Podcasts about Sleep medicine

Insomnia affects neurologic health, quality of life, and daily functioning, but effective treatments are available. In this episode, Dr. Brandon Peters-Mathews discusses a practical approach to evaluating chronic insomnia, highlights the importance of identifying contributing conditions such as sleep apnea and mood disorders, and reviews cognitive behavioral therapy for insomnia (CBT-I), the recommended first-line treatment. Learn how addressing sleep can improve outcomes across a wide range of neurologic disorders. In this episode, Katie Grouse, MD, FAAN, speaks with Brandon R. Peters-Mathews, MD, FAAN, FAASM, author of the article "Insomnia" in the Continuum® August 2026 Sleep Neurology issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Peters-Mathews is the Section Head of Sleep Medicine at Virginia Mason Franciscan Health in Seattle, Washington. Additional Resources Read the article: Insomnia 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: @BrandonPetersMD Full episode transcript available here Dr Grouse: Insomnia may be one of the most common medical issues experienced by patients, yet our knowledge about how to manage it remains limited. Today, I have the opportunity to speak with one of the world's leading experts on sleep disorders, Dr. Brandon Peters-Mathews, about the latest issue of Continuum on Neurology of Sleep.  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 Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Dr. Brandon Peters-Mathews about his article on insomnia. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Welcome to the podcast, and please introduce yourself to our audience.  Dr Peters-Mathews: It's my pleasure to join you, and I'm happy to talk about this article. I think it's an interesting one for most folks. I am a board-certified sleep neurologist. I practice at Virginia Mason Franciscan Health in Seattle. I did my neurology training back at the University of Minnesota and my sleep training at Stanford University. I've been in practice for more than thirteen years at this point. It's hard to believe, but it's exciting to be able to speak with you today.  Dr Grouse: This is definitely an important topic for everybody. Certainly, sleep and the lack of it affects all of our patients, and I can't imagine there's a single clinical neurologist who doesn't have to answer questions and help evaluate patients with this problem, so very high-yield topic for everyone. Now, having read your article, I'm curious if you had to choose one key point that you want the readers of your article to take away after reading it, what would it be?  Dr Peters-Mathews: Emphasize for my patients that insomnia is a condition that we can work through and resolve, that if we really can understand the underlying contributing causes and resolve those issues, we can typically improve sleep. It's a process. It takes time. It takes some attention and, and sometimes even testing to figure out what's going on. But if we can dial into these root causes, we can typically help somebody to sleep much better. As part of that, we often employ a therapy called CBT-I, which we'll talk about here a little bit later. But that also helps us to identify some of these contributing factors that are leading to the poor sleep.  Dr Grouse: And I definitely want to talk more about CBT, it's such an important topic. But even before we get into that, I'd love it if you could just walk us through a hypothetical case of a patient with insomnia. I think the type of patient that I think we've all seen in our clinical practice and somebody who says, "You know, I've had poor sleep. I've had insomnia for many years. I've tried all of the things you're supposed to try. You know, I've tried sleep hygiene. I've tried this. I've tried that. I've tried medications. Nothing seems to work." Could you walk us through how you would evaluate a patient like this and start to consider what to recommend? Dr Peters-Mathews: So, some simple information that we can gather, would be information about when they're trying to go to bed, how long it's taking them to fall asleep initially. If they wake in the night and have trouble getting back to sleep, how often they wake in the night. If they're experiencing early morning awakenings, their final wake time, and when they actually get out of bed in the morning. That gives me a sense of the structure of their sleep pattern and whether or not they might be spending an excessive amount of time in bed for their own sleep need at their current age. The other factors that we might consider are sleep disorders, and typically, I would assess for other symptoms that would point me towards sleep apnea or restless legs and occasionally other disorders of sleep. We wanna make sure we're not missing comorbid conditions that might be affecting that person. These often include mood disorders. Sleep and mood walk hand in hand, and so anxiety and depression are important to identify and treat if present. We also want to make sure someone's not suffering from chronic pain or other conditions that might be impacting their sleep. So, I take a broad approach. I ask the same questions to each patient that comes to see me. I wanna make sure I'm not missing some of these details. And then some of these folks will require testing to further understand their sleep. Others may move on to a different therapy, and long-term may require even other interventions, including medications, to fully resolve their condition.  Dr Grouse: You mentioned in your article circadian rhythm sleep disorders. How often are these really a factor in patients with chronic insomnia? And do you think that's something that we as kind of first-line clinicians should be screening for as well?  Dr Peters-Mathews: So delayed sleep phase syndrome is the most common circadian disorder, and these are folks who are night owls by nature. They often develop their sleep patterns, as teenagers, if not before, and they may fade away in the working years but come back in retirement age. I would say that's a very common condition. It may affect as many as one in ten people. The other circadian disorders are pretty uncommon, so advanced sleep phase syndrome, where somebody is sleepy early and waking too early, that may only affect one in three hundred people. There are other conditions that affect specific populations, like non-twenty-four circadian pattern affects blind people. Typically, half of blind people have that condition. There are conditions that affect the regularity of sleep, so an irregular sleep-wake pattern that might occur more in folks with maybe an advanced dementia. So, there are populations where these conditions can be fairly common, but among the general population, that night owl tendency is by far the most common.  Dr Grouse: That's really helpful. And just taking a step back, why is insomnia bad for us? So, we worry about this in our patients. We know it can make neurologic issues worse. But in general, like, what are the reasons that having poor sleep can affect our health? Dr Peters-Mathews: Yeah, and it's not enough hours, certainly quantity, but also quality of sleep that matters. And I tell people that sleep is a pillar of health, just like nutrition and exercise. It's the other main contributor to our health and well-being. And so, it has its fingers in almost every aspect of our health. Insomnia on its own is a risk factor for other psychiatric conditions, including depression, anxiety, even disorders like bipolar and schizophrenia. Folks with insomnia are more likely to have alcohol or drug abuse issues and are at higher risk for things like chronic pain, suicide and, and social and occupational dysfunction. So, it's a disorder that has a really profound effect on how someone functions during the day, and again, may take a toll on their health over time.  Dr Grouse: That makes sense, and I would assume that there are certain populations within our neurology practices where we should really be attuned to the risk of insomnia. Are there specific populations you'd recommend really make it a habit of screening for insomnia?  Dr Peters-Mathews: I was joking with someone recently that anyone with a neurological nervous system can have issues, impacted by poor sleep. There are certain groups, so chronic headache patients are perhaps one that might warrant a further evaluation and management. Folks with multiple sclerosis or Parkinson's may have physical conditions that lead to more discomfort in sleep, fewer movements of their body in sleep, issues around nocturia that would disturb their sleep. Certainly, those with dementia, Alzheimer's disease and other dementias. Parkinson's and Lewy body dementia overlap a lot, as does multiple system atrophy. That can point us towards other conditions like REM sleep behavior disorder, but also insomnia can be an important feature of those disorders as well. And then folks with stroke often have disturbance to their sleep and may develop insomnia after experiencing a stroke. So those are specific populations where I think the yield is high to be looking for insomnia and other sleep disorders.  Dr Grouse: Yeah, that makes sense. I think a lot of us think of insomnia as almost like, make sure we're not missing this as sort of a mimic of the problem, when in fact it's probably just more part and parcel of the problem and something we need to be thinking about treating as part of their disorder. So helpful to think about it in that light, at least in my own mind. Now, I want to get a little bit back to some of the therapies you've recommended, and I think first just stopping again at sleep hygiene. Your article has a really great list, I think, of sort of like a checklist of actions that people should be taking to make sure that they are managing their sleep hygiene well. And I definitely recommend our listeners look to that. How often do you think that focusing on sleep hygiene helps when you get a patient who says, "Hey, I have got terrible sleep. You know, what do I do?"  Dr Peters-Mathews: It's pretty common for people to have access to this information through their own reading online, and most folks have worked through this by the time they've come to see me, and often a primary care provider or specialist may have given some of this guidance as well. It's pretty rare for them to not recognize something as obvious as having caffeine too late in the day by the time they're coming to my attention. The sleep hygiene generally is used as a control when we do research to look at how something like medication is working or CBT-I might be working. It's the comparative control. It's almost like the null intervention. So, it's not highly effective, and if folks are not finding it helpful, they've made those adjustments to their sleep environment or their habits, and they're continuing to have issues, there's typically more that needs to be done, and that's where CBT-I really comes in as a strong intervention for those people.  Dr Grouse: And then getting on the topic of CBT-I, so helpful. I'm really glad that your article spent a lot of time talking about it as really a truly high-yield, great intervention for insomnia. And I really felt that the question shouldn't be: When is cognitive behavior therapy for insomnia helpful? But like, when isn't it helpful? What are your thoughts about that?  Dr Peters-Mathews: Yeah. I always point out that the American College of Physicians has recommended CBT-I for adult patients as the initial treatment for chronic insomnia even before the use of a medication for nearly ten years. That recommendation came out in July of 2016. So, there are folks who may not be good candidates for it, who may be screened out because of other conditions that they have, and there certainly are folks who don't do as well with CBT-I. And adherence is important. Somebody needs to be able to follow the instructions and apply that to their lives. And certainly, there are a number of things that could interfere with that compliance. I would say untreated anxiety and pain are two things that often trip people up. It's like running a race with a broken leg. Despite their best efforts, if those are not addressed, they will continue to have issues around insomnia. And then one thing that often is unrecognized and may be missed is untreated sleep apnea. That is a common contributor to a chronic insomnia, especially in older folks, women beyond the age of menopause and men even starting in middle age, thirties and forties. We don't want to miss sleep apnea. Even insomnia that's, "I can't fall asleep at the beginning of night," that could still be sleep apnea, so that's something I really emphasize with my patients.  Dr Grouse: Really great reminder about sleep apnea for sure. Something that always is beneficial to make sure we are not missing. Oftentimes I'll bring up a CBT for insomnia, and what is that? Like, what would we actually do, and what is a high-level overview of what happens with CBT-I?  Dr Peters-Mathews: Yeah. So, I generally tell my patients that this is a six-week program. It's a structured program, almost like a boot camp for sleep, in which we are addressing underlying causes, recognizing what those are and, and working through those underlying causes. There is often tracking using a sleep log or sometimes wearable data.To guide decisions that are made in the program. It's very goal-directed, science-based therapy. We often introduce concepts around sleep drive, circadian rhythm dealing with a busy mind at night. There's concepts of mindfulness and relaxation training that are introduced. People often are able to taper or stop using sleeping pills as part of this therapy. And the nice thing is they walk away with a set of skills that they can apply the rest of their lives to sleep more normally. And so, there's good research that suggests even years after someone's completed a CBT-I course, they continue to sleep more normally. They have the tools that they need to sleep better even years beyond that education.  Dr Grouse: You know, this just sounds so great. It almost sounds like why wouldn't someone benefit from this? But of course, like I would imagine many institutions experience, I've definitely run into difficulties with access for my patients for CBT-I, and we have long wait lists. And I imagine there's many places where there just aren't even any specialists that patients can get to, to help with this. What are the resources that our listeners can take advantage of for their patients to get access to these types of therapies?  Dr Peters-Mathews: So, one thing I tried to really emphasize in the article is that there are resources that can be drawn in. I'll give you some examples. So, at our institution, we have three sleep specialists, full-time sleep specialists, who trained at Stanford to become CBT-I specialists, and so we have more resources than probably most institutions would have. We do shared medical appointment workshops so that we can manage the number of patients that we have to see. And, and unfortunately, not everybody has that opportunity. You might plug into resources in your community, and one of the resources I point to in the article is the International Directory that's managed by the University of Pennsylvania that has eight hundred and seventy-five CBT-I specialists listed with contact information, et cetera. And I think that's an amazing opportunity to access this therapy. Unfortunately, there are countries and certainly states that do not have a specialist, that there's no one in the state that provides this therapy. And then we need to extend other resources, and that could be online treatment programs that can be done independently, bibliotherapy, so accessing books that could guide people through the therapy, even accessing other apps and maybe even wearables that pair with an app that could provide some of this guidance. The Veterans Administration worked with Stanford and worked with the National Center for PTSD and developed an app called CBT-I Coach that is free and can be downloaded and, and gives, I think, good education, good guidance. So, there are resources that exist. It's somewhat finding what might work for your individual patient, how they're preferring to access this or their learning preferences. Do they want to read a book or not? And getting them into the right pathway.  Dr Grouse: And I think that gets me into a whole other Pandora's box of the fact that they're already out there in the world are tons of different apps, wearable devices, all sorts of things that promise that they can help us with sleep, some that may have more, I think, data and evidence behind them than others. Do any of these apps or wearables in your mind show promise in our patients helping our patients track and diagnose and manage their insomnia?  Dr Peters-Mathews: Yeah, there's a lot out there, and unfortunately, some of these devices actually can make sleep worse. People can develop a condition called orthosomnia or straight sleep, where they're trying to perfect their sleep and their sleep numbers, their metrics, and the wearables feeding them data that they continue to try to improve upon. And that fixation on those metrics can actually make their sleep quite a bit worse. A lot of these wearables and apps and other resources have not been well-studied. There's not research trials showing outcomes comparing to other standards of care. I would say the basic guidance of CBT-I, which many of these programs are based on, I think will be helpful to the majority of folks who are able to engage and complete that education. A lot of these are not dependent on that sort of framework or structure so that we may not actually be using the standards of CBT-I to try to improve sleep. They may be connecting you with other resources, like listen to this sleep story or this relaxation file or do some meditation, et cetera, which again, may be of some benefit, but it is not the same as a structured CBT-I experience. So, I think there are a few good resources that we highlight within the article, and I think there are probably others coming that may give individuals a more individualized, directed approach to managing their sleep issues. But it's almost like going to the App Store and there's thousands of apps. It's hard to know which one might be most based on science or the most beneficial to that individual.  Dr Grouse: Well, I really appreciate in your article that you did have a great list of apps and things along those lines to try, so I do encourage our listeners to check that out as well. Some really, really great resources there in the article in many different areas. Now, I wanted to turn the conversation to a slightly different thing, which is medications for insomnia. Now, when are medications appropriate for treating insomnia? When should we be thinking about turning to these for our patients?  Dr Peters-Mathews: So again, we would suggest that CBT-I would be first, and that failing improvement with CBT-I, that medications would be extended to a person affected by insomnia. And over-the-counter options as well as prescription medications might be used. Unfortunately, that's not how things unfold in the real world. Many people are jumping to medications first, whether that be an over-the-counter supplement or other medication, or they're seeing primary care and other specialists who's providing them a prescription for sleep aid. So there's data from the CDC going back to twenty twenty that suggests that about six point three percent of adults were taking a sleeping medication every day in the months prior to the survey. And women who were older than sixty five, white women, were more likely to be using a sleeping medication every day. That number was 13.5 percent of those surveyed. So, lots of folks are on medications, and certainly melatonin is widely used. Unfortunately, it's not regulated by the FDA in a sense that we don't have exact concentrations controlled. So, people can take melatonin that has no melatonin in it. They might take melatonin that's forty or more times the dose. There's variance within lots from the same manufacturer. There's a lot of trouble knowing exactly what you're getting when you try to take something like melatonin over the counter. Other sleep aids that we might reach to over the counter, like variants of diphenhydramine or doxylamine, and these are often the PM drugs that we think about. They have risks associated with population-based studies which suggest risk of dementia, risk of falling, risk of mortality with these drugs, especially in older populations. So again, that would give us potentially pause. The prescription medications that we go to, there are some that the American Academy of Sleep Medicine would recommend as more beneficial than harmful, and some are good for both initiating and maintaining sleep. Some have such a short half-life that they're really best as initiation drugs. And then others are better for maintenance of sleep, so reducing awakenings and wakefulness in the night. My own individual take, often people are coming to me on medications, typically over the counter, but often prescriptions, and have even tried and failed many of those medications before they finally come to see a specialist. And so, I don't often reach to medications until I've exhausted CBT-I, until we've completed a sleep test to make sure we're not missing something like sleep apnea, until we've ruled out some other potential contributing causes. But there are patients I have who really will not sleep without medication support and sometimes even multiple medications that work in complementary ways to try to normalize their sleep. And so, in some cases it is necessary, but it is not meant to be a first line for anyone.  Dr Grouse: Yeah, and I think all of our listeners can relate to the fact that we often see patients who've been on sleep medicines for many, many years and take them every night. It's good to know that there is sort of a procedure here to consider and perhaps again, back to the plug to CBT-I as being the right starting point to see if there's some that we can help get off of these meds, although, as you mentioned, maybe not always going to be successful. Well, I really appreciate our conversation about this. It's been really great to read this article about insomnia. Again, I encourage our listeners to check it out. Some really great resources for many different therapies, thinking about other alternative diagnoses and different medical conditions where insomnia really needs to be considered. And I really appreciate you writing this article. It's been a pleasure to talk with you today.  Dr Peters-Mathews: It's my pleasure to share this information with folks, and I hope that you find it useful in your clinical practice or even your personal life as the need arises.  Dr Grouse: Again today, I've been interviewing Dr. Brandon Peters-Mathews about his article on insomnia. 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 for joining today.  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. 

