank you, Dr. Lee-Iannotti, for joining us today. Dr Lee-Iannotti: Thank you.  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. 

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.  

Sleep apnea can cause you to stop breathing repeatedly during the night — sometimes dozens or even hundreds of times — without you realizing it. And while loud snoring is a common warning sign, it is not the only one.In this episode of Baptist HealthTalk, host Dr. Anthony Gonzalez talks with sleep specialist Dr. Edward Mezerhane about how sleep apnea affects the body, the symptoms people often miss, and what can happen when the condition goes untreated.They also break down how sleep apnea is diagnosed, why weight and airway anatomy matter, what to do if CPAP is difficult to tolerate, and the other treatment options available. What sleep apnea is and how common it may be  Why people can stop breathing without realizing it  Common and overlooked symptoms of sleep apnea  The connection between sleep apnea, weight gain and heart health  Whether losing weight can improve sleep apnea  How sleep studies confirm a diagnosis  Ways to make CPAP easier to tolerate  Alternatives to CPAP, including oral appliances and surgical options Sleep apnea is highly treatable. If you regularly wake up exhausted, snore loudly, or a bed partner notices pauses in your breathing, getting evaluated may help improve both your sleep and your long-term health.For more health and wellness information, visit BaptistHealth.net/News.Host:Anthony Gonzalez, M.D.Chief of Surgery, Baptist Health Baptist HospitalMedical Director of Bariatric Surgery, Baptist HealthGuest:Edward Mezerhane, M.D.Sleep Medicine PhysicianIf you found this episode helpful, you may also enjoy:7 Ways Summer Can Wreck Your SleepThis is What Lack of Sleep Does to your Brain and HeartPillow Talk: Uncovering the Sleep-Heart Link

Join Dr. Pinkston as she sits down with John Goldman, founder and CEO of Rebel Health Alliance. John shares his journey from feeling chronically exhausted, pre-diabetic, and dependent on a CPAP machine to revitalizing his metabolic health and training to qualify for the Boston Marathon. Together, they discuss the limitations of traditional primary care, the power of deep-dive diagnostics, lifestyle medicine, and alternative models like high-performance primary care paired with community health sharing. Key Topics Covered: The Broken Primary Care System: Why traditional insurance-driven models fail to catch early markers of metabolic dysfunction, visceral fat, and inflammation. Deep Diagnostics: How comprehensive testing—including DEXA scans, VO2 max, DNA analysis, and coronary calcium scores—forms the foundation for long-term vitality. Overcoming Obstructive Sleep Apnea: John's personal experience transitioning to a CPAP/BiPAP and eventually resolving his condition through weight loss and metabolic restoration. The Rebel Health Model: Combining full-time physicians, strength coaches, registered dietitians, and genetic counselors into a seamless, accessible care team. Ejecting from Insurance: How direct primary care paired with community-based health sharing offers financial protection without corporate middleman restrictions. Project Unreasonable: John’s public journey at age 50 to qualify for the Boston Marathon while showcasing human potential. Rebel Health Alliance: Explore high-performance primary care and longevity protocols at rebelhealthalliance.io Visit drpbetterlife.com to access show archives, guest links, and integrative health resourcesSee omnystudio.com/listener for privacy information.

The most common treatment for obstructive sleep apnea (OSA) is an at-home CPAP machine, but patients often remove their mask in their sleep or stop using the machine all together. Neomi Shah, MD, Mount Sinai Hospital, and host Ugo Ezema, MD, Tulane University, discuss a novel oral medication that opens a patient's airway, exponentially improving their quality of sleep.  

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

Broadcast from KSQD, Santa Cruz on 7-09-2026: Researchers refined a technique to reverse skin cell aging by about 30 years while preserving cellular identity. Exposing adult fibroblasts to Yamanaka factors—stopping before full reversion to pluripotent stem cells,reset the epigenetic clock and gene expression patterns to resemble much younger cells. The rejuvenated fibroblasts produced significantly more collagen, migrated faster to close artificial wounds, and showed reversal of gene expression patterns associated with Alzheimer's and cataracts. Since long-term epidemiologic data doesn't yet exist, Dr. Dawn follows up on last week's vaping question by exploring cancer mechanisms. Vaping aerosols impair DNA repair fidelity while triggering IL-6, IL-8, and TNF-alpha secretion. Nicotine-derived nitrosamines, reactive carbonyls (formaldehyde, acetaldehyde, acrolein) are generated when propylene glycol and vegetable glycerin are heated. Upregulated cytochrome P450 enzymes convert precarcinogens like benzopyrene into carcinogens. Mice exposed for 54 weeks developed lung adenocarcinomas in 22% and precancerous bladder hyperplasia in 57%, with markers matching those show predict lung cancer years before diagnosis. The Mexican Biobank—which includes over 40,000 samples from all 31 Mexican states revealed dramatic regional variation in drug-metabolism genes driven by Indigenous ancestry. In Chiapas, nearly 40% of the population carries two copies of a CYP2D6 variant reducing fentanyl metabolism, versus just 10% in Sinaloa. The SLCO1B1 variant hindering statin metabolism is found in over 15% of Yucatán residents., where 8 million Mexicans take statins. Dr. Dawn discusses both the promise and potential dark side of population genetic testing, including UK plans to genotype all children at birth for inborn errors of metabolism. Dr. Dawn briefly revisits the recent Indian study showing conch-shell blowing reduces sleep apnea by 34%, comparing it to earlier didgeridoo research, both of which strengthen airway muscles through forced-blowing exercises. A caller from Capitola recovering from non-Hodgkin's lymphoma near the L5 nerve asks about Japanese Kampo medicine formulas (Goshajinkigan, Yokukansan) for post-treatment nerve pain. Dr. Dawn suggests the pain likely originates from scar tissue tethering the nerve, and recommends consulting the Oriental Medicine Doctor program at Five Branches in Santa Cruz where faculty can advise on herbal formulas that trace back thousands of years through cultural exchange between China and Japan. Dr. Dawn explains Lp(a):lipoprotein(a), a small protein string attached to LDL particles that promotes clumping and clotting, is a genetically-determined coronary artery disease and stroke risk factor invisible to standard lipid panels. Levels of 250 particles double coronary risk and 350 particles triple it. Less than 75 is normal. Two new pharmaceutical strategies are in development to reduce Lp(a) : antisense oligonucleotides (single-stranded RNA that recruits RNase H to cleave target mRNA) and small interfering RNA (double-stranded RNA that triggers destruction of matching mRNA). Pelacarsen, a monthly injection in Phase 3 trials, reduces Lp(a) by 80%. These gene-silencing platforms open therapeutic possibilities for previously undruggable orphan diseases. Vitamin K2 is produced in the gut microbiome. MK-4 is most common in humans. Dr. Dawn recommends MK7 for stabilizing coronary calcium plaques and directing calcium into bone. A study of hepatitis B and C patients found MK4 to be protective in hepatocellular carcinoma. HCC developed in 2 of 21 MK-4-treated patients versus 9 of 19 controls, with a risk ratio of 0.2. MK-4 activates protein kinase A in vitro, inhibits HCC invasiveness, and restores apoptosis signaling that cancer cells normally block. Dr. Dawn recommends a couple milligrams of MK-4 daily for anyone with cirrhosis or prior hepatitis B or C infection.

