The Future of Sleep Medicine,      A Lay Perspective
Disclaimer - Renuncia          I am not a          doctor, nor do I          play one on          television.             ...
Agenda   Sleep Medicine   as it is   Sleep Medicine   as it should be                     3
4
Sleep Apnea is an equal opportunity condition                                                5
Sleep Medicine As It IsAwareness     Diagnosis      Treatment     Missing is Follow-up/Support                            ...
The patient can often fall through a crack as large as the Grand Canyon                                                   ...
Sleep Medicine – The Future                   The Internet Awareness             The General Practice Doctor or           ...
Sleep Medicine – The Future                Screening    Awareness   Limited Channel                Full PSGDiagnosis      ...
With some patients it is easy to know whether they have sleep apnea                                  TRIAGE               ...
Sleep Medicine – The Future                Screening    Awareness   Limited Channel                Full PSGDiagnosis      ...
Sleep Medicine – The Future                 Behavioral Changes    Awareness                 “Adjunctive” TherapyDiagnosis ...
Sleep Medicine – The Future     Awareness   Acclimatizing                 Acceptance Diagnosis                 Adherence  ...
Impossible Dream?        • Awareness          – Trusted Sources        • Diagnosis          – Triage        • Treatment   ...
There is much work to do – we have reach the only the tip                                                    15
Remember the goal is to sleep like babies – Thank you    Edward Grandi - egrandi@sleepapnea.org                           ...
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Future of sleep medicine madrid5

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An edited verison of a talk I gave in Madrid Spain on February 17, 2012.

Published in: Health & Medicine
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  • Good afternoon and thank you for the honor and privilege of speaking to you on the future of sleep medicine. As the only speaker from the United States in a company of brilliant researchers and clinicians – I have a large challenge ahead of me.
  • Just to be absolutely clear – I am not a doctor. The basis of my understanding comes from being a keen observer of the sleep medicine field in the United States. My position as executive director of the only national patient organization addressing this subject give me a unique perspective. Again I am honored to offer my vision of the future.
  • In the brief amount of time I have, let me share a few slides about sleep medicine as it is and as it should be, my opinion. My talk references specifically sleep apnea; it among sleep disorders is the most common and its consequences most serious.
  • Snoring and sleep apnea as many speakers have shared is a serious, yet under-recognized condition – contributing to a number of life-threatening conditions – cardiovascular disease as well as metabolic disorders. But we can not forget that these conditions affect the bed partner as well and robs them of valuable sleep. There are two victims – assuming there is still a bed partner in the bed or the house!
  • Snoring and sleep apnea as many speakers have shared is a serious, yet under-recognized condition – contributing to a number of life-threatening conditions – cardiovascular disease as well as metabolic disorders. But we can not forget that these conditions affect the bed partner as well and robs them of valuable sleep. There are two victims – assuming there is still a bed partner in the bed or the house!
  • A person may become aware they have a problem with sleep apnea when their spouse tells them or perhaps as a result of an auto accident or worse as a result of a heart attack. At that point they must seek out help if they know where to look. The diagnosis may be by PSG or home study or using something like an apnealink. Depending on the doctor they saw may determine the type of treatment recommended – surgery, PAP, oral appliance, a new pillow. What is missing from this picture is follow up. If the patient is not lost by this point, it is very likely they will be now.
  • A person may become aware they have a problem with sleep apnea when their spouse tells them or perhaps as a result of an auto accident or worse as a result of a heart attack. At that point they must seek out help if they know where to look. The diagnosis may be by PSG or home study or using something like an apnealink. Depending on the doctor they saw may determine the type of treatment recommended – surgery, PAP, oral appliance, a new pillow. What is missing from this picture is follow up. If the patient is not lost by this point, it is very likely they will be now.
  • The future of sleep medicine will be about integrating the messages on sleep disorders with the trusted messengers – The Internet can be useful tool conveying information, but only if the healthcare professional is there to confirm what is true from what is false and sadly there is a lot that is false out there now.
  • There is an embarrassment of riches when it comes to figuring out if someone has sleep apnea. Then, of course, in some cases you can just tell. The future of sleep medicine will be to triage – in the doctor or dentist’s office, the patient to determine what of diagnostic services, if any, are needed.
  • There is an embarrassment of riches when it comes to figuring out if someone has sleep apnea. Then, of course, in some cases you can just tell. The future of sleep medicine will be to triage – in the doctor or dentist’s office, the patient to determine what of diagnostic services, if any, are needed.
  • There is an embarrassment of riches when it comes to figuring out if someone has sleep apnea. Then, of course, in some cases you can just tell. The future of sleep medicine will be to triage – in the doctor or dentist’s office, the patient to determine what of diagnostic services, if any, are needed.
  • We began with surgery, following by Positive Airway Pressure and then Oral Appliance therapy – there are variations on all of these and likely to be more. The future of sleep medicine will rest in phenotyping, which will help determine based on a persons genetic make-up what treatment is likely to be most effective.
  • Compliance/adherence to therapy is not very good, at least in the United States and it does not matter whether the treatment is for sleep apnea or heart disease or diabetes. The future of sleep medicine will depend on creating a model of follow up that will encourage the patient to stay with their chosen therapy.
  • The dentist, whether they specialize in sleep medicine or not, has an important role to play in the future of sleep medicine as does the general practice physician – from being a trusted source of information on sleep disorders, to triaging the patient for diagnosis, understanding the therapeutic options, Finally support – perhaps as important as awareness - if a patient does not use their chosen therapy