Send us Fan Mail In this episode of Your Child Is Normal, Dr. Jessica Hochman talks with pediatric sleep specialist Dr. Bhattacharjee, who leads the sleep program at Rady Children's Hospital, about why sleep is so important for children's physical health, mood, learning, attention, and athletic performance.They discuss why teenagers naturally want to stay up later, how early school schedules work against adolescent biology, and what parents can realistically do to help. Dr. Bhattacharjee shares practical advice about screens, phones in the bedroom, caffeine, weekend sleep schedules, bedtime routines, and figuring out how much sleep your individual child actually needs.They also discuss the connection between sleep deprivation and ADHD-like symptoms, whether sleep helps children grow, melatonin and other sleep aids, when excessive sleepiness deserves medical attention, and why consistency may be one of the most underrated sleep strategies.Learn more about Dr. Bhattacharjee: Dr. Bhattacharjee practices at UC San Diego and Rady Children's Hospital in San Diego and is an active member of the American Academy of Sleep Medicine. Make sure and Follow Your Child Is Normal  podcast for practical, evidence-based conversations designed to help parents learn more and worry less.Your Child is Normal is the trusted podcast for parents, pediatricians, and child health experts who want smart, nuanced conversations about raising healthy, resilient kids. Hosted by Dr. Jessica Hochman — a board-certified practicing pediatrician — the show combines evidence-based medicine, expert interviews, and real-world parenting advice to help listeners navigate everything from sleep struggles to mental health, nutrition, screen time, and more. Follow Dr Jessica Hochman:Instagram: @AskDrJessica and Tiktok @askdrjessicaYouTube: Ask Dr JessicaShop my favorite products for kids on Amazon hereIf you are interested in placing an ad on Your Child Is Normal click here or fill out our interest form.To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA The information presented in Ask Dr Jessica is for general educational purposes only.  She does not diagnose medical conditions or formulate treatment plans for specific individuals.  If you have a concern about your child's health, be sure to call your child's health care provider.

Kathryn Nicolai is the creator and host of Nothing Much Happens, one of the most listened-to sleep podcasts in the world, where millions of listeners use her stories to calm anxiety, fall asleep, and feel more at ease in their bodies. With over 20 years of experience as a yoga and meditation teacher, Kathryn is a trusted voice in self-care, with a focus on sleep hygiene, nervous system regulation, mindfulness, and storytelling as medicine. She draws on lived experience and practices including Vipassana meditation, gentle movement, brain training, and bibliotherapy to support people navigating stress, anxiety, depression, and more. Through her work, Kathryn helps people cultivate rest, creativity, and emotional resilience in a culture shaped by overstimulation and burnout. Her new audio book, On The Street Where You Live, also comes out in July 2026. In this episode, Kathryn Nicolai breaks down why storytelling calms the anxious brain, how repetition helps you fall asleep, and why joy—not discipline—is the real key to lasting wellness.   RESOURCES: Learn more about Kathryn, her podcast, app and book here: https://www.nothingmuchhappens.com/ Instagram: @nothingmuchhappens Get 10% off Peluva minimalist shoe with coupon code COACHTARA here: http://peluva.com/coachtara   CHAPTERS: 00:00 – Intro: meet Kathryn Nicolai 01:32 – Sponsor: Peluva Shoes ad 03:19 – Interview begins: 200 million downloads 05:11 – Storytelling and the sleeping brain 08:06 – Coqui frogs, Hawaii, and finding your own sound 09:40 – There's no one "right" way to sleep 11:09 – Falling asleep vs. staying asleep 13:45 – Brain dumps, tension release, and medical help 15:54 – Meditation, impulsivity, and Vipassana 17:51 – Neurodivergence, discipline, and choosing joy 21:59 – Eating disorders and food freedom 23:28 – Terra's coaching, app, and retreats 28:16 – Turning bedtime into a ritual, not a chore 30:23 – Soft spaces over rigid sleep rules 32:16 – Morning rituals and the "witching hour" 33:38 – Sleep is brain training: give it time 35:19 – Inside Nothing Much Happens' story structure 38:04 – Origin story: from Flint, Michigan to 200M downloads 40:18 – Healing fiction, gratitude, and negativity bias    WORK WITH TARA: Are You Looking for Help on Your Wellness Journey? Here's how Tara can help you: TRY TARA'S APP FOR FREE: http://taragarrison.com/app INDIVIDUAL ONLINE COACHING: https://www.taragarrison.com/work-with-me CHECK OUT HIGHER RETREATS: https://www.taragarrison.com/retreats   SOCIAL MEDIA:  Instagram @coachtaragarrison TikTok @coachtaragarrison Facebook @coachtaragarrison Pinterest @coachtaragarrison   INSIDE OUT HEALTH PODCAST SPECIAL OFFERS: ☑️ Upgraded Formulas Hair Test Kit Special Offer: https://bit.ly/3YdMn4Z ☑️ Upgraded Formulas - Get 15% OFF Everything with Coupon Code INSIDEOUT15: https://upgradedformulas.com/INSIDEOUT15 ☑️ Rep Provisions: Vote for the future of food with your dollar! And enjoy a 15% discount while you're at it with Coupon Code COACHTARA: https://bit.ly/3dD4ZSv   If you loved this episode, please leave a review! Here's how to do it on Apple Podcasts: Go to Inside Out Health Podcast page: https://podcasts.apple.com/us/podcast/inside-out-health-with-coach-tara-garrison/id1468368093 Scroll down to the 'Ratings & Reviews' section. Tap 'Write a Review' (you may be prompted to log in with your Apple ID). Thank you!

In this episode, Charles Powell, MD, MBA, Chief Executive Officer, Mount Sinai Respiratory Institute; Regional Medical Director, Mount Sinai Hospital Doctors Faculty Practice; System Division Chief, Pulmonary, Critical Care and Sleep Medicine, Mount Sinai Health System, discusses advances in respiratory care, lung cancer risks linked to air pollution, AI in clinical practice, and emerging approaches to preventing chronic disease.

Do you struggle to get good sleep? The reason you're exhausted, waking up at 3 a.m., or struggling to feel like yourself might surprise you. And likely has to do with sneaky and quietly disruptive sleep habits. In this episode of the HEAL with Kelly Podcast, I sit down with world renowned sleep expert Dr. Michael Breus, PhD, a double board-certified Clinical Psychologist and Clinical Sleep Specialist known as The Sleep Doctor. After nearly 25 years in the field, he has a refreshingly simple message: we may be making wellness — and sleep — far more complicated than it needs to be. There is a ton of information jam packed in this episode. We explore the fascinating science of our individual sleep chronotypes (I'm a Lion, what are you?!) and how understanding your body's natural rhythm could change the way you approach not only sleep, but your entire day. Dr. Breus shares some surprisingly simple sleep tips that challenge many of the things we've been taught about getting a good night's rest. We tackle some of the biggest questions around sleep — from those frustrating middle-of-the-night wake-ups, to menopause, sleep apnea, melatonin, sleep trackers, caffeine, alcohol, and the everyday habits that may be affecting us more than we realize. And we go beyond sleep itself, exploring the fascinating world of dreams, the connection between sleep and emotional healing, and why the timing of everything from your morning routine to intimacy may matter more than you think. This conversation made me look at sleep in an entirely new way. Rather than chasing the perfect nighttime routine, what if better sleep actually begins with what you do the moment you wake up? If you're ready to understand your sleep differently and discover simple ways to feel more rested and energized, this episode is for you. Key Moments You'll Love ✨ : ⏰ [0:30] Wake Up at the Same Time Every Day — Here's the Biology

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. 