When we think of Obstructive Sleep Apnea (OSA), we usually think of snoring, disrupted sleep, and daytime fatigue. But there is a critical link between OSA and dysphagia. In this episode, we sit down with Prof. Ankita Bhutada from Northwestern University to explore how upper airway collapse and chronic respiratory disruption can profoundly impact swallowing function. We cover: Understanding OSA: What is obstructive sleep apnea, its primary risk factors, and why it is a major public health concern. The link to dysphagia: Understanding the sensorimotor mechanisms and neuromuscular changes that connect sleep-disordered breathing to swallowing dysfunction. Clinical Presentation: How dysphagia typically manifests in individuals with OSA Diagnostics: Why clinicians should consider routinely screening people with OSA for dysphagia and how to adapt existing assessment tools for this population. High-Risk Groups: Identifying which specific patient profiles within the OSA population face the highest risk for airway compromise. Management & Treatment: A look at current and emerging treatment approaches for dysphagia in people with OSA. Literature that we discuss: Bhutada et al. (2022). Predictors of Patient-Reported Dysphagia and Reflux Symptoms in Obstructive Sleep Apnea. Bhutada et al. (2020). Obstructive sleep apnea syndrome (OSAS) and swallowing function—A systematic review. Bhutada et al. (2025). Effects of Expiratory Muscle Strength Training on Oropharyngeal Swallow Physiology in Persons with Obstructive Sleep Apnea (OSA): A Preliminary Study.

Sleep, Glymphatic Detox, and the Hidden Heart Risks of Sleep Apnea: Nutritionist Leyla Muedin explains how sleep supports brain “housekeeping” via the glymphatic system, a glial-lymphatic waste-clearance network most active during sleep that moves cerebrospinal fluid through brain spaces to remove metabolites and toxic proteins such as amyloid beta, with sleep deprivation linked to amyloid accumulation. She notes other clearance pathways, including meningeal lymphatic vessels, whose impaired function is associated with neurodegenerative disease and brain injury. Reviews of human studies suggest sleep influences glymphatic outcomes, though results are inconsistent and methods vary. She emphasizes that poor sleep is associated with dementia risk, depressive symptoms, cardiovascular events, mortality, and impaired glucose metabolism, and highlights lifestyle strategies that may improve sleep. She warns that untreated obstructive sleep apnea accelerates cardiovascular aging via intermittent hypoxia and inflammation, raising blood pressure and cardiovascular event risk, while treatment (e.g., CPAP) may halt or reverse damage.

Dr Peter Wallbridge (sleep and respiratory physician) joins Dr Preeya again after multiple requests from the audience for another chat on sleep! Obstructive sleep apnea - why it can present differently in women, options for management and all the super interesting stuff everyone wants to know on dreaming, sleep walking and talking!Instagram: ⁠⁠⁠⁠⁠@doctor.preeya.alexander⁠⁠⁠⁠⁠Books: ⁠⁠⁠⁠⁠Eat, Sleep, Play, Love⁠⁠⁠⁠ by Dr Preeya Alexander⁠⁠⁠⁠⁠Full Plate⁠⁠⁠⁠⁠, out nowTo find out more about AIA Australia head to ⁠⁠⁠www.aia.com.au

Study Looks at Impact of Female Hormones on Obstructive Sleep ApneaBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/study-looks-at-impact-of-female-hormones-on-obstructive-sleep-apnea/Need CE? Start earning CE credits today at ⁠⁠⁠https://rdh.tv/ce⁠⁠⁠ Get daily dental hygiene articles at ⁠⁠⁠https://www.todaysrdh.com⁠⁠⁠ Follow Today's RDH on Facebook: ⁠⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠⁠Follow Kara RDH on Facebook: ⁠⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠⁠Follow Kara RDH on Instagram: ⁠⁠⁠https://www.instagram.com/kara_rdh/⁠

Joanne Alves e Nordman Wall convidam Caroline Millon para discutir a abordagem da Síndrome de Apneia e Hipopneia Obstrutiva do Sono (SAHOS). Referências: Myers, Kathryn A et al. “Does this patient have obstructive sleep apnea?: The Rational Clinical Examination systematic review.” JAMA vol. 310,7 (2013): 731-41. doi:10.1001/jama.2013.276185Gawrys, Breanna et al. “Obstructive Sleep Apnea in Adults: Common Questions and Answers.” American family physician vol. 110,1 (2024): 27-36.Hong, Yanan et al. “The study of the relationship between moderate to severe sleep obstructive apnea and cognitive impairment, anxiety, and depression.” Frontiers in neurology vol. 15 1363005. 10 May. 2024, doi:10.3389/fneur.2024.1363005US Preventive Services Task Force et al. “Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement.” JAMA vol. 328,19 (2022): 1945-1950. doi:10.1001/jama.2022.20304Palombini, Luciana de Oliveira. “Critérios diagnósticos e tratamento dos distúrbios respiratórios do sono: RERA” [Diagnostic criteria and treatment for sleep-disordered breathing: RERA]. Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia vol. 36 Suppl 2 (2010): 19-22. doi:10.1590/s1806-37132010001400007Yeghiazarians, Yerem et al. “Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association.” Circulationvol. 144,3 (2021): e56-e67. doi:10.1161/CIR.0000000000000988Duarte, Ricardo Lm et al. “Obstructive Sleep Apnea Screening with a 4-Item Instrument, Named GOAL Questionnaire: Development, Validation and Comparative Study with No-Apnea, STOP-Bang, and NoSAS.” Nature and science of sleep vol. 12 57-67. 23 Jan. 2020, doi:10.2147/NSS.S238255Gottlieb, Daniel J, and Naresh M Punjabi. “Diagnosis and Management of Obstructive Sleep Apnea: A Review.” JAMA vol. 323,14 (2020): 1389-1400. doi:10.1001/jama.2020.3514Malhotra, Atul et al. “Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity.” The New England journal of medicine vol. 391,13 (2024): 1193-1205. doi:10.1056/NEJMoa2404881

