The Complexities of Sleep Medicine
Article Summary
- Miller School researchers played a major role at this year’s International Surgical Sleep Society meeting.
- Sleep is now one of the AHA’s “Life’s Essential 8” factors that improve cardiovascular health.
- Miller School researchers presented on a litany of sleep topics and emphasized personalized sleep plans.
University of Miami Miller School of Medicine researchers and clinicians played a major role at the recent International Surgical Sleep Society meeting. Held in Miami, the conference brought in an international group to discuss emerging techniques to help patients get the sleep they need.
“This was a multidisciplinary meeting that focused on treating patients with sleep disorders, such as sleep apnea and snoring,” said Maria Suurna, M.D., professor of otolaryngology-head and neck surgery at the Miller School and conference co-chair. “We had ENTs, pulmonologists, neurologists, dentists, psychiatrists, anesthesiologists and bariatric surgeons in attendance. We explored many sleep issues, including CPAP (continuous positive airway pressure) and alternative therapies for patients who need them.”
The Importance of Sleep
Improving sleep has become an important focus in recent years. In 2022, the American Heart Association added sleep to its Life’s Essential 8, a list of lifestyle refinements that improve cardiovascular health.
“People are becoming increasingly aware of sleep’s benefits and have begun monitoring their sleep and adopting wearable devices,” said Dr. Suurna, also the Miller School’s director of sleep surgery. “At the same time, there’s an incredibly high prevalence of sleep disorders, particularly sleep apnea, which affects around a billion people worldwide.”
Sleep apnea, during which people intermittently stop breathing during sleep, can cause drowsiness, fatigue, cardiovascular issues and other concerns. It’s often undiagnosed. Many people feel poor sleep is not a serious problem or do not associate snoring with sleep apnea. Still, car accidents, train derailments, workplace injuries and other incidents have been linked to untreated sleep apnea. Routine screenings are becoming more common.
Personalized Sleep Care
CPAP revolutionized sleep apnea treatment. However, devices can be bulky and patient compliance can be an issue. During the meeting, Alejandro Chediak, M.D., professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine at the Miller School, discussed ways to optimize compliance and identify related sleep disorders that often accompany sleep apnea.
As CPAP isn’t ideal for all patients, sleep medicine specialists have been investigating new ways to personalize care. Emerging approaches include dental appliances, soft tissue and palate surgeries, nasal procedures, skeletal surgery and neurostimulation.
“I co-moderated a panel on neurostimulation, which is a newer way to treat sleep apnea,” said Dr. Suurna. “We implant a device that stimulates the hypoglossal nerve, which controls the tongue, and that helps move the tongue forward and ease the patient’s condition.”
Sleep conditions can be quite complex, with some patients dealing with several issues at once, including sleep apnea, insomnia and leg movement disorders. Researchers and clinicians at the conference showcased a variety of multidisciplinary approaches to improve care.
A large group of Miller School researchers and clinicians shared their work.
• Salim Dib, M.D., associate professor of clinical neurology and chief of the Division of Sleep Medicine at the Miller School, spoke about neurocognitive outcomes in sleep apnea.
• Nestor De la Cruz Munoz, Jr., M.D., professor in the DeWitt Daughtry Family Department of Surgery and chief of bariatric surgery at the Miller School, discussed bariatric procedures and GLP1 agonists, a new class of drugs that promotes weight loss.
• Eric Geil, M.D., discussed sleep-related movement disorders.
• Alexandre Rocha Abreu, M.D., assistant professor in the Miller School Division of Pulmonary, Critical Care and Sleep Medicine at the Miller School, moderated a scientific session that focused on ongoing research.
• Naresh Punjabi, M.D., professor and chief of the Division of Pulmonary, Critical Care and Sleep Medicine at the Miller School, moderated a session exploring treatment options for co-existing sleep issues, such as movement disorders.
• Todd Smaka, M.D., assistant professor of anesthesiology at the Miller School, presented on the challenges of caring for sleep apnea patients during and after surgery.
The meeting also offered a “How I Do It” class to demonstrate advanced surgical techniques and a hands-on dissection course in the Miller School’s Minimally Invasive Surgical Training and Education Center.
While sleep apnea is often perceived as an adult issue, it can also affect children. During the meeting, Ignacio Tapia, M.D., chief of the Miller School’s Division of Pediatric Pulmonology, discussed how sleep apnea can impact children’s cognition. Lauren Yarholar, M.D., a plastic surgeon in the DeWitt Daughtry Family Department of Surgery, presented on using craniofacial surgery to treat pediatric sleep apnea.
“This field is exciting because it is still relatively unexplored, and meetings like this help us share new findings,” said Dr. Suurna. “One-size-fits-all solutions don’t work for many patients and we’ve had to develop more personalized approaches to treat sleep apnea, other sleep disorders or combined sleep disorders. With new technologies like neurostimulation and sleep monitoring devices, we can do a lot more for patients.”
Tags: Division of Pulmonary and Critical Care, Dr. Alejandro Chediak, Dr. Alexandre Abreu, Dr. Lauren M. Yarholar, Dr. Maria Suurna, Dr. Naresh Punjabi, Dr. Nestor de la Cruz-Muñoz, Dr. Salim Dib, Dr. Todd Smaka, obstructive sleep apnea, sleep, sleep apnea, sleep medicine