Every night, while you're asleep, your brain runs a cleaning cycle that clears out the kind of toxic buildup linked to Alzheimer's and dementia. And, with age, most of us sleep less. We are shortchanging the benefits without ever realizing how much control we actually have over sleeping longer, and better.Dr. Rebecca Robbins is an Assistant Professor in Sleep Medicine at Harvard Medical School and an Associate Sleep Scientist at Brigham and Women's Hospital, where her research spans sleep's relationship to cognitive function, cardiometabolic health, and long-term brain health. She's published more than 100 peer-reviewed studies, co-authored Sleep for Success!, and her work is exactly the kind of research most of us never hear about until someone frames it the way she does here.In this conversation, you'll explore:Why sleep really does shift around age 38 to 40, and what that shift does and doesn't mean for youThe neuroscience discovery of the brain's overnight "wash cycle," and what Dr. Robbins's own eight-year study found about sleep complaints and dementia riskWhy jumping your bedtime back an hour almost never works, and the fifteen-minute method that doesThe at-home test Jonathan didn't realize he'd already run on himselfThe "sleep divorce" reframe one of Dr. Robbins's patients calls a "sleep marriage," and what it means for couplesIf you've quietly decided your sleep is just what it is at this stage of life, this conversation will change what you think is actually possible tonight.You can find Rebecca at: Website | Instagram | Episode TranscriptNext week, we're sitting down with Tommy Wood to talk about what the research actually shows about keeping your brain sharp across decades, including which levers matter most, what's mostly noise, and what you can realistically start tomorrow, whether you're 45 or 65. Be sure to follow Good Life Project wherever you get your podcasts so you don't miss any upcoming episodes!Check out our sponsors and resources: Visit Our Sponsor Page Hosted on Acast. See acast.com/privacy for more information.

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.  

In this eye-opening episode of Something Bigger With Rodrigo Canelas, we sit down with Dr. Manvir Bhatia, Senior Neurologist and Sleep Specialist with over 40 years of clinical experience, Director of the Neurology and Sleep Centre in Hauz Khas, New Delhi, and a specialist affiliated with the Department of Sleep Medicine at Max Hospital. Together, we explore one of the most overlooked aspects of modern life: sleep. This conversation will make you rethink the hours you spend, or fail to spend, asleep and how they impact your brain, body, and long-term health. Most people think of sleep as a passive afterthought, something you catch up on over the weekend, or trade away for one more hour of productivity. Dr. Bhatia dismantles that idea with numbers that are hard to ignore: 1 billion people worldwide have sleep apnea, and roughly 100 million of them are in India alone, with up to 50 million classified as moderate to severe. She reveals a phenomenon she now sees daily in patients in their late 30s and early 40s: a hyper-aroused, "tired but wired" brain that simply won't shut off at night, driven by always-on phones, stretched-out work hours, and a nervous system stuck permanently in fight-or-flight. The consequences aren't cosmetic. Poor sleep is now linked to high blood pressure that resists medication, pre-diabetes, atrial fibrillation, weight gain driven by disrupted hunger hormones, worsening depression, and even a measurable rise in the amyloid proteins associated with Alzheimer's disease because, as she explains, your brain has its own overnight cleaning system, and it only turns on when you're properly asleep.She introduces circadian biology and the real reason your body clock gets desynchronized: cortisol pushed late into the night by screens and stress, and melatonin suppressed by artificial light, leaving people wide awake at 2 or 3 a.m. even when they're "getting their eight hours." She reveals a strikingly simple, science-backed fix: morning sunlight is more effective at protecting your night's sleep than any blue-light blocking glasses. She breaks down why coffee's half-life means your 4 p.m. cup is still active in your bloodstream past midnight, why wearable sleep trackers are only reliably accurate for onset and wake times (and can be 10–15% off on deeper metrics), and why some of her most difficult patients are the ones who've simply normalized feeling exhausted for so long they no longer believe better is possible. She also shares a case of a man whose entire personality irritability, social withdrawal, rising blood pressure reversed within eight weeks, without medication, simply by fixing his sleep schedule.This conversation isn't just about sleep. It's about the foundation underneath every other goal you're chasing: your focus, your patience with the people you love, your metabolic health, your risk of disease decades from now. Before you reach for another cup of coffee to survive the afternoon, ask yourself: is the problem your schedule, or is it your sleep?Time Stamps:(3:35) – The Wearable Device That Shocked Her Into Action(4:33) – The Hidden Signs You're Sleep Deprived Without Knowing It(7:51) – What Really Worries Her About This New Generation of Sleepers(11:49) – The Slippery Slope From "Just One Pill" to a Dangerous Cycle(13:18) – The Startling Link Between Sleep Medication and Dementia(20:44) – How Many Hours of Sleep Do You Actually Need?(23:36) – Why Some People Have Secretly Normalized Feeling Exhausted(26:30) – Why Your 4 P.M. Coffee Is Still in Your System at Midnight(28:27) – Are Sleep Trackers Actually Accurate? The Surprising Answer(42:15) – The Overlap Between Depression and Sleep Apnea Almost Nobody Catches(45:08) – The 5 Questions Every Doctor Should Ask About Your Sleep(45:38) – What Actually Causes Snoring (And Why It's Not Always Weight)(51:42) – Why Room Temperature and Darkness Matter More Than You Think(54:34) – Her Final Message: Stop Taking Sleep for Granted

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.  

Ten million prescriptions a year, and most of them aren't for what the drug was built to treat. Seroquel started life as an antipsychotic — engineered to quiet psychosis, not close your eyes. Somewhere along the way it became one of the most common "off the record" sleep aids in America, riding on a side effect nobody set out to sell. The evidence behind that shift is thinner than most people assume — and Seroquel isn't the only drug doing this. In this episode we will:Trace quetiapine from its 1997 approval for schizophrenia through its quiet migration onto millions of nightstands, and unpack the receptor science that explains why a psychosis drug puts you to sleep at allSpotlight the actual clinical trials behind quetiapine-for-insomnia — including the 13-patient study nearly the entire off-label practice rests on — and the newer data linking it to cardiovascular events, dementia, and fallsBreak down what the American Academy of Sleep Medicine's guideline really says about quetiapine (it's not what most people assume), and why that gap in the data is its own kind of red flagDraw the parallel to trazodone — a different drug, a different original disease, and somehow the exact same storyTo find out more about this week's podcast sponsor Sleep Reset, please use the following link: http://thesleepreset.com/podcast Audio Engineer: Bradley Bransly BarkerOriginal intro music Vigilanteology by Abhinav Singh (copyright 2026) Original outro music Vigilanteology (reprise) by Abhinav Singh (copyright 2026)Produced by: Maeve WinterMusic by: Dr. Abhinav Singh (@sleep_vigilante), all rights reservedMoreTwitter: @drchriswinterIG: @drchriwinterThreads: @drchriswinterBluesky: @drchriswinterThe Sleep Solution and The Rested ChildThanks for listening and sleep well!

Dr. Saema Tahir is a quadruple board-certified physician specializing in Pulmonary Disease, Critical Care Medicine, and Sleep Medicine in New York City. She completed her medical training at Ross University School of Medicine, followed by residency at Case Western Reserve University and fellowships in Sleep Medicine at Temple University Hospital and Pulmonary and Critical Care Medicine at Drexel University Hahnemann Medical Center. Known for her patient-centered and holistic approach, Dr. Tahir focuses on building trust through personalized care that considers each patient's physical, social, and psychological well-being. After serving on the front lines in New York City intensive care units during the COVID-19 pandemic, she returned to her passion for sleep and pulmonary medicine. Outside of medicine, she enjoys traveling with her husband and two children and staying active through fitness, including spinning, Lagree, and Pilates. SHOWNOTES: ( 10-12 points)

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Laura Donahue, an assistant professor of sleep medicine at Vanderbilt University with a background in internal medicine and a researcher in sustainable healthcare, to discuss the environmental impact of sleep medicine practice and practical strategies for reducing carbon footprint and medical waste. Recent environmental challenges—heat waves exacerbating insomnia, wildfires affecting respiratory and sleep health—highlight how climate directly impacts patient wellbeing. But do sleep medicine clinicians have an obligation to reduce their own environmental footprint? Dr. Donahue explores this question, examining the waste generated by sleep testing, PAP therapy, and ongoing supplies. The conversation begins with foundational concepts: How does climate change impact sleep health? What exactly constitutes medical waste, and how does it differ from carbon footprint? Dr. Donahue explains methods for calculating carbon footprint and how the US healthcare system compares globally. She introduces life cycle analysis—a comprehensive tool for understanding environmental impact across product lifecycles. Sleep lab waste assessments receive detailed attention. Dr. Donahue walks through how to conduct a waste audit of sleep facilities and why examining both carbon footprint and waste matters, acknowledging that these metrics don't always move directionally. Her research on PAP device waste, conducted with Dr. Morgenthaler, revealed substantial environmental costs associated with standard OSA therapy—findings that prompted examination of alternatives. Telemedicine emerges as a potential sustainability strategy. Dr. Donahue compares carbon footprints of virtual versus in-person sleep consultations, exploring how practice model choices affect environmental impact. However, the analysis doesn't focus solely on PAP therapy—hypoglossal nerve stimulators and other non-PAP treatment options receive consideration as alternatives with potentially different environmental profiles. SHAPE, an organization dedicated to helping healthcare providers examine their carbon footprint and waste generation, receives discussion. Dr. Donahue explains SHAPE's mission and practical resources available to sleep medicine programs. She provides concrete guidance on reducing environmental impact: waste audits, supply chain evaluation, and transitioning to circular economy models where possible. A particularly relevant discussion addresses plastic waste from CPAP devices and consumable supplies. Dr. Donahue explains how waste audits serve as the first step toward identifying reduction opportunities and discusses strategies for minimizing single-use plastics in sleep medicine practice. The episode acknowledges that sustainability requires institutional commitment and individual awareness. Dr. Donahue emphasizes that small changes—from supply selection to practice model design—accumulate to meaningful environmental impact. Whether you're interested in sustainable healthcare, concerned about medical waste, seeking to reduce your sleep practice's carbon footprint, or wanting to better understand climate impacts on sleep health, this episode provides practical guidance and evidence-based approaches. Join us for this important conversation about environmental responsibility in sleep medicine practice.

In this episode from January 2026, Ian Sample puts listeners' questions about dreams and nightmares to Dr Michelle Carr, the director of the Dream Engineering Laboratory in Montreal's Centre for Advanced Research in Sleep Medicine, and the author of the book Into the Dream Lab. They look at why we dream, what we can learn by examining our dreams, and what we can do when dreams turn into nightmares. Carr gives her top tips for taking charge of our dreams and trying to influence their content. Help support our independent journalism at theguardian.com/sciencepod

Roger Seheult, MD of MedCram explains the ways permanent daylight saving time would affect health. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on July 18th, 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.

Permanent Daylight Saving Time MUST BE STOPPED! Improvement Warrior Podcast Episode #90Hey Improvement Warriors, Jason Yun here — welcome back to the Improvement Warrior Podcast, Episode 90. I'm a former gym owner and food-and-exercise guy who finally saw the light (literally). Since 2018 I've been deep in the teachings of Dr. Jack Kruse and circadian biology. My core message never changes: your light environment is more important than food or exercise. In this episode we're tackling something urgent and timely — the push for Permanent Daylight Saving Time. Politicians are once again trying to lock us into dark winter mornings forever. I'll break down exactly why this is a biological disaster, how it wrecks your mitochondria, sleep, hormones, and energy, and what we must do to stop it. Grab your blue blockers, get some real sunlight if you can, and let's go. Time Stamp and Highlights of the show0:00 – 4:30 – Cold open & welcome. Jason introduces Episode 90 and the core thesis: Permanent Daylight Saving Time must be stopped. 4:30 – 12:00 – Quick recap of past DST episodes (especially Episode 82 “Daylight Saving Time Sucks”) and why the current political push (Sunshine Protection Act) is different and more dangerous. 12:00 – 22:00 – History of DST, energy-saving myths debunked, and the real biological cost of shifting clocks away from solar time. 22:00 – 34:00 – Deep dive into circadian biology: morning sunlight as the master zeitgeber, SCN, melatonin, cortisol, and why late winter sunrises under permanent DST create chronic misalignment (effectively permanent social jet lag). 34:00 – 42:00 – Health consequences: increased accidents, heart attacks, depression, cancer risk gradients across time zones, school performance, and mitochondrial dysfunction. 42:00 – 52:00 – Outdoor sunlight segment (shirtless, grounded). Live demonstration of proper morning light exposure and why dark mornings destroy the signal. 52:00 – 60:00 – Practical action steps: what individuals can do right now, how to contact legislators, better alternative (permanent Standard Time), and tie-in to full circadian lifestyle. Show notes / full page (once live): Previous related episode: Daylight Saving Time Sucks – Episode 82 → Glo-Ojo Blueblockers (use code improvementwarrior)Daylight Computer (use code improvementwarrior)Midwest Light Therapy (use code improvementwarrior)NewsletterPatreon / support: Discovery call: Substack: American Academy of Sleep Medicine position on permanent Standard Time Save Standard Time / anti-permanent-DST advocacy resources Sarah Kleiner's Substack with Script for SenatorsPlanet Mind ControlThat's a wrap on Improvement Warrior Podcast Episode 90. Permanent Daylight Saving Time is not progress — it's a direct attack on your biology. Morning light is non-negotiable. If this hit home, share it with everyone you know, leave a 5-star review on Apple or Spotify (it helps the algorithm and gets you free webinar access — just email me the screenshot), and get on the newsletter at improvementwarriorfitness.com/NL. Your light environment is more important than food or exercise. Keep seeking the real sun, protect your nights, and I'll see you in the next one. Stay an Improvement Warrior. Stay strong, stay positive, be the Improvement Warrior!