Please visit answersincme.com/YVT860 to participate, download slides and supporting materials, complete the post test, and get a certificate. Presented by Michael Mak, MD, FRCPC, DRCPSC, FCPA, FAPA, FAASM; and Sabrina Kwon, BSc, MD. In this activity, experts in sleep and primary care discuss strategies for the screening, diagnosis, and treatment of adults with obesity and obstructive sleep apnea. Upon completion of this activity, participants should be better able to: Recognize key clinical and diagnostic challenges in identifying obstructive sleep apnea (OSA) in adults with obesity; Evaluate the role of weight management strategies, including incretin-based therapies, in the comprehensive management of OSA in adults with obesity; and Apply practical, patient-centered approaches to optimize obesity and OSA management across the care pathway.

Today we're diving into the nuanced world of circadian rhythm sleep syndromes, and how biological and environmental factors intersect in shaping our children's sleep. My guest is Alex Mortlock, a registered clinical psychologist who has been in practice since 2010, with training rooted in evidence-based approaches to mental health. Alex will help us unpack what's actually happening when a child's sleep rhythm is out of sync, and why this is so often misunderstood. We talk about practical strategies, the role of light exposure and light therapy, and how melatonin can be used thoughtfully to support regulation.  About Dr. Devon Price Alex Mortlock has been a registered clinical psychologist since 2010, trained at the University of Canterbury with a focus on evidence-based approaches to mental health assessment and treatment. His work is grounded in psychological science, with an emphasis on the interplay of emotion, cognition, and motivation. He uses evidence-based methods to help people make positive changes in their behaviour, fostering an environment of authenticity, acceptance, and understanding. Throughout his career, Alex has had the privilege of witnessing growth and transformation in people from diverse backgrounds — experiences that have reinforced his belief that, with the right support and guidance, everyone has the capacity to flourish. He lives in Christchurch, New Zealand with his wife, who is also a clinical psychologist, and their two over-analysed children. Curiosity, compassion, courage, and flexibility are the values that guide him through the professional and personal challenges that human life presents.   Things you'll learn from this episode  How circadian rhythms shape sleep patterns and why they matter for children's overall health Why conditions like delayed sleep phase, advanced sleep phase, and non-24-hour sleep disorders can disrupt typical sleep cycles How neurodivergence can influence light sensitivity and circadian regulation Why gradual light exposure, environmental adjustments, and low-dose melatonin can help realign sleep rhythms How habits like late-night screen use can interfere with healthy sleep patterns When to seek professional support and how parents can practically support their child's sleep development Resources mentioned Alex Mortlock's website Late Nights, Later Days: The Under-Recognized Impact of Delayed Sleep Phase Syndrome in ADHD (Additude Magazine) Reset Your Inner Clock: The Drug-Free Way to Your Best-Ever Sleep, Mood, and Energy by Michael Termin, PhD Prevalence of Obstructive Sleep Apnea in Joint Hypermobility Syndrome: A Systematic Review and Meta-Analysis (National Institute of Health) Article on Light Boxes (Yale School of Medicine) Light Therapy Visors (results page from Amazon search)   Learn more about your ad choices. Visit podcastchoices.com/adchoices

GLP-1 drugs like Ozempic and Mounjaro are now everywhere. But what do they actually do beyond weight loss? And what do you need to know before starting them? In this episode, we're joined by Dr Ania Jastreboff, a world-leading researcher at the forefront of GLP-1 treatments and writer of the New York Times bestselling book Enough: Your Health, Your Weight, and What It's Like To Be Free, co-authored with Oprah Winfrey. Dr Jastreboff explains everything you need to know about Ozempic, Mounjaro, Wegovy and other GLP-1 medications for 2026. You'll learn how GLP-1s may reduce the risk of heart disease, improve blood sugar control, and support conditions like sleep apnoea. We also explore why weight often returns after stopping, and what you need to know about Ozempic side effects and long-term use. If these drugs can change how your brain controls hunger, what does that mean for willpower, weight gain, and how we treat obesity long term?

Send us Fan MailRobert Sassoon, WTR Senior Healthcare Analyst, joins Tim Gerdeman to discuss obstructive sleep apnea (OSA) and the rapidly evolving treatment landscape for this widespread yet often undiagnosed and potentially fatal condition. The conversation explores the shift away from CPAP amid high non‑adherence rates toward emerging alternatives, including neurostimulation, pharmacotherapy, and oral appliances. Sassoon also highlights the valuation gap between incumbents such as ResMed (NYSE: RMD) and innovators like Vivos Therapeutics (NASDAQ: VVOS), whose approach extends beyond symptom management to address finite anatomical correction.

Dr. Douglas Krohn is an award-winning primary care physician, a Clinical Professor at New York Medical College, and a sleep apnea patient with deep insights into the patient journey and effective care delivery. He is a member of the American Academy of Sleep Medicine, the American Telemedicine Association, and the American Board of Pediatrics.   SHOWNOTES:

Editor-in-Chief Cecelia E. Schmalbach, MD, MSc, is joined by senior author Romaine F. Johnson, MD, MPH, and Associate Editor M. Boyd Gillespie, MD, to discuss whether childhood obesity is associated with increased severity of obstructive sleep apnea during adolescence, as outlined in the paper "Association Between Weight Gain Trajectories and Severe Obstructive Sleep Apnea Among Adolescents" which published in the February 2026 issue of Otolaryngology–Head and Neck Surgery. To read the full article, click here.

Dr. John Fleetham chats with Danny Eckert about his article, "Obstructive Sleep Apnea is Exacerbated on Weekends."

Roger Seheult, MD of MedCram explores a study comparing treatments for obstructive sleep apnea. See all Dr. Seheult's videos at: https://www.medcram.com (This video was recorded on January 21st, 2026) Roger Seheult, MD is the co-founder and lead professor at: www.medcram.com He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine. MEDCRAM WORKS WITH MEDICAL PROGRAMS AND HOSPITALS: MedCram offers group discounts for students and medical programs, hospitals, and other institutions. Contact us at customers@medcram.com if you are interested. MEDIA CONTACT:  Media Contact: customers@medcram.com Media contact info: https://www.medcram.com/pages/media-contact Video Produced by Kyle Allred Edited by Daphne Sprinkle of Sprinkle Media Consulting, LLC FOLLOW US ON SOCIAL MEDIA: Facebook:  www.facebook.com/MedCram Twitter/X: www.twitter.com/MedCramVideos Instagram: www.instagram.com/medcram DISCLAIMER: MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor. #OSA #apnea #Apnoea

Dr. Stavan Patell, Oral and Maxillofacial Surgeon with WK Health, joins Healthline 3 to discuss surgical options available to those suffering from obstructive sleep apnea.

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.

How would you manage this patient with obstructive sleep apnea (OSA) and associated comorbidities? Credit available for this activity expires: 12/18/26 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/spotlight-obstructive-sleep-apnea-focus-hcp-patient-2025a1000z5l?ecd=bdc_podcast_libsyn_mscpedu

Recentemente, a ANVISA aprovou a indicação do medicamento Mounjaro para o tratamento da apnéia do sono. Essa indicação soma-se às já existentes: diabetes tipo 2, obesidade, redução do risco cardiovascular e redução na progressão da doença renal do diabetes. Em breve, é provável que vejamos indicações formais para gordura no fígado e ovários policísticos. Isso significa que uma extensa gama de especialidades médicas passarão a prescrever os injetáveis rotineiramente - e isso requer alguns cuidados.Links relacionados:Anvisa aprova uso de Mounjaro para tratamento da apneia do sonoTirzepatide for the Treatment of Obstructive Sleep Apnea and ObesityOvários policísticos melhoram com Low CarbEpisódio Extra – Série Além Da Moda – Episódio 9: Resistência À Insulina, Síndrome Metabólica E DiabetesEstamos no Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Dr. Souto⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Sari Fontana⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Para ser avisado sobre cada novo episódio e receber os links das matérias mencionadas e as referências bibliográficas por e-mail, cadastre-se gratuitamente em ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drsouto.com.br/podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Adquira seu livro - UMA DIETA ALÉM DA MODA: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (também na versão Kindle)"Dance of the Sugar Plum Fairy"Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 3.0⁠⁠⁠⁠⁠⁠⁠⁠http://creativecommons.org/licenses/by/3.0/⁠⁠

Interview with Eric J. Kezirian, MD, MPH author of Anteroposterior and Lateral Epiglottis-Related Obstruction in Adult Obstructive Sleep Apnea. Hosted by Paul C. Bryson, MD MBA. Related Content: Anteroposterior and Lateral Epiglottis-Related Obstruction in Adult Obstructive Sleep Apnea

Join leading experts Fariha Abbasi-Feinberg, MD, FAASM, Medical Director of Sleep Medicine at Millennium Physician Group and President Elect for the American Academy of Sleep Medicine; Inderpreet K. Madahar, MD, MBBS, Assistant Professor of Endocrinology, Diabetes, and Metabolism at Corewell Health; and Sarah Nadeem, MD, FACE, Assistant Professor, Section of Endocrinology, Diabetes, and Metabolism at Baylor College of Medicine, Houston, TX, as they discuss the complex relationship between obstructive and central sleep apnea and metabolic disorders such as obesity and type 2 diabetes.Key topics include:Who should be screened for sleep apnea and the recommended screening toolsFirst-line and adjunctive therapies for managementThe evolving role of multidisciplinary careHow clinical practice is shifting with the recent FDA label expansion of tirzepatide (Zepbound®)When tirzepatide may be considered alongside or in place of CPAP, APAP, and BiPAP therapiesTune in for practical insights to better identify, manage, and support patients at risk. This episode is made possible through a sponsorship from Lilly.

Editor-in-Chief Cecelia E. Schmalbach, MD, MSc, is joined by senior author Colin T. Huntley, MD, and Associate Editor Boyd Gillespie, MD, to discuss how long-term changes in body mass index (BMI) following hypoglossal nerve stimulation (HGNS) impact surgical success as outlined in the paper "Impact of Postoperative Weight Changes on Hypoglossal Nerve Stimulation Success for Obstructive Sleep Apnea," which published in the September 2025 issue of Otolaryngology- Head and Neck Surgery. Click here to read the full article.

In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss treatment of OSA. In Part 1 we discussed an overview of OSA, in Part 2 we discussed making the diagnosis, Part 3 was treatment, and in Part 4 we bring it all together with a case to explore clinical decision making for OSA. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Sanjay Patel, M.D, Professor of Medicine, Epidemiology, & Clinical and Translational Science, and Director of the Center for Sleep and Cardiovascular Outcomes Research; Medical Director of the Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center Susan Kuchera, M.D. - Clinical Associate Professor of Family and Community Medicine at the Sidney Kimmel Medical College of Thomas Jefferson University and Program Director of the Family Medicine Residency at Jefferson Health Abington. Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400 Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med 2024;391:1193-1205  

In 2023, we released 2 episodes on obstructive sleep apnea (OSA) and adverse pregnancy. Now, on September 16, 2025, a new publication from JAMA Network Open adds more insights to disturbed sleep and adverse pregnancy outcomes. How does insomnia affect pregnancy? And is there any data on night shift work and its altered circadian rhythms on adverse pregnancy outcomes? Listen in for details. 1. Ross N, Baer RJ, Oltman SP, et al. Ischemic Placental Disease and Severe Morbidity in Pregnant Patients With Sleep Disorders. JAMA Netw Open. 2025;8(9):e2532189. doi:10.1001/jamanetworkopen.2025.321892. Cai C, Vandermeer B, Khurana R, et al. The Impact of Occupational Shift Work and Working hours during Pregnancy on Health Outcomes: a systematic Review and Meta-Analysis.American Journal of Obstetrics and Gynecology. 2019;221(6):563-576. doi:10.1016/j.ajog.2019.06.051.3. Dominguez JE, Cantrell S, Habib AS, Izci-Balserak B, Lockhart E, Louis JM, Miskovic A, Nadler JW, Nagappa M, O'Brien LM, Won C, Bourjeily G. Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology Consensus Guideline on the Screening, Diagnosis, and Treatment of Obstructive Sleep Apnea in Pregnancy. Obstet Gynecol. 2023 Aug 1;142(2):403-423. doi: 10.1097/AOG.0000000000005261. Epub 2023 Jul 5. PMID: 37411038; PMCID: PMC10351908.4. Kader M, Bigert C, Andersson T, et al . Shift and Night Work During Pregnancy and Preterm Birth-a Cohort Study of Swedish Health Care Employees. International Journal of Epidemiology. 2022;50(6):1864-1874. doi:10.1093/ije/dyab135.STRONG COFFEE PROMO: 20% Off Strong Coffee Companyhttps://strongcoffeecompany.com/discount/CHAPANOSPINOBG