Hey there Voices of the Bench community, this is Trish Jones with Ivoclar. If you've been curious about fast-firing zirconia to improve efficiency but aren't convinced it can deliver predictable, high-quality results, I'd encourage you to connect with us. Our new IPS Emax Zirconia offers multiple fast-fire protocols designed to help save you valuable production time while maintaining consistent results. Time is money in every lab. Don't wait. Reach out to your local Ivoclar rep today and discover how IPS Emax Zirconia can help streamline your workflow. As full-arch dentistry continues to grow, so do the demands on today's dental laboratories. That's why Knight Dental recently launched SimplyARCH Studio, a dedicated production environment built exclusively for full-arch restorations. To support this specialized workflow, Knight invested in an XTCERA milling system and carefully evaluated multiple CAM software solutions before choosing hyperDENT. The decision came down to exceptional milling quality, minimal hand finishing, and impressive production efficiency. But what truly set hyperDENT apart was the implementation process. From the very beginning, the team provided more than software training—they shared the knowledge and experience needed to build an optimized workflow for complex full-arch cases. With proven expertise in advanced milling strategies and laboratory production, hyperDENT helped ensure SimplyARCH Studio was designed for long-term success from day one.Matt Everatt joins Elvis and Barb for a fascinating conversation that takes a deep dive into his journey through the dental laboratory industry and the story behind his book, The Invisible Profession. From discovering dental technology at 16 and specializing in maxillofacial prosthetics and orthodontics to working in hospitals, developing early sleep-apnea appliances, and nearly leaving the profession altogether, Matt's career has taken some seriously interesting turns. Eventually, he helped co-found S4S, building a successful business around sleep-apnea appliances, occlusal splints, orthodontics, and more before eventually stepping away from ownership. Matt Everatt joins Elvis and Barb for a fascinating conversation that takes a deep dive into his journey through the dental laboratory industry and the story behind his book, The Invisible Profession. From discovering dental technology at 16 and specializing in maxillofacial prosthetics and orthodontics to working in hospitals, developing early sleep-apnea appliances, and nearly leaving the profession altogether, Matt's career has taken some seriously interesting turns. Eventually, he helped co-found S4S, building a successful business around sleep-apnea appliances, occlusal splints, orthodontics, and more before eventually stepping away from ownership. But this conversation goes far beyond Matt's career. His book, The Invisible Profession, explores how the dental laboratory industry arrived at a place where technicians and laboratories are often undervalued, pushed into price competition, and expected to simply keep their heads down and produce. Matt shares his thoughts on the "million little things" that shaped the industry, the danger of becoming a "busy fool," and why laboratories need to stop competing solely on price and start becoming known for the value, expertise, and partnership they bring to the dental team. Elvis, Barb, and Matt also talk about the changing landscape of digital dentistry, AI, 3D printing, speed, service, and why the labs that embrace change and remain agile will be the ones positioned for the future. It's an honest, thought-provoking, and ultimately optimistic conversation about where the dental laboratory profession has been, where it is today, and where it can go next.Special Guest: Matt Everatt.

Twice every year, Americans change their clocks—but should we?Should the United States eliminate Daylight Saving Time? More importantly, if we do, should we adopt permanent Daylight Saving Time or permanent Standard Time?As Congress debates the Sunshine Protection Act, Karin Johnson, MD discusses the health, safety, and productivity implications of our current system, the scientific evidence behind permanent Standard Time, and what citizens can do if they want to influence future legislation.In this episode of SleepTech Talk, we sit down with Dr. Karin Johnson, one of the nation's leading sleep medicine experts and advocates for permanent Standard Time, to discuss the growing national debate surrounding the Sunshine Protection Act.Dr. Johnson explains the science behind our circadian rhythms, why many sleep medicine organizations support permanent Standard Time instead of permanent Daylight Saving Time, and what everyday citizens can do to make their voices heard.In this episode you'll learn:• The difference between Daylight Saving Time and Standard Time• The pros and cons of ending the twice-yearly clock changes• Why many physicians believe permanent Standard Time is healthier• How time changes affect sleep, productivity, mood, and public safety• Where non-healthcare professionals can learn more• How you can contact your elected officials about the issueDr. Karin Johnson serves as Vice President of Save Standard Time and co-chairs the Coalition for Permanent Standard Time, representing leading medical organizations including the American Academy of Sleep Medicine and the National Sleep Foundation. She has also testified before the U.S. Senate regarding the health implications of permanent Daylight Saving Time.Learn More• https://ditchdst.com/• https://savestandardtime.com/If this conversation was valuable, please consider contacting your U.S. Senator and sharing your thoughts on the future of Daylight Saving Time legislation.

Dr. Davoudian is a board-certified Health psychologist with expertise in reproductive mental health. She provides psychotherapy to patients who are pregnant, postpartum or seeking fertility treatment. Dr. Davoudian also offers psychological consultations for individuals utilizing third-party reproduction as well as assessments of gamete donors and gestational surrogates. Her research interests include psychological aspects of third party reproduction and has served as a principal investigator on a study examining posttraumatic stress among fertility patients. Glorisel González Viera, MD, is double board-certified in Psychiatry and Sleep Medicine by the American Board of Psychiatry and Neurology. She is an Assistant Professor at Baylor College of Medicine in the Departments of Obstetrics & Gynecology and Psychiatry & Behavioral Sciences, where she practices as a Reproductive Psychiatrist at The Women's Place at Texas Children's Hospital Pavilion for Women. Originally from Puerto Rico, she completed her Psychiatry residency at Ponce Health Sciences University, serving as Chief Resident, followed by fellowships in Sleep Medicine at the VA Caribbean Healthcare System and Women's Mental Health at Baylor College of Medicine. Her clinical and research interests center on the intersection of sleep and women's mental health across the reproductive lifespan, with a particular focus on perimenopause and menopause. She also conducts research in reproductive loss and atypical forms of grief. Dr. González Viera is passionate about advancing evidence-based care, educating healthcare professionals, and improving access to specialized mental health care for women.   CONNECT WITH DVORA ENTIN: Website: https://www.dvoraentin.com/ Instagram: https://www.instagram.com/dvoraentin YouTube: https://www.youtube.com/@misconceptionspodcast  

If you enjoy this episode, we're sure you will enjoy more content like this on The Occult Rejects.  In fact, we have curated playlists on occult topics like grimoires, esoteric concepts and phenomena, occult history, analyzing true crime and cults with an occult lens, Para politics, and occultism in music. Whether you enjoy consuming your content visually or via audio, we've got you covered - and it will always be provided free of charge.  So, if you enjoy what we do and want to support our work of providing accessible, free content on various platforms, please consider making a donation to the links provided below.  Thank you and enjoy the episode!Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Substackhttps://substack.com/@theoccultrejects?r=7auau0&utm_campaign=profile&utm_medium=profile-pageCash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsCore Sleep Paralysis ScienceSharpless, Brian A., and Jacques P. Barber. “Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review.” Sleep Medicine Reviews 15, no. 5 (2011): 311–315.Sharpless, Brian A. “A Clinician's Guide to Recurrent Isolated Sleep Paralysis.” Neuropsychiatric Disease and Treatment 12 (2016): 1761–1767.Cheyne, J. Allan, Steve D. Rueffer, and Ian R. Newby-Clark. “Hypnagogic and Hypnopompic Hallucinations during Sleep Paralysis: Neurological and Cultural Construction of the Night-Mare.” Consciousness and Cognition 8, no. 3 (1999): 319–337.Cheyne, J. Allan. “Sleep Paralysis and the Structure of Waking-Nightmare Hallucinations.” Dreaming 13, no. 3 (2003): 163–179.Cheyne, J. Allan. “Situational Factors Affecting Sleep Paralysis and Associated Hallucinations: Position and Timing Effects.” Journal of Sleep Research 11, no. 2 (2002): 169–177.Solomonova, Elizaveta. “Sleep Paralysis: Phenomenology, Neurophysiology and Treatment.” In The Oxford Handbook of Spontaneous Thought: Mind-Wandering, Creativity, and Dreaming, edited by Kieran C. R. Fox and Kalina Christoff. Oxford University Press, 2018.Baland Jalal / Panic-Hallucination / TreatmentJalal, Baland. “How to Make the Ghosts in My Bedroom Disappear? Focused-Attention Meditation Combined with Muscle Relaxation (MR Therapy): A Direct Treatment Intervention for Sleep Paralysis.” Frontiers in Psychology 7 (2016): 28. doi:10.3389/fpsyg.2016.00028.Jalal, Baland, and V. S. Ramachandran. “Sleep Paralysis and ‘The Bedroom Intruder': The Role of the Right Superior Parietal, Phantom Pain and Body Image Projection.” Medical Hypotheses 83, no. 6 (2014): 755–757.Jalal, Baland. “The Neuropharmacology of Sleep Paralysis Hallucinations: Serotonin 2A Activation and a Novel Therapeutic Drug.” Psychopharmacology 235, no. 11 (2018): 3083–3091.Jalal, Baland, Lucia Moruzzi, Andrea Zangrandi, Matteo Filardi, Claudio Franceschini, Fabio Pizza, et al. “Meditation-Relaxation (MR Therapy) for Sleep Paralysis: A Pilot Study in Patients with Narcolepsy.” Frontiers in Neurology 11 (2020): 922. doi:10.3389/fneur.2020.00922.Folklore, Myth, and the Old HagHufford, David J. The Terror That Comes in the Night: An Experience-Centered Study of Supernatural Assault Traditions. Philadelphia: University of Pennsylvania Press, 1982.Hufford, David J. “Sleep Paralysis as Spiritual Experience.” Transcultural Psychiatry 42, no. 1 (2005): 11–45.Adler, Shelley R. Sleep Paralysis: Night-mares, Nocebos, and the Mind-Body Connection. New Brunswick: Rutgers University Press, 2011.Davies, Owen. “The Nightmare Experience, Sleep Paralysis, and Witchcraft Accusations.” Folklore 114, no. 2 (2003): 181–203.Bond, John. An Essay on the Incubus, or Nightmare. London: Printed for D. Wilson and T. Durham, 1753.Golzari, Samad E. J., et al. “Sleep Paralysis in Medieval Persia — The Hidayat of Akhawayni (?–983 AD).” Neuropsychiatric Disease and Treatment 8 (2012): 229–234.Cross-Cultural Sleep ParalysisHinton, Devon E., Vuth Pich, Dara Chhean, and Mark H. Pollack. “‘The Ghost Pushes You Down': Sleep Paralysis-Type Panic Attacks in a Khmer Refugee Population.” Transcultural Psychiatry 42, no. 1 (2005): 46–77.Hinton, Devon E., Vuth Pich, Dara Chhean, Mark H. Pollack, and Richard J. McNally. “Sleep Paralysis among Cambodian Refugees: Association with PTSD Diagnosis and Severity.” Depression and Anxiety 22, no. 2 (2005): 47–51.Jalal, Baland, and Devon E. Hinton. “Rates and Characteristics of Sleep Paralysis in the General Population of Denmark and Egypt.” Culture, Medicine, and Psychiatry 37, no. 3 (2013): 534–548.Jalal, Baland, Joseph Simons-Rudolph, Bamo Jalal, and Devon E. Hinton. “Explanations of Sleep Paralysis among Egyptian College Students and the General Population in Egypt and Denmark.” Transcultural Psychiatry 51, no. 2 (2014): 158–175.Jalal, Baland, Andrea Romanelli, and Devon E. Hinton. “Cultural Explanations of Sleep Paralysis in Italy: The Pandafeche Attack and Associated Supernatural Beliefs.” Culture, Medicine, and Psychiatry 39, no. 4 (2015): 651–664.Olunu, Esther, Ruth Kimo, Esther Olufunmbi Onigbinde, Mary-Amadeus Uduak Akpanobong, and Inyene Ezekiel Enang. “Sleep Paralysis, a Medical Condition with a Diverse Cultural Interpretation.” International Journal of Applied and Basic Medical Research 8, no. 3 (2018): 137–142.Sensed Presence / Body Map / Shadow Person NeuroscienceArzy, Shahar, Margitta Seeck, Stephanie Ortigue, Laurent Spinelli, and Olaf Blanke. “Induction of an Illusory Shadow Person.” Nature 443 (2006): 287.Blanke, Olaf, Stephanie Ortigue, Theodor Landis, and Margitta Seeck. “Stimulating Illusory Own-Body Perceptions.” Nature 419 (2002): 269–270.Blanke, Olaf, Theodor Landis, Laurent Spinelli, and Margitta Seeck. “Out-of-Body Experience and Autoscopy of Neurological Origin.” Brain 127, no. 2 (2004): 243–258.Ionta, Silvio, Lukas Heydrich, Bigna Lenggenhager, Michael Mouthon, Eleonora Fornari, Dominique Chapuis, Roger Gassert, and Olaf Blanke. “Multisensory Mechanisms in Temporo-Parietal Cortex Support Self-Location and First-Person Perspective.” Neuron 70, no. 2 (2011): 363–374.Blanke, Olaf, Polona Pozeg, Masayuki Hara, Lukas Heydrich, Andrea Serino, Akio Yamamoto, Toshiro Higuchi, et al. “Neurological and Robot-Controlled Induction of an Apparition.” Current Biology 24, no. 22 (2014): 2681–2686.Alien Abduction / Modern Mythic MaskMcNally, Richard J., and Susan A. Clancy. “Sleep Paralysis, Sexual Abuse, and Space Alien Abduction.” Transcultural Psychiatry 42, no. 1 (2005): 113–122.Clancy, Susan A. Abducted: How People Come to Believe They Were Kidnapped by Aliens. Cambridge, MA: Harvard University Press, 2005.Blackmore, Susan. “Abduction by Aliens or Sleep Paralysis?” Skeptical Inquirer 22, no. 3 (1998): 23–28.Clinical Sleep / Narcolepsy / REM BackgroundAmerican Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed., text revision. Darien, IL: American Academy of Sleep Medicine, 2023.Scammell, Thomas E. “Narcolepsy.” New England Journal of Medicine 373, no. 27 (2015): 2654–2662.Saper, Clifford B., Patrick M. Fuller, Nigel P. Pedersen, Jun Lu, and Thomas E. Scammell. “Sleep State Switching.” Neuron 68, no. 6 (2010): 1023–1042.Brooks, Patricia L., and John H. Peever. “Identification of the Transmitter and Receptor Mechanisms Responsible for REM Sleep Paralysis.” Journal of Neuroscience 32, no. 29 (2012): 9785–9795.Avidan, Alon Y., and Phyllis C. Zee, eds. Handbook of Sleep Medicine. Philadelphia: Lippincott Williams & Wilkins, 2011.Visual / Art HistoryFuseli, Henry. The Nightmare. 1781. Oil on canvas. Detroit Institute of Arts.Myrone, Martin. Gothic Nightmares: Fuseli, Blake and the Romantic Imagination. London: Tate Publishing, 2006.Powell, Nicolas. Fuseli: The Nightmare. London: Allen Lane, 1973.Also want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. 