In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss treatment of OSA. In Part 1 we discussed and overview of OSA, in Part 2 we discussed making the diagnosis will, and Part 4 will look at cases. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Sanjay Patel, M.D, Professor of Medicine, Epidemiology, & Clinical and Translational Science, and Director of the Center for Sleep and Cardiovascular Outcomes Research; Medical Director of the Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400 Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med 2024;391:1193-1205

What happens when two systemic diseases collide? In this episode of New Retina Radio Journal Club with VBS, moderator Lediana Goduni, MD, is joined by Alexis Warren, MD, and Joshua Uhr, MD, to discuss a new retrospective cohort study by Rahimy et al. The panel explores how obstructive sleep apnea impacts the progression of diabetic retinopathy and elevates the risk for systemic vascular events such as stroke, heart attack, and death. With nearly 24,000 patients analyzed, the study sheds light on the importance of screening and managing comorbidities in patients with nonproliferative diabetic retinopathy—and raises critical questions about what role retina specialists should play in addressing them.

Beyond Sports is the ESPN public affairs show. Airing Sunday mornings, from 5-6am, Beyond Sports presents topical guests and stories in an entertaining and comfortable format. Each week your host, Hannah Stanley, brings a new show covering a current issue, news item, upcoming event, or local charity. This is the first episode featuring Dr. Raj in a recurring monthly segment. Hannah Stanley is the Public Affairs Manager for ESPN AM 1000. She is co-chair of the Chicago Chapter of the Disney VoluntEars, and involved with TEAM ESPN. She resides in the western suburbs with her husband and children. Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textWelcome back Rounds Table Listeners! In this throwback episode, Drs. Mike and John Fralick chat about five important research studies published in 2024:Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (FINEARTS-HF) (0:00 – 4:09)Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (SURMOUNT-OSA) (4:10 – 9:28)Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (FLOW) (9:29 – 14:23)Tirzepatide for Metabolic-Dysfunction Associated Steatohepatitis with Liver Fibrosis (SYNERGY-NASH) (14:24 – 20:28)Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections (BALANCE) (20:29 – 23:59)And for the Good Stuff:Toronto Star Santa Claus Fund, Calgary Food Bank, Epilepsy Canada (24:00 - 25:23)Calling keen trainees!Trainees, med students, residents: The Rounds Table and Trial Files (https://trialfiles.substack.com/) are looking for keen individuals to support our efforts.Reach out to fralickmpf@gmail.com if you are interested in getting involved. Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss diagnosis of OSA. In Part 1 we discussed and overview of OSA, Part 3 will discuss treatment options, and Part 4 will look at cases. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Sanjay Patel, M.D, Professor of Medicine, Epidemiology, & Clinical and Translational Science, and Director of the Center for Sleep and Cardiovascular Outcomes Research; Medical Director of the Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400

Dr. Rachel Whelan and Dr. Ryan Soose joined the podcast today to discuss sleep apnea in both children and adults with Down syndrome.  The podcast discusses how and when to screen for sleep apnea and management options that currently are in use.   For more information on the pediatric hypoglossal nerve stimulator trial discussed on the podcast, go to: https://clinicaltrials.gov/study/NCT04801771?cond=Down%20syndrome,%20sleep%20apnea&rank=10 If you would like to suggest a topic for us to cover on the podcast, please send an e-mail to DownSyndromeCenter@chp.edu. If you would like to partner with the Down Syndrome Center, including this podcast, please visit https://givetochildrens.org/downsyndromecenter. We are thankful for the generous donation from Caring for Kids – The Carrie Martin Fund that provides the funding for the podcast recording equipment and hosting costs for this podcast.

What is the relationship between obstructive sleep apnea and the development and progression of age-related macular degeneration? Dr. Drew Carey talks with Dr. Ahmed M. Alshaikhsalama and Dr. Amer F. Alsoudi on their recent Ophthalmology Retina article, “Association between Obstructive Sleep Apnea and Age-related Macular Degeneration Development and Progression.” Association between Obstructive Sleep Apnea and Age-related Macular Degeneration Development and Progression. Alshaikhsalama, Ahmed M. et al. Ophthalmology Retina , Volume 9, Issue 6, 537 – 545. Sign up for the next Ophthalmology Journal Virtual Club on August 27, 2025, at https://store.aao.org/ophthalmology-virtual-journal-club.html

Obstructive sleep apnea (OSA) is an increasingly common diagnosis. Yet most behavioral health providers are unaware that they can play a role in both the assessment and treatment of OSA in their patients. Today we're joined by an expert in the subfield of sleep psychology, Dr. Phil Gehrman. He shares basic information about what OSA is, how providers can effectively screen for it, and how they can facilitate treatment for this dangerous condition. Despite what you might have heard before, Dr. Gehrman posits that behavioral health providers can play “a huge potential role that really is untapped.” Dr. Phil Gehrman is Professor of Psychology in the Department of Psychiatry of the University of Pennsylvania School of Medicine. He directs the Sleep, Neurobiology and Psychopathology lab at Penn. He has an active research program exploring the mechanisms and treatment of sleep and circadian dysregulation in the context of mental health disorders. Dr. Gehrman's clinical specialization is on the delivery of cognitive behavioral and chronotherapeutic interventions for insomnia, circadian rhythm disorders, and other sleep disorders. The overarching goal of his work is to advance the understanding of the links between sleep and mental illness through translational research that spans biology to therapeutics.Resources mentioned in this episode: STOP Screening tool for Obstructive Sleep Apnea: https://deploymentpsych.org/content/insomnia-toolsMotivational Interviewing for CPAP Adherence: Rapelli G, Pietrabissa G, Manzoni GM, Bastoni I, Scarpina F, Tovaglieri I, Perger E, Garbarino S, Fanari P, Lombardi C and Castelnuovo G (2021) Improving CPAP Adherence in Adults With Obstructive Sleep Apnea Syndrome: A Scoping Review of Motivational Interventions. Front. Psychol. 12:705364. doi: 10.3389/fpsyg.2021.705364Motivational Interviewing resources: https://deploymentpsych.org/Clinical-Skills-ResourcesSystematic desensitization: https://www.veterantraining.va.gov/insomnia/docs/PAP_Desensitization.pdfPractical for Your Practice voice mail: speakpipe.com/cdpp4pPractical for Your Practice email: cdp-podcast-ggg@usuhs.edu Calls-to-action: Incorporate the STOP into your practiceBecome familiar with behavioral and motivational approaches listed aboveConnect with your local sleep medicine clinicReach out to us via Speakpipe with your questions and commentsSubscribe to the Practical for Your Practice PodcastSubscribe to The Center for Deployment Psychology Monthly Email at https://deploymentpsych.org/CDP-MED-Opt-In

Sleep Apnea or Obstructive Sleep Apnea, is a phenomenon that many people do not understand nor associate with significant disease due to the fears of diagnosis and therapy. Sleep apnea or obstructive sleep apnea is a cause of significant fatigue, brain fog, lack of concentration, and other common symptoms. Sleep Apnea is a cause of cardiovascular disease, such as heart attack, stroke, congestive heart, failure, stroke, treatment resistant, hypertension, and many other diseases. Do not underestimate how this disease can affect quality and quantity of life. Learn more with today’s podcast on OSA. See omnystudio.com/listener for privacy information.

In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss an overview of OSA. In Part 2 we will take a deep dive into diagnosis, Part 3 will discuss treatment options, and Part 4 will look at cases. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Paul Doghramji, MD – Medical Director of Health Services at Ursinus College, Attending Family Physician at Collegeville Family Practice Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400 Obstructive sleep apnea and obesity: A review of epidemiology, pathophysiology and the effect of weight-loss treatments.  Sleep Medicine Reviews 2024;78:1-12

Sleep apnea is a condition that affects millions of people, often without them even knowing it. It's more than just loud snoring or restless nights. It can have serious health consequences. And the state Office of Cannabis Management has new data about using cannabis to treat the condition. They conducted the largest survey on record about the condition and cannabis. And their findings show it could really help patients. Joining Minnesota Now to explain is Grace Christensen, a research analyst at the Office of Cannabis Management.