Donate to the Institute: https://givenow.nova.edu/donations-for-me-cfs-research-2026  In today's episode, Haylie Pomroy sits down with Dr. Jaime Tartar, Professor and Chair of the Department of Psychology and Neuroscience at Nova Southeastern University, to reframe everything you think you know about stress and give you the science-backed tools to actually manage it. Dr. Tartar explains the biological difference between acute stress, chronic stress, and eustress, why worry is a physiological state that releases cortisol, and how perception is the single most powerful variable in whether stress helps or harms you. She walks through the neuroscience of cognitive reframing, the measurable brain benefits of gratitude, and the two-phase sleep cycle that determines how well you process emotions and recover from the day before.  She also covers screen time, electronic boundaries, the physiological impact of nature and movement on the stress response, and practical strategies for helping children navigate catastrophic thinking. For anyone navigating chronic illness, autoimmune conditions, long COVID, or ME/CFS, watch this episode of the Hope and Help For Fatigue and Chronic Illness podcast.     Jaime Tartar is a Professor of Neuroscience at Nova Southeastern University. She earned her Ph.D. in the Behavioral Neuroscience program at the University of Florida, where the focus of her research involved discovering long-term changes that occur in neurobiological pathways involved in stress responses and developing animal models of stress. Dr. Tartar has also completed Postdoctoral Training at Harvard Medical School, where she studied the neurological consequences of sleep perturbations using in vitro electrophysiological recording techniques. She also received training in Sleep Medicine at Harvard Medical School. She was also awarded an Honorary Doctorate at Nova Southeastern University. Dr. Tartar is the co-founder and CEO of The Society for Sports Neuroscience, an academic organization for the field of Sports Neuroscience. Dr. Tartar's current research is focused on stress, sleep, and athletic performance in humans.   LinkedIn: https://www.linkedin.com/in/jaime-tartar-1545889/    Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.   Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com   Instagram: https://www.instagram.com/hayliepomroy  Facebook: https://www.facebook.com/hayliepomroy  YouTube: https://www.youtube.com/@hayliepomroy/videos  LinkedIn: https://www.linkedin.com/in/hayliepomroy/  X: https://x.com/hayliepomroy    Thank you for tuning in to the Hope and Help For Fatigue and Chronic Illness Podcast. Sign up today for our newsletter.

Standard Time or Daylight Savings Time? What is your pick? Sterling talks the sleep effects that would be felt across the country if our time zones are locked in by Congress. For more on this, Sterling turns to Dr. Ann Romaker, Director of Sleep Medicine the University of Cincinnati. Tune in!See omnystudio.com/listener for privacy information.

Standard Time or Daylight Savings Time? What is your pick? Sterling talks the sleep effects that would be felt across the country if our time zones are locked in by Congress. For more on this, Sterling turns to Dr. Ann Romaker, Director of Sleep Medicine the University of Cincinnati. Tune in!

Standard Time or Daylight Savings Time? What is your pick? Sterling talks the sleep effects that would be felt across the country if our time zones are locked in by Congress. For more on this, Sterling turns to Dr. Ann Romaker, Director of Sleep Medicine the University of Cincinnati. Tune in!See omnystudio.com/listener for privacy information.

Standard Time or Daylight Savings Time? What is your pick? Sterling talks the sleep effects that would be felt across the country if our time zones are locked in by Congress. For more on this, Sterling turns to Dr. Ann Romaker, Director of Sleep Medicine the University of Cincinnati. Tune in!

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Karin Johnson, Professor of Neurology at UMass Chan School of Medicine–Baystate and expert on circadian rhythm policy, to discuss two competing legislative bills addressing permanent time change in the United States. Two bills currently before Congress present starkly different solutions: the Sunshine Protection Act for permanent daylight saving time and the Sunshine for Our Kids Act for permanent standard time. Both campaigns use compelling language that makes their position sound obvious, complicating decisions for policymakers and clinicians alike. Dr. Johnson reviews the AASM's official position on daylight saving time and what research reveals about time change effects—both short-term consequences of bi-annual clock transitions and long-term health impacts of permanent DST, particularly on adolescent mental health and circadian rhythm disruption. She explains what happened during the 1974 experiment with year-round daylight saving time and why that experience remains relevant today. The conversation details both the Sunshine Protection Act and the Sunshine for Our Kids Act, including their legislative progress and specific provisions. Dr. Johnson clarifies which approach sleep medicine clinicians support and provides practical guidance on advocacy. An intriguing discussion explores a proposed compromise to move clocks by 30 minutes and leave them there—why didn't this gain traction? Dr. Johnson also reveals how industry influence shapes policy, discussing candy companies' historical support for daylight saving time and other commercial interests that complicate what should be a health-based decision. Dr. Johnson emphasizes that permanent standard time better aligns with human circadian biology, particularly for adolescents whose naturally delayed circadian rhythms suffer under permanent DST. Whether you're seeking to understand these competing bills, advocate for science-based policy, or interested in how medical evidence influences legislation, this episode provides clarity on a complex issue with direct health implications. Join us for this important conversation about how sleep medicine can influence public health policy.

Breathing changes, like wheezing, coughing, or shortness of breath, are common in young children, especially with colds or asthma. Learn what's usually normal, what to watch for, and when breathing symptoms should be checked out. Featuring Anayansi Lasso-Pirot, MD, Division Head for Pediatric Pulmonary, Allergy and Sleep Medicine at the University of Maryland Medical Center and Assistant Professor of Pediatrics at the University of Maryland School of Medicine.  For more information about Dr.Lasso-Pirot, visit Dr. Anayansi Lasso-Pirot, MD at University of Maryland Golisano Children's HospitalFor more information about Pediatrics at UM Gulisano Children's Hospital To find another pediatrics provide in Maryland 

Do you have trouble sleeping? An occasional late night or early morning is probably not dangerous, but too many people get too little sleep on a regular basis. How does that affect their health? Even more importantly, what can they do to change the situation? You'll want to listen to find out if you need a sleep reset. At The People's Pharmacy, we strive to bring you up to date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, July 18, 2026, through your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can't listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on July 20, 2026. The podcast will be available on Monday (July 20, 2026) Do You Need a Sleep Reset? Why is sleep so important for good health? Our guest is a sleep medicine specialist who uses a metaphor of Disneyland. Crucial maintenance on the theme park happens at night, when there are no visitors. Streets are cleaned, flower beds are weeded, and rides are inspected and, if needed, repaired. None of that can happen while the park is open for business. Our bodies and brains also need time for maintenance and repair, and some of that happens while we are sleeping. When we don't get the rest we need, we may find ourselves at increased risk for diabetes, cardiovascular problems, cancer, cognitive challenges and even premature death. Unfortunately, anxiety about not sleeping can keep people awake all on its own. How can people break that cycle? We'll also discuss ways that people can get help avoiding screens at night. That is an important part of a sleep reset. Blue light from the screen signals the brain to be alert instead of relax. Scrolling social media can often be emotionally upsetting, which also makes it more difficult to fall asleep. Is Your Diet Keeping You Awake? Most of us recognize that a big midnight snack, á la Dagwood Bumstead of the Blondie comic, is probably not conducive to sleeping well. How does nighttime eating affect our circadian rhythm? Are there diets that we should avoid because of their impact on sleep? Dr. Seheult describes a study in which volunteers had their sleep stages monitored closely during the time they were consuming different diets (Obesity, July 2023). When they followed a high-fat, high-sugar diet, it disturbed the pattern of their brain waves during what should have been restorative sleep. How Do Sleep Problems Affect Eating Habits? A lot of us are aware that when we are sleep deprived, we are more inclined to become hangry and we may be less discerning about what we eat. A recent study shows that the sleep deprivation can have an effect even if it is fairly mild and short-term. Scientists recruited people who normally sleep seven to eight hours a night and asked them to stay up an extra hour and a half (Annals of Internal Medicine, July 7, 2026).  During the six weeks of that part of the experiment, people were less active during the day. They also ate more, so they gained about a pound, on average, during those six weeks. Presumably, disrupting sleep for a longer period of time would result in greater weight gain and metabolic disruption. Would a Ketogenic Diet Help with a Sleep Reset? A ketogenic diet, in which the body relies on ketones rather than glucose for energy production, may be helpful. In particular, fasting overnight for at least 14 hours helps the body do what it must during sleep time. To figure out when you should stop eating, identify when you usually start to feel sleepy. That should be your bedtime. Having your last meal of the day about three hours before that will generally offer enough time for digestion so that you don't experience reflux in the middle of the night. Morning Light and Afternoon Naps Your sleep reset may depend on getting your own circadian rhythm to synchronize with the rest of the world. That is where early exposure to morning light comes in. It's beginning to feel a bit like The People's Pharmacy is on repeat: get morning light exposure! It sets your system up for feeling awake and alert during the day and starting to feel sleepy as the light fades in the evening. Obviously, this is most helpful for people who work during daylight hours. Those working overnight shifts would have to organize their days differently. People who have trouble falling asleep may be tempted to take a nap in the afternoon to make up for the lost sleep. That could be a mistake, as it relieves the sleep pressure that helps people fall asleep without trying. Learning to Fall Asleep If you interact with parents of very young children, you may have heard of sleep training. People have strong feelings about this, both pro and con. Adults rarely need sleep training, though. What we are more likely to need is “not-sleeping un-training.” Too many people approach the bedroom as though it were a stage, and sleep is the performance. No wonder they may develop some performance anxiety about sleeping! Other individuals have learned to associate the bedroom with tossing, turning and watching the clock. Consequently, their bodies tense up instead of relaxing when they get between the sheets. There is no easy quick fix for this problem, but cognitive behavior therapy for insomnia has been proven effective for most people. How About PM Pain Relievers? Even though there isn't an easy fix for sleep troubles, many people want one. They reach for the PM pain reliever and hope it will offer them a good night's sleep without a prescription. The “PM” part of that pain reliever is an old-fashioned antihistamine called diphenhydramine. You might be more familiar with its brand name: Benadryl. You'll also find it in Tylenol PM, Advil PM and all the other PM meds because it tends to make people feel drowsy. What's wrong with that? To start with, it isn't clear that it remains effective after a week or two. In addition, people with restless leg syndrome often find that it makes their condition worse. Other folks report that diphenhydramine can result in an unpleasant “hangover” the next day, in which they feel drowsy though not asleep for a good part of their waking hours. What Wakes You Up at Night? If your sleep problem is waking in the wee hours and having trouble getting back to sleep, you should consider the possibility that you have sleep apnea. The REM sleep of those early morning hours is not as deep as some other sleep stages. Consequently, an alarm signal from your brain saying you haven't taken a breath for 20 or 30 seconds may be more likely to wake you. Sleep apnea may be treated by providing air so that the pressure props the collapsing airway open. We discuss this in greater detail along with a new alternative to a CPAP machine in the podcast for this week. This Week’s Guest Dr. Roger Seheult is an Associate Clinical Professor at the University of California, Riverside School of Medicine. He is also an Assistant Clinical Professor at the School of Medicine and Allied Health at Loma Linda University. He is quadruple board-certified in Internal Medicine, Pulmonary Diseases, Critical Care Medicine, and Sleep Medicine through the American Board of Internal Medicine. His current practice is in Beaumont, California. He is a critical care physician, pulmonologist, and sleep physician at Optum California. Dr. Seheult lectures routinely across the country at conferences and for medical, PA, and RT societies. He is the director of a sleep lab and the Medical Director for the Crafton Hills College Respiratory Care Program. He is co-founder and presenter for MedCram.com, a site that offers concise and easy-to-follow medical videos on a range of topics. Roger Seheult, MD, MedCram, Loma Linda, UC-Riverside Listen to the Podcast The podcast of this program will be available Monday, July 20, 2026, after broadcast on July 18. You can stream the show from this site and download the podcast for free. Download the mp3, or listen to the podcast on Apple Podcasts or Spotify.

Dr. Michael J. Breus, PhD has the distinction of being a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine. He is one of only 168 people in the world to have passed the Sleep Medical Speciality board without going to Medical School. World-renowned as The Sleep Doctor™, he is a bestselling author, media personality, keynote speaker, and brand advisor, bringing science-backed sleep expertise to the public for nearly three decades. Tens of millions of Americans silently struggle with poor sleep, from undiagnosed sleep apnea to chronic insomnia. SleepDoctor.com was founded to make sleep health accessible—combining clinical expertise, consumer-friendly tools, and affordable at-home diagnostics so people can finally get the rest they need. SHOWNOTES:

As part of the June issue, the European Respiratory Journal presents the latest in its series of podcasts. Deputy Chief Editor Don Sin interviews Melanie Königshoff (Center for Lung Aging and Regeneration, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, and Geriatric Research Education and Clinical Center at the VA Pittsburgh Healthcare System, Pittsburgh, PA, USA) about her Back to Basics review of the hallmarks of the ageing lung, published in this issue of the ERJ (https://doi.org/10.1183/13993003.01272-2025). Cite this podcast as: ERJ Podcast June 2026: The ageing lung. Eur Respir J 2026; 67: 26E6706 [https://doi.org/10.1183/13993003.E6706-2026].

Obstructive sleep apnea (OSA) is a condition that affects millions globally, causing daytime sleepiness, lack of oxygen, and higher risks of developing cardiac issues. A new randomized control trial, called the Pavlov study, evaluated the efficacy and long-term conditioning effects of a positional therapy device for treating positional obstructive sleep apnea. Irene Cano-Pumarega, MD, PhD, Ramón y Cajal Hospital, discusses how she and her team developed the study, the initial results, and what future positional treatments for OSA could look like on this episode of the ATS Breathe Easy podcast. 

In this episode of The Hamilton Review Podcast, Dr. Bob welcomes Dr. Sande Okelo, Founding Division Chief of Pediatric Pulmonology and Sleep Medicine at UCLA and Director of the UCLA Pediatric Asthma Center of Excellence. With years of experience caring for children with asthma and leading research to improve treatment, Dr. Okelo shares practical, reassuring guidance for families. Together, they discuss how asthma is diagnosed, what parents should know about common triggers, the latest treatment options, and simple steps that can help children breathe easier and stay active. An important discussion for every parent from a top doctor in the field of Pulmonology.  As a pediatric pulmonologist and researcher, Dr. Okelo is interested in improving asthma care for children.  He has developed an asthma specialist clinic for children that incorporates clinical care, patient education and clinical research.   Dr. Okelo's research interests range from physician decision-making regarding asthma treatment to the development of strategies to improve asthma care. How to contact Dr. Sande Okelo: Breathium   How to contact Dr. Bob: Dr. Bob on YouTube: https://www.youtube.com/channel/UChztMVtPCLJkiXvv7H5tpDQ Dr. Bob on Instagram: https://www.instagram.com/drroberthamilton/ Dr. Bob on Facebook: https://www.facebook.com/bob.hamilton.1656 Dr. Bob's Seven Secrets Of The Newborn website: https://7secretsofthenewborn.com/ Dr. Bob's website: https://roberthamiltonmd.com/ Pacific Ocean Pediatrics: http://www.pacificoceanpediatrics.com/  

Is my child getting enough sleep? How much sleep does my baby need? These are common questions I get from parents, and they can create a lot of stress. The evidence I use to answer these types of questions always includes the National Sleep Foundation recommendations. So I was very excited to have Dr. Dzierzewski From the National Sleep Foundation on the podcast to talk about their latest annual poll focusing on sleep in the pediatric population, ages 0-13. I'll be honest, some of these results really surprised me while others felt very in line with what I see in my practice. our discussion focuses on the poll results, but with lots of stories, examples, and times where I share how the families I see do and do not fit into this more representative data. We talk through the role of naps, importance of bedtime routines, and the reasons many littles may not be getting enough sleep (shown by the survey results) along side the pressure for high sleep totals coming from some popular sleep apps and sites. This was a varied, data focused, and really wonderful conversation that I hope you find as fascinating as I did. About Dr. DzierzewskiDr. Joseph Dzierzewski is a nationally recognized sleep scientist, clinician, and public health leader who directs the scientific mission of the National Sleep Foundation. As Senior Vice President of Research & Scientific Affairs, he oversees the Foundation's evidence-based sleep health guidelines, shapes its research agenda, and serves as a primary scientific voice for media, industry, and policy partners across the country.A former tenured Associate Professor at Virginia Commonwealth University, Dr. Dzierzewski built a prolific research program at the intersection of sleep, aging, and behavioral medicine. He is a well-funded investigator with more than $11 million in total research support and over 400 scholarly works, including 170 peer-reviewed publications, multiple edited volumes and chapters, and more than 250 scientific presentations. Independent analyses have identified him as the most published author in the field of sleep in older adults, underscoring his leadership in this critical area of population health.Dr. Dzierzewski has served on scientific review committees for the National Institutes of Health and the American Academy of Sleep Medicine, and as Associate Editor for several academic journals. His editorial and conceptual expertise have made him a trusted arbiter of scientific rigor and a leader in shaping the direction of sleep research.A committed science communicator, he works to translate complex sleep science for the public, healthcare professionals, and policymakers. His insights have been featured across national and regional media, in podcasts, and presentations to legislative bodies. His work reflects a core belief: that advancing sleep health requires not only generating high-quality science, but ensuring that science is accessible, actionable, and impactful.Trained as a Clinical Health Psychologist with specialization in behavioral sleep medicine, Dr. Dzierzewski maintains an active clinical license, grounding his scientific leadership in real-world patient care and ensuring that his work remains connected to the lived experiences of individuals and families.Connect with The National Sleep Foundation National Sleep Foundation website: https://www.thensf.orgInstagram: https://www.instagram.com/sleepfoundation/ YouTube: https://www.youtube.com/user/NatlSleepFoundation/Resources related to this episodeSee the poll write up here: https://www.thensf.org/wp-content/uploads/2026/03/NSF-2026-Sleep-in-America-Poll-Report.pdfAnd more on the Sleep Awareness Week here: https://www.thensf.org/sleep-awareness-week/Connect with Kim Grab a free sleep myth busting guide and learn more about working with Kim: https://intuitiveparentingdc.com/Instagram: instagram.com/intuitive_parenting_dcFacebook:  facebook.com/intuitiveparentingdc

"When we sleep, a spinal fluid washes over our brain and gets rid of a peptide called beta-amyloid which is implicated in the Alzheimer dementia process. So if we're not getting enough sleep on a regular basis, we really do suffer the consequences later on."   This is a special episode only available to our podcast subscribers, which we call The Mini Chief. These are short, sharp highlights from our fabulous guests, where you get a 5 to 10 minute snapshot from their full episode. This Mini Chief episode features Dr Carmel Harrington, an Executive Sleep Guru and Managing Director of Sleep for Health. Her full episode is titled The myths and factors of sleep that drive optimal health, joy and performance. You can find the full audio and show notes here:

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

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

Guest: Michelle Carr, Director of the Dream Engineering Laboratory at Montreal's Centre for Advanced Research in Sleep Medicine and author of ‘Into the Dream Lab: The New Science of Dreams and Nightmares'.

Roger Seheult, MD of MedCram explores two new rooftop ICU facilities and tries out the MiEye light sensor. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on June 9th, 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.

On this edition, Guy Murphy speaks with University of Newcastle alumni and medical director of Sleep Medicine, Dr Antonio Ambrogetti, about factors influencing sleep quality, hygiene, and disorders. See omnystudio.com/listener for privacy information.

Are you trading your long-term brain health for late-night screen time? Dr. Paul Chung, physician and researcher at Northwestern University, joins host Deborah Westphal to reveal why sleep is far more than rest - and why ignoring it could cost you decades of cognitive health.Dr. Chung is an Assistant Professor at Northwestern University, a pulmonary and sleep medicine physician, and a 2023 Toffler Scholar. His research sits at the intersection of sleep, circadian biology, and Alzheimer's disease - with a special focus on adults with Down syndrome as a model for understanding cognitive decline.What You'll Learn in This EpisodeWhy sleep is an active process of repair - not passive rest - and how it regulates your heart, brain, immune system, and metabolismWhat sleep apnea actually is (beyond snoring) and why it causes a body-wide stress response every single nightWhy sleep apnea remains dramatically underdiagnosed - even 60 years after being formally defined - and what patients say when asked why they skip sleep studiesThe shocking truth: a third of adults and children still aren't getting enough sleep, and the number is even worse for teenagersHow disrupted circadian rhythms are linked to the buildup of amyloid beta - the protein central to Alzheimer's diseaseWhy individuals with Down syndrome are an invaluable research population for understanding Alzheimer's progression in the broader populationWhat "slow wave activity" in sleep EEG data reveals about cognitive declineThe science of chronotherapy - why when you take a medication or vaccine may be just as important as what you takeNight owls vs. early birds: the genetic reality behind your body clock, and why society quietly punishes night owlsThe future of personalized sleep medicine - beyond CPAPKey TakeawaySleep is the third pillar of health alongside diet and exercise - yet it's the one most people sacrifice firstAbout Dr. Paul ChungDr. Paul Chung is a physician and Assistant Professor at Northwestern University's Feinberg School of Medicine, specializing in pulmonary and sleep medicine. He is a 2023 Toffler Scholar whose research focuses on sleep EEG microstructure, actigraphy, and circadian rhythms as they relate to cognitive vulnerability and Alzheimer's disease - with a particular emphasis on adults with Down syndrome.Research inquiries: paul.chung@northwestern.edu (For clinical appointments, contact Northwestern Medicine directly.)Resources MentionedKaren Toffler Charitable Trust - Funding innovative, early-stage health research: tofflertrust.orgNIH INCLUDE Project - Initiative to increase Down syndrome research funding: www.nih.govAlzheimer's Biomarkers Consortium for Down Syndrome (ABC-DS) - Large collaborative cohort studyNorthwestern University Feinberg School of Medicine - Sleep Medicine ProgramIf this conversation opened your eyes to the power of sleep science, please subscribe, leave a review, and share it with someone who keeps saying they'll "sleep when they're dead." Your support helps us bring more groundbreaking researchers to this mic.To learn more about the breakthroughs discussed in this episode and to support ongoing research, visit our website at tofflertrust.org. Technical Podcast Support by Jon Keur at Wayfare Recording Co.