Tem gente que dorme de lado. Outras pessoas preferem a barriga pra cima. Outras gostam da barriga pra baixo. Braço esticado. Perna dobrada. Com ou sem coberta... Afinal, a posição e o jeito como dormimos tem alguma relação com nossa personalidade ou nosso estado, segundo a ciência?Confira o papo entre o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.>> OUÇA (52min 35s)*Naruhodo! é o podcast pra quem tem fome de aprender. Ciência, senso comum, curiosidades, desafios e muito mais. Com o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.Edição: Reginaldo Cursino.http://naruhodo.b9.com.br*APOIO: INSIDERIlustríssima ouvinte, ilustríssimo ouvinte do Naruhodo, chegou abril, o mês de aniversário da INSIDER!E adivinha quem sai ganhando? Quem entende que menos é mais! Ou seja: você e eu!Você já sabe que eu uso INSIDER há anos, tanto para o trabalho quanto para o lazer. Porque eu quero menos consumo por impulso, mais peças que duram e uma moda que valorize o meu estilo pessoal.E eu sei que você tava só esperando uma desculpa pra comprar aquela camiseta da INSIDER que eu vivo usando e sobre a qual vivo falando bem... Então, vem experimentar INSIDER você também!Em abril, o cupom NARUHODO mais os descontos do site podem chegar a até 30% de desconto. É isso mesmo: 30% de desconto!Para aproveitar, o jeito mais fácil é usar o endereço https://bit.ly/naruhodo-abril-2025 ou clicar no link da descrição deste episódio: o cupom será aplicado automaticamente no carrinho.INSIDER: inteligência em cada escolha.#InsiderStore*APOIO: HOMO ACADEMICUSAqui no Naruhodo, a gente vive falando sobre as dificuldades da vida acadêmica. Ao mesmo tempo, a gente acredita que ela pode ser mais legal e menos solitária.Por isso temos a felicidade de divulgar um projeto admirável: o HOMO ACADEMICUS.O HOMO ACADEMICUS surge como um esforço comunitário que ambiciona inspirar as pessoas a buscar outras formas de viver a universidade. Que une pessoas de vários países da América Latina, como Brasil, Peru, Chile, Equador, Argentina e México. E também diferentes áreas do conhecimento e habilidades, como de escrita, edição, tradução, design e pesquisa.Ele é um podcast? É. Traz temas como as regras não ditas da universidade, gestão do tempo, violência na universidade, comunidades de pesquisas, escrita acadêmica, entre outros.Mas HOMO ACADEMICUS é também muito mais que um podcast, e será cada vez mais. É capacitação, é reflexão, é diálogo.E traz ainda uma ideia muito bacana: os Clubes de Escuta, que são redes de apoio que vocês - estudantes, pesquisadores e professores - podem criar para discutirem os desafios de seus contextos, usando como suporte os recursos que são preparados para cada episódio.Então conheça hoje mesmo essa belíssima iniciativa:homoacademicus.org*REFERÊNCIASDormir de lado ativa sistema glinfático e é melhor para o cérebrohttps://search.app/qpGVbN6cmZTwP4sr8Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleephttps://www.science.org/doi/10.1126/science.aax5440The Effect of Body Posture on Brain Glymphatic Transporthttps://www.jneurosci.org/content/35/31/11034Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptomshttps://pubmed.ncbi.nlm.nih.gov/29138608/The Glymphatic System: A Novel Component of Fundamental Neurobiologyhttps://www.jneurosci.org/content/41/37/7698.abstractA Novel Sleep Positioning Device Reduces Gastroesophageal Reflux: A Randomized Controlled Trialhttps://pubmed.ncbi.nlm.nih.gov/26053170/Infant sleeping position and the sudden infant death syndrome: systematic review of observational studies and historical review of recommendations from 1940 to 2002https://pubmed.ncbi.nlm.nih.gov/15843394/Influence of the right- versus left-sided sleeping position on the apnea-hypopnea index in patients with sleep apneahttps://pubmed.ncbi.nlm.nih.gov/21678115/High Negative Predictive Value of Normal Body Mass Index for Obstructive Sleep Apnea in the Lateral Sleeping Positionhttps://pubmed.ncbi.nlm.nih.gov/29852898/Sleep positions and personality: Zuckerman-Kuhlman's big five, creativity, creativity styles, and hypnotizabilityhttps://www.researchgate.net/publication/287884030_Sleep_positions_and_personality_Zuckerman-Kuhlman's_big_five_creativity_creativity_styles_and_hypnotizabilityUpper airway obstruction during sleep in infants with laryngomalacia is frequently sleep-position-dependenthttps://www.nature.com/articles/s41390-025-03919-zFactors Related to the Sleep Duration of 3-Month-Old Infantshttps://www.thieme-connect.com/products/ejournals/html/10.1055/s-0044-1782168Sleep positions : the night language of the bodyhttps://archive.org/details/sleeppositionsni00dunk/page/n5/mode/2upThe contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: the Chicago Infant Mortality Studyhttps://pubmed.ncbi.nlm.nih.gov/12359794/Naruhodo #129 - Sono polifásico funciona segundo a ciência?https://www.youtube.com/watch?v=h6AfuI46VhQNaruhodo #188 - Contar carneirinhos faz a gente dormir mais rápido?https://www.youtube.com/watch?v=Txu8-QTZB7INaruhodo #191 - É possível aprender idiomas dormindo?https://www.youtube.com/watch?v=nz1FoXN8XqANaruhodo #256 - Por que roncamos?https://www.youtube.com/watch?v=SfJH_F2GsI4Naruhodo #153 - Sonambulismo tem cura?https://www.youtube.com/watch?v=ghcxHlIK5RINaruhodo #156 - O que é paralisia do sono?https://www.youtube.com/watch?v=h9om8soj_uANaruhodo #138 - O que é bruxismo do sono?https://www.youtube.com/watch?v=CFVyaXRNs0QNaruhodo #123 - O que é e como funciona o sonho lúcido?https://www.youtube.com/watch?v=ThUlmkFFr1UNaruhodo #83 - O que são sonhos?https://www.youtube.com/watch?v=rKvDGxCg7XENaruhodo #297 - Balançar de um lado para o outro ajuda a dormir melhor?https://www.youtube.com/watch?v=LvuqqtayK60Naruhodo #318 - Por que algumas pessoas acordam de mau humor?https://www.youtube.com/watch?v=PKvR_lr5ZIw*APOIE O NARUHODO!O Altay e eu temos duas mensagens pra você.A primeira é: muito, muito obrigado pela sua audiência. Sem ela, o Naruhodo sequer teria sentido de existir. Você nos ajuda demais não só quando ouve, mas também quando espalha episódios para familiares, amigos - e, por que não?, inimigos.A segunda mensagem é: existe uma outra forma de apoiar o Naruhodo, a ciência e o pensamento científico - apoiando financeiramente o nosso projeto de podcast semanal independente, que só descansa no recesso do fim de ano.Manter o Naruhodo tem custos e despesas: servidores, domínio, pesquisa, produção, edição, atendimento, tempo... Enfim, muitas coisas para cobrir - e, algumas delas, em dólar.A gente sabe que nem todo mundo pode apoiar financeiramente. E tá tudo bem. Tente mandar um episódio para alguém que você conhece e acha que vai gostar.A gente sabe que alguns podem, mas não mensalmente. E tá tudo bem também. Você pode apoiar quando puder e cancelar quando quiser. O apoio mínimo é de 15 reais e pode ser feito pela plataforma ORELO ou pela plataforma APOIA-SE. Para quem está fora do Brasil, temos até a plataforma PATREON.É isso, gente. Estamos enfrentando um momento importante e você pode ajudar a combater o negacionismo e manter a chama da ciência acesa. Então, fica aqui o nosso convite: apóie o Naruhodo como puder.bit.ly/naruhodo-no-orelo

Dr. Hoffman continues his conversation with Dr. Julie Siemers, a nurse educator and author of “Surviving Your Hospital Stay: A Nurse Educator's Guide to Staying Safe and Living to Tell About It.” 