"When we sleep, a spinal fluid washes over our brain and gets rid of a peptide called beta-amyloid which is implicated in the Alzheimer dementia process. So if we're not getting enough sleep on a regular basis, we really do suffer the consequences later on." In this Best of Series episode, we replay a chat I had in 2019 with Executive Sleep Guru, Dr Carmel Harrington, on the myths and factors of sleep that drive optimal health, joy and performance.

Roger Seheult, MD of MedCram explores the fundamentals of Ebola virus and the best hope for treatment, especially of the BDBV species. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on May 28th, 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.

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.In this Mind Moments episode, Todd Arnedt, PhD, professor of psychiatry and neurology at Michigan Medicine-University of Michigan, joins the podcast to discuss the recently published American Academy of Sleep Medicine clinical practice guideline on combination treatment for chronic insomnia disorder in adults. Arnedt explains the rationale behind formal recommendations for concurrent use of cognitive behavioral therapy for insomnia (CBT-I) and pharmacotherapy, particularly as combination treatment becomes increasingly common in clinical practice. The conversation reviews the evidence supporting CBT-I as the preferred foundational treatment approach, where combination therapy may offer advantages over pharmacotherapy alone, and how clinicians should think about factors such as symptom burden, treatment goals, access to CBT-I, and patient preference when selecting treatment strategies. Arnedt also outlines ongoing research gaps involving sequential treatment approaches, medication classes, long-term outcomes, and personalized insomnia care. Looking for more Sleep Disorders discussion? Check out the NeurologyLive® Sleep Disorders clinical focus page.Episode Breakdown: 1:15 – Why formal insomnia combination treatment guidance was needed 2:45 – Defining concurrent CBT-I and pharmacotherapy approaches 4:35 – Evidence supporting CBT-I as foundational insomnia treatment   7:15 – Situations where combination therapy may improve patient outcomes 7:50 – Neurology News Network  10:20 – Patient-specific factors influencing insomnia treatment selection 12:30 – Barriers involving CBT-I access, cost, and real-world implementation 16:55 – Research gaps surrounding sequencing, long-term outcomes, and personalization The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here: Topline Phase 2 CELIA Results Show Diranersen Misses Primary End Point in Early Alzheimer Disease FDA Grants Priority Review to Bayer's Asundexian for Secondary Stroke Prevention Dyne Submits BLA for Z-Rostudirsen in Exon 51 Skipping Duchenne Muscular Dystrophy Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.

Most responses to civilizational crises focus outward – policy levers, energy systems, geopolitical actors, and material flows – with little focus on how the humans inside these systems might change and grow in parallel. At the same time, the minds that built this complex and fragile world are also the instruments we must use to navigate its unraveling, making them a critical factor in defining humanity's future. With that said, who will we be as simplification unfolds, and how do we prepare our inner terrains for what's coming? In this episode, Nate is joined by meditation practitioner, Andrew Holecek, for an exploration of the concept of dark retreats, periods of extended time in complete absence of light, as a practical path toward reflection and reconnection with ourselves and others. Andrew draws on decades of study in Tibetan Buddhism and non-dual wisdom traditions to explore how the external complexity of modern life is mirrored in the internal complexity of the modern mind. Central to his work is the concept of non-duality: a return from the fragmented display of self-versus-world toward a more unified, less suffering-prone relationship with reality. Andrew and Nate also explore the misleading entanglement of happiness and consumption, arguing that satisfaction arises not from acquiring what we want, but from the cessation of wanting itself.  What would it mean to practice darkness as a needed reprieve from constant light and stimulation, rather than deprivation? If the coming decades hold a forced reduction in external, material complexity, how could a deepening of our internal worlds make us more resilient, compassionate, and grounded? And could confronting fear – by learning to move through it rather than avoid it – be one of the most practical preparations for navigating future uncertainty and social fracture? (Conversation recorded on April 28th, 2026)    About Dr. Andrew Holecek: Andrew Holecek is an interdisciplinary scholar-practitioner in Tibetan Buddhism and other nondual wisdom traditions who has spent over thirty years helping people transform life's greatest challenges into opportunities for awakening. A dedicated meditation practitioner who completed the traditional Tibetan Buddhist three-year retreat, Andrew is known for making profound contemplative practices accessible and practical. He is actively involved in scientific research on dark retreat with the University of Wisconsin-Madison, as well as the Institute for Advanced Consciousness Studies where he serves as Resident Contemplative Scholar. Andrew is a member of the American Academy of Sleep Medicine, the author of several scientific papers on lucid dreaming, and was also the host of the now-concluded Edge of Mind podcast, where he interviewed guests to explore ancient teachings and modern topics about the nature of mind and reality. Andrew's newest area of focus is dark retreat, the ancient Buddhist practice of extended meditation in complete darkness. His most recent book, Total Eclipse of the Mind: Unleashing the Power of Darkness for Creativity, Healing, and Transformation, draws on more than thirty years of personal dark retreat experience. True to his approach, Andrew teaches dark retreat – and the more accessible gray retreat practice of weaving in and out of darkness – as a genuine path to healing, creativity, and self-understanding.   Show Notes and More   Watch this video episode on YouTube   Want to learn the broad overview of The Great Simplification in 30 minutes? Watch our Animated Movie.   ---   Support The Institute for the Study of Energy and Our Future   Join our Substack newsletter   Join our Hylo channel and connect with other listeners

Does GABA Actually Help With Sleep? What the Research Says for Brain Injury Recovery Someone in our community recently asked me about GABA for sleep. They’d seen it recommended online, understood that sleep was critical for their recovery, and wanted to know whether the supplement was worth exploring or just noise. It’s a genuinely good question. And it deserves a proper answer. In this post, I’m going to walk you through what GABA is, what the clinical research actually shows about its effect on sleep, why the blood-brain barrier debate matters (and why it might not derail the whole argument), and what the evidence says about the relationship between sleep and brain recovery. By the end, you’ll have enough to have an informed conversation with your medical team. I’m not a doctor. I’m a three-time haemorrhagic stroke survivor who has spent years researching the science of brain recovery and interviewing hundreds of clinicians and survivors on the Recovery After Stroke podcast. What I offer is a careful read of the evidence, not a clinical prescription. What Is GABA and Why Does It Matter for Sleep? GABA (gamma-aminobutyric acid) is the brain’s primary inhibitory neurotransmitter. If your nervous system were a car, GABA is the brake pedal. It reduces neuronal excitability, quiets cortical arousal, suppresses the brain’s primary arousal centre (the locus coeruleus), and modulates the HPA axis, the stress-response system that drives cortisol. Most sedative medications work by amplifying GABA activity. Benzodiazepines, for instance, bind to GABA-A receptors to increase chloride channel opening, producing their calming effect. GABA isn’t doing something unusual here – it’s doing something fundamental. The question with supplemental oral GABA is more specific: Does taking GABA as a capsule or powder actually produce meaningful neurological effects? What Does the Research Show? Finding 1 — Oral GABA Reduces Sleep Latency (and EEG Can Measure It) A 2015 clinical trial published in the Journal of Nutritional Science and Vitaminology by Yamatsu and colleagues used EEG measurement, actual brainwave monitoring, rather than self-reported sleep questionnaires. One hundred milligrams of oral GABA shortened sleep latency (time to fall asleep) by 5.3 minutes compared to placebo. That might sound modest. But for someone lying awake for 30–40 minutes each night, it’s a meaningful shift. Crucially, this was objective neurophysiological data, not a survey response. (PMID: 26052150) Finding 2 — A 90-Day RCT Showed Improved Sleep Efficiency and Mood A 2024 randomised double-blind placebo-controlled trial published in the Journal of Dietary Supplements (Guimarães et al.) gave 200 mg of GABA daily for 90 days to sedentary overweight women also undergoing an exercise program. The GABA group showed significantly improved Pittsburgh Sleep Quality Index (PSQI) scores, significantly reduced depression scores, and improved heart rate variability, a marker of parasympathetic nervous system activity. The HRV finding is particularly interesting. It suggests GABA may be doing something broader than simply reducing sleep latency – it appears to support the overall physiological state that makes rest restorative. (PMID: 38321713) Finding 3 — But a High-Dose RCT Found No Effect Here’s where intellectual honesty matters. A 2023 Dutch RCT (de Bie et al.) published in the American Journal of Clinical Nutrition gave participants 500 mg of GABA three times daily, 1,500 mg/day total, and found no significant effect on self-reported sleep quality. Fasting plasma GABA wasn’t significantly elevated either, raising real bioavailability questions at that dose. This isn’t a reason to dismiss GABA entirely. It is a reason to pay attention to the dose. The evidence base supports 100–300 mg, not 1,500 mg. Higher is not better, and the non-linear dose response is clinically important. (PMID: 37495019) The Blood-Brain Barrier Debate — and Why the Gut May Be the Point The most common objection to oral GABA supplementation is this: GABA is a zwitterion at physiological pH, meaning it has low lipophilicity and poor predicted ability to cross the blood-brain barrier via passive diffusion. So if it can’t get into the brain directly, how does it produce neurological effects? The emerging explanation involves the gut-brain axis. The enteric nervous system, your gut’s own neural network, has GABA receptors. When oral GABA activates these enteric receptors, it can signal the brain via vagal afferents without needing to cross the BBB at all. Think of it as a side door rather than the front entrance. Supporting this: a 2024 RCT (Li et al.) found that a probiotic strain engineered to increase gut GABA production significantly improved objective sleep duration as measured by wearable devices, alongside reduced cortisol and suppressed HPA axis activity. The mechanism wasn’t direct CNS access – it was gut-brain signalling. (PMID: 39385735) The BBB debate doesn’t negate the clinical effect. It changes how we understand the mechanism. Why Sleep Is Not Optional in Brain Recovery This is the part that I think gets underweighted in recovery conversations — and the research is unambiguous. A 2026 large retrospective cohort study (Muhtar et al., Sleep Medicine) matched over 35,000 stroke patients and found that post-stroke insomnia was associated with a 29% higher risk of post-stroke cognitive impairment and a 30% higher risk of all-cause dementia. The association with Alzheimer’s disease was also significant. (PMID: 41924789) A 2024 observational study from Monash University and Alfred Health (Smith et al.) found that in stroke rehabilitation patients, poor sleep quality was significantly associated with higher fatigue severity and lower salivary BDNF gene expression. BDNF (brain-derived neurotrophic factor) is one of the primary molecular drivers of neuroplasticity. Less BDNF means a less receptive environment for the neurological rewiring that rehab is trying to build. (PMID: 38802847) And then there’s the glymphatic system: the brain’s waste-clearance mechanism that is most active during deep sleep. Poor sleep means reduced clearance of metabolic byproducts, including proteins associated with neurodegeneration. This is not a theoretical risk. It is an active, ongoing process. Sleep is not passive recovery. It is one of the primary mechanisms of recovery. What to Do With This Information Here are three practical steps if you’re exploring GABA for sleep: 1. Measure your sleep baseline first. Use the Pittsburgh Sleep Quality Index (freely available online) before you make any changes. Understanding whether you’re struggling with latency, duration, or quality will determine what you actually need to address. 2. If you trial GABA, choose the right form and dose. Look for PharmaGABA — naturally fermented GABA, derived from Lactobacillus hilgardii, which has the strongest clinical evidence base. A dose of 100–300 mg taken 30–60 minutes before bed is consistent with the positive studies. Avoid very high doses; the null result at 1,500 mg/day is important context. Important drug interaction note: If you are taking benzodiazepines, anticonvulsants (gabapentin, pregabalin, valproate), or any other GABAergic medication, discuss GABA supplementation with your prescriber before adding it. The additive sedative effect is a real risk. The same applies if you drink alcohol regularly. 3. Don’t skip the foundation. Sleep hygiene interventions, consistent sleep and wake times, a dark and cool room, and no screens in the 60 minutes before bed, are consistently among the highest-leverage sleep interventions in the literature. GABA may provide a genuine incremental benefit. But it cannot compensate for a fundamentally disrupted sleep environment. The Bottom Line The evidence for GABA and sleep is more substantive than I expected when I started researching it. The EEG data is real. The 90-day RCT showed meaningful clinical outcomes. The gut-brain axis mechanism is biologically plausible and now has direct RCT support. And the consequences of poor sleep in neurological recovery are not trivial – they are quantifiable, significant, and, to a degree, addressable. GABA is not a guaranteed fix. Individual responses vary. The research is not yet definitive at the level of large multi-centre trials in neurological populations. But as one tool in a comprehensive approach to sleep quality alongside good sleep hygiene, appropriate medical support, and consistent rehabilitation, the case for cautious exploration is reasonable. The next step is a conversation with your neurologist, GP, or rehab physician. Take the research with you if it’s useful. Research References All studies cited in this post are retrievable via PubMed: Yamatsu et al. — GABA sleep latency EEG clinical trial (2015) — PMID: 26052150 Guimarães et al. — GABA 200mg RCT, sleep efficiency + mood (2024) — PMID: 38321713 de Bie et al. — GABA high-dose RCT, null sleep result (2023) — PMID: 37495019 Li et al. — Gut-brain GABA axis and sleep RCT (2024) — PMID: 39385735 Muhtar et al. — Post-stroke insomnia and cognitive decline cohort (2026) — PMID: 41924789 Smith et al. — Sleep, BDNF, and fatigue in stroke rehabilitation (2024) — PMID: 38802847 This post is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making changes to your supplementation or treatment plan. If you or someone you care about is recovering from a stroke, brain injury, or any neurological condition, the Recovery After Stroke podcast and this blog exist for you. Subscribe on YouTube @BillGasiamis, or visit Recovery After Stroke to find episodes, resources, and community. The post GABA, Sleep, and Brain Health – Neurological Recovery appeared first on Recovery After Stroke.

If you enjoy this episode, we're sure you will enjoy more content like this on The Occult Rejects.  In fact, we have curated playlists on occult topics like grimoires, esoteric concepts and phenomena, occult history, analyzing true crime and cults with an occult lens, Para politics, and occultism in music. Whether you enjoy consuming your content visually or via audio, we've got you covered - and it will always be provided free of charge.  So, if you enjoy what we do and want to support our work of providing accessible, free content on various platforms, please consider making a donation to the links provided below.  Thank you and enjoy the episode!Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Cash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsFull show-notes bibliographyCore EEG and oscillationsAbubaker, M., & Dankaerts, W. (2021). Working memory and cross-frequency coupling of neuronal oscillations. *Frontiers in Psychology, 12*, 742860.Axmacher, N., Henseler, M. M., Jensen, O., Weinreich, I., Elger, C. E., & Fell, J. (2010). Cross-frequency coupling supports multi-item working memory in the human hippocampus. *Proceedings of the National Academy of Sciences, 107*(7), 3228–3233.Jensen, O., & Mazaheri, A. (2010). Shaping functional architecture by oscillatory alpha activity: Gating by inhibition. *Frontiers in Human Neuroscience, 4*, 186.Rayi, A., et al. (2022). Electroencephalogram. *StatPearls*. StatPearls Publishing.StatPearls / NCBI Bookshelf. (2024). Introduction to electroencephalography (EEG). *NCBI Bookshelf*.Theta, alpha, beta, gamma, and controlCavanagh, J. F., & Shackman, A. J. (2015). Frontal midline theta reflects anxiety and cognitive control: Meta-analytic evidence. *Journal of Physiology-Paris, 109*(1–3), 3–15.Eisma, J., et al. (2021). Frontal midline theta differentiates separate cognitive control strategies while still generalizing the need for cognitive control. *Scientific Reports, 11*, 14641.Jensen, O., Bonnefond, M., & VanRullen, R. (2012). An oscillatory mechanism for prioritizing salient unattended stimuli. *Trends in Cognitive Sciences, 16*(4), 200–206.Lundqvist, M., Herman, P., & Miller, E. K. (2018). Working memory: Delay activity, yes! Persistent activity? Maybe not. *Journal of Neuroscience, 38*(32), 7013–7019.Sleep architecture, spindles, and memoryCaporro, M., Haneef, Z., Yeh, H.-J., Mohamed, F. B., & Levin, H. S. (2012). Functional MRI of sleep spindles and K-complexes. *Clinical Neurophysiology, 123*(2), 303–309.Chen, P., Miao, X., Chen, J., et al. (2023). The devastating effects of sleep deprivation on memory: Lessons from rodent models, aging, and Alzheimer's disease. *Frontiers in Neuroscience, 17*, 1151639.Ng, T., et al. (2025). Bayesian meta-analysis reveals the mechanistic role of slow oscillation-spindle coupling in sleep-dependent memory consolidation. *eLife, 13*, RP101992.Patel, A. K., et al. (2024). Physiology, sleep stages. *StatPearls*. StatPearls Publishing.Páez, A., Gillman, S. O., Dogaheh, S. B., et al. (2025). Sleep spindles and slow oscillations predict cognition and biomarkers of neurodegeneration in mild to moderate Alzheimer's disease. *Alzheimer's & Dementia, 21*, e14424.Hypnagogia, N1, and dream incubationHorowitz, A. H., Esfahany, S., Boyle, M. R., et al. (2023). Targeted dream incubation at sleep onset increases post-sleep creative performance. *Scientific Reports, 13*, 5055.Lacaux, C., Andrillon, T., Bastoul, D., et al. (2021). Sleep onset is a creative sweet spot. *Science Advances, 7*(50), eabj5866.Meditation, prayer, chanting, and yoga nidraDatta, K., Mallick, H. N., Tripathi, M., Ahuja, G. K., & Deepak, K. K. (2022). Electrophysiological evidence of local sleep during yoga nidra practice in young male volunteers. *Frontiers in Neurology, 13*, 910794.Dobrakowski, P., Błaszkiewicz, M., & Skalski, S. (2020). Changes in the electrical activity of the brain in the alpha and theta bands during prayer and meditation. *International Journal of Environmental Research and Public Health, 17*(24), 9567.Gao, J., Leung, H. K., Wu, B. W. Y., Skouras, S., & Sik, H. H. (2019). The neurophysiological correlates of religious chanting. *Scientific Reports, 9*, 4262.Kaur, C., & Singh, P. (2015). EEG derived neuronal dynamics during meditation: Progress and challenges. *Advances in Preventive Medicine, 2015*, 614723.Lomas, T., Ivtzan, I., & Fu, C. H. Y. (2015). A systematic review of the neurophysiology of mindfulness on EEG oscillations. *Neuroscience & Biobehavioral Reviews, 57*, 401–410.Hypnosis and suggestionJensen, M. P., Adachi, T., & Hakimian, S. (2015). Brain oscillations, hypnosis, and hypnotizability. *American Journal of Clinical Hypnosis, 57*(3), 230–253.Kirenskaya, A. V., Novototsky-Vlasov, V. Y., Chistyakov, A. V., & Zvonikov, V. M. (2011). Waking EEG spectral power and coherence differences between highly hypnotizable and low hypnotizable subjects. *International Journal of Clinical and Experimental Hypnosis, 59*(2), 144–164.Mendoza, M. E., & Capafons, A. (2024). Neural correlates of hypnosis: A systematic narrative review. *Frontiers in Psychology, 15*, 1327738.Ritual rhythm, trance, and synchronyHuels, E. R., Kim, H. S., Lee, U., & Mollaahmetoglu, O. M. (2021). Neural correlates of the shamanic state of consciousness. *Frontiers in Human Neuroscience, 15*, 610466.Mogan, R., Fischer, R., & Bulbulia, J. A. (2017). To be in synchrony or not? A meta-analysis of synchrony's effects on behavior, perception, cognition and affect. *Journal of Experimental Social Psychology, 72*, 13–20.Tarr, B., Launay, J., & Dunbar, R. I. M. (2016). Silent disco: Dancing in synchrony leads to elevated pain thresholds and social closeness. *Evolution and Human Behavior, 37*(5), 343–349.Entrainment, binaural beats, fatigue, and overloadGoodman, S. P. J., et al. (2025). Approaches to inducing mental fatigue: A systematic review and meta-analysis of (neuro)physiologic indices. *Neuroscience & Biobehavioral Reviews, 170*, 105957.Ingendoh, R. M., Posny, E. S., & Heine, A. (2023). Binaural beats to entrain the brain? A systematic review of the effects of binaural beat stimulation on brain oscillatory activity, and the implications for psychological research and intervention. *PLOS ONE, 18*(5), e0286023.Snipes, S., et al. (2024). Extended wakefulness alters the relationship between EEG theta and alpha bursts and behavioural outcome. *European Journal of Neuroscience, 60*(8), 6268–6284.Xiang, C., et al. (2024). A resting-state EEG dataset for sleep deprivation. *Scientific Data, 11*, 406.Parkinson's disease and pathological betaAsadi, A., et al. (2022). The origin of abnormal beta oscillations in the parkinsonian corticobasal ganglia circuit. *Frontiers in Neuroscience, 16*, 823719.Paulo, D. L., et al. (2023). Corticostriatal beta oscillation changes associated with cognitive function in Parkinson's disease. *NPJ Parkinson's Disease, 9*, 202.Ancient sleep, dreams, and Asclepian healingAskitopoulou, H. (2015). Sleep and dreams: From myth to medicine in ancient Greece. *Journal of Anesthesia History, 1*(3), 70–75.Kapotsis, G., & Steiropoulos, P. (2025). Sleep incubation [enkoimesis] in medical practice at Asclepieia of Ancient Greece — the Ancient Greek sleep medicine. *Sleep Medicine, 130*, 85–89.Pavli, A. (2024). Asclepieia in ancient Greece: pilgrimage and healing. *Journal of Integrative Medicine and Research, 3*(2), 100119.Also want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. A

Roger Seheult, MD of MedCram explains the mechanism by which hantavirus kills. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on May 7th, 202 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.

Roger Seheult, MD of MedCram explores the deadly Andes hantavirus outbreak on the MV Hondius Cruise Ship. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on May 4th, 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.

Roger Seheult, MD of MedCram explores the connection between hantavirus and interferon. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on May 6th, 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.

Dr. Alan Schaffer is a board-certified physician specializing in pulmonary, critical care, and sleep medicine. With decades of clinical experience, he focuses on the intersection of respiratory health, sleep disorders, and metabolic health, including the role of nutrition and carbohydrate restriction in improving chronic disease. Dr. Schaffer practices with St. Peter's Health Partners in New York and is a frequent educator and media guest discussing conditions such as sleep apnea, insomnia, and the broader drivers of cardiometabolic health.   In this episode, Drs. Tro and Alan talk about… (00:00) Intro (09:59) Sleep Medicine and metabolic health (13:37) Pulmonary Medicine and environmental factors (18:57) How Dr. Alan helps his patients improve their sleep quality and metabolic health (26:43) Helping late bloomer patients (32:30) How to help patients trust you as a doctor (37:07) Sleep apnea and CPAP (42:52) Sleep apnea tools and tips (46:08) Sleep tape (52:05) Didjeridoo (55:16) Weight loss and sleep apnea (01:01:52) The Cholesterol Code documentary (See links below) For more information, please see the links below. Thank you for listening! Links: Please consider supporting us on Patreon: https://www.lowcarbmd.com/ Resources Mentioned in this Episode: The Cholesterol Code Screening (Wed, Apr 22, 2026 at 6:00 PM CDT): https://gathr.com/events/0ed2437d/the-cholesterol-code-at-amc-crystal-run-16 Cholesterol Code Movie: https://cholesterolcodemovie.com Dr. Alan Schaffer: https://www.sphp.com/provider/alan-edward-schaffer-md-sleep-medicine-0 Dr. Brian Lenzkes:  Website: https://arizonametabolichealth.com/ Twitter: https://twitter.com/BrianLenzkes?ref_src=twsrc^google|twcamp^serp|twgr^author Dr. Tro Kalayjian:  Website: https://toward.health Twitter: https://twitter.com/DoctorTro IG: https://www.instagram.com/doctortro/ Toward Health App Join a growing community of individuals who are improving their metabolic health; together.  Get started at your own pace with a self-guided curriculum developed by Dr. Tro and his care team, community chat, weekly meetings, courses, challenges, message boards and more.  Apple: https://apps.apple.com/us/app/doctor-tro/id1588693888  Google: https://play.google.com/store/apps/details?id=uk.co.disciplemedia.doctortro&hl=en_US&gl=US Learn more: https://toward.health/community/