Dr. Julie Siemers, a nurse educator and author of “Surviving Your Hospital Stay: A Nurse Educator's Guide to Staying Safe and Living to Tell About It,” details the importance of patient safety in hospitals, the dangers of medical errors, and how patients and their families can advocate for better care. Dr. Siemers talks about the critical role of nurses, the hierarchy within the nursing profession, and the importance of effective communication between healthcare providers and patients. She also offers practical advice on dealing with high-risk medications, leveraging AI in healthcare, and ensuring better health outcomes by being informed and proactive.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-425 Overview: In this episode we discuss updates on the treatment and management of obstructive sleep apnea (OSA). This is a common health concern, but it is often underdiagnosed and can have significant health impacts. We review its prevalence and standard treatments, highlighting the recently used medication therapy that has been found to be effective in treating OSA, particularly in individuals with obesity.  Episode resource links: https://www.aafp.org/pubs/afp/issues/2023/0300/uspstf-obstructive-sleep-apnea.html https://emedicine.medscape.com/article/295807-overview Malhotra, A., Grunstein, R. R., Fietze, I., Weaver, T. E., Redline, S., Azarbarzin, A., ... & Bednarik, J. (2024). Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. New England Journal of Medicine. Mangione, C. M., Barry, M. J., Nicholson, W. K., Cabana, M., Chelmow, D., Coker, T. R., ... & US Preventive Services Task Force. (2022). Screening for obstructive sleep apnea in adults: US Preventive Services Task Force recommendation statement. Jama, 328(19), 1945-1950. https://aasm.org/rising-prevalence-of-sleep-apnea-in-u-s-threatens-public-health/ Guest: Mariyan L. Montaque, DNP, FNP-BC  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Inside the Hidden Battle: Dr. Chris Frueh & Rob Sweetman on "Operator Syndrome" and Military Mental Health In this week's compelling episode of the Team Never Quit Podcast, we welcome Dr. Chris Frueh, a distinguished clinical psychologist, professor of psychology, and published author with over 30 years of experience working with military veterans and active-duty personnel. Dr. Frueh shares his extensive expertise drawn from decades of clinical trials, epidemiology, historical insights, and neuroscience research. Listen as he unpacks his groundbreaking work on “Operator Syndrome” and reveals how this paradigm-shifting concept is transforming our understanding and treatment of the complex health, psychological, and interpersonal challenges faced by those in military special operations. Extensive Expertise: Over thirty years of professional experience with military veterans and active-duty personnel. Academic & Clinical Leadership: Clinical Psychologist, Professor of Psychology, and co-author of more than 300 scientific publications, including a graduate textbook on adult psychopathology. Innovative Research: Pioneering work on “Operator Syndrome”—a framework addressing the interrelated challenges emerging from a career in military special operations Influential Voice: Dr. Frueh has testified before the US Congress and served as a contractor for organizations such as the Department of Defense, Veterans Affairs, US State Department, and the National Board of Medical Examiners. Media Presence: His insights have been featured in top publications and cited by outlets like the Wall Street Journal, The Economist, Washington Post, Scientific American, and NBC News. Along with Dr Freud, Rob Sweetman brings much to the discussion. A former Navy SEAL with eight years of service, Rob faced numerous hidden injuries, including PTSD, Traumatic Brain Injury (TBI), Obstructive Sleep Apnea, and Insomnia. The loss of a teammate to suicide became a turning point in his life, driving him to dedicate himself to the study of sleep science, determined to make a difference in the lives of others.  Whether you're a veteran, a mental health professional, or simply interested in groundbreaking research that bridges military experience and psychology, this episode is a must-listen. Tune in to gain valuable insights and join the conversation on advancing care for our military community. In this episode you will hear: • Through the military, the VA system, we've completely screwed the pooch with PTSD. We've put everything on PTSD. (6:47) •  Because we've put that reliance on PTSD, we've not attended to sleep, and sleep apnea.  (7:22) • We've failed a generation of soldiers. (8:01) • Soldiers injure their brains in 2 ways. Impact forces that cause a concussion, but also the blasts have a shearing effect. That scars the glial cells in the nervous system. (8:21) • We need to overhaul our approach to how we take care of soldiers, and by the way, this also affects first responders. (9:49) • Soldiers fight their wars overseas (so far). Responders are in the streets of their home town. (10:08) • We, and I say we as the medical establishment, of which I've been a part of for 30 years, we've fucked it all up. We're not paying attention. (10:36) • We've put all the focus on the psychological without appreciating the physiological. (15:49) • There's a lot of powers in the pharmaceutical companies, insurance companies, and the hospitals that control the actions of doctors. (23:01) • You can't say that all sleep causes all mental [issues] and you can't say that all mental health [issues] causes sleep health, but they're definitely related. (24:55) • We still don't have suicide figured out. (26:26) • You gotta have discipline. (32:22) • A hypnogram is how we measure sleep with brain wave activity. (41:57) • We have the best fighting force in the world. But we've been playing in the sand box of Iraq and Afghanistan. What's gonna happen when we have our first word threat. When that pops up, are we gonna be ready? (51:45) • Mr. Hegseth's number one mission is to improve the lethality of the war fighter. (56:26) • Last year, the VA spent 600 million dollars on suicide prevention efforts, that did not move the needle one little bit. (59:52) • The concept of Operator Syndrome is not a diagnosis, it's a framework for understanding how they're all interrelated. (63:25) • Your sleep affects your metabolism; it affects your hormone production. Testosterone is produced during sleep. Your brain health is affecting your sleep and your sleep is affecting your brain health. (63:38) Socials: - IG: Sleepgenius - https://ballastbooks.com/purchase/operator-syndrome/ Support TNQ - IG: team_neverquit , marcusluttrell , melanieluttrell , huntero13 -  https://www.patreon.com/teamneverquit Sponsors:   - shipsticks.com/TNQ    - Navyfederal.org           - Robinhood.com/gold    - strawberry.me/TNQ    - stopboxusa.com {TNQ}    - ghostbed.com/TNQ [TNQ]   -  kalshi.com/TNQ    - PXG.com/TNQ   -  joinbilt.com/TNQ    - Tonal.com [TNQ]   - greenlight.com/TNQ   - PDSDebt.com/TNQ   - drinkAG1.com/TNQ   - Shadyrays.com [TNQ]   - qualialife.com/TNQ [TNQ]   - Hims.com/TNQ   - Shopify.com/TNQ   - Aura.com/TNQ   - Policygenius.com   - TAKELEAN.com [TNQ]   - usejoymode.com [TNQ]   - Shhtape.com [TNQ]

In this episode, host Dr. Seema Khosla tackles a critical question in sleep medicine: What defines "well-treated" obstructive sleep apnea? Joined by Dr. Barry Krakow, a pioneering sleep medicine physician, the discussion explores the nuanced approach to assessing sleep apnea treatment beyond traditional metrics.  Discover insights into clinical endpoints for evaluating OSA treatment, the complex relationship between upper airway collapsibility and anxiety, and innovative strategies for patients with challenging sleep disorders. Dr. Krakow shares his unique perspectives on PAP therapy, including approaches for patients with PTSD and the potential role of behavioral interventions. 

Visit www.magicmind.com/highyieldjan for 45% off! VISIT US AT ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠NCLEXHIGHYIELD.COM⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ No matter where you are in the world, or what your schedule is like, access the entire course at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.NCLEXHighYieldCourse.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  The NCLEX High Yield Podcast was featured on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Top 15 NCLEX Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠! Make sure you ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠JOIN OUR NEW VIP FACEBOOK GROUP!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://nclexhighyield.com/blogs/news/nclex-high-yield-quick-links⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ A topic that confuses many, but listen to how Dr. Zeeshan breaks this bad boy down! Many people get overwhelmed with all the information that's out there, we keep it simple! Join us weekly for FREE Zoom Sessions and be one of the many REPEAT test takers that passed the exam by spending NO MONEY with NCLEX High Yield! NCLEX High Yield is a Prep Course and Tutoring Company started by Dr. Zeeshan in order to help people pass the NCLEX, whether it's the first time , or like the majority of our students, it's NOT their first time. We keep things simple, show you trends and tips that no one has discovered, and help you on all levels of the exam! Follow us on Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@NCLEXHighYield ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠or check out our website www.NCLEXHighYield.com Make sure you join us for our FREE Weekly Zoom Sessions! Every Wednesday 3PM PST / 6PM EST. Subscribe to our newsletter at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠nclexhighyield.com⁠⁠⁠⁠⁠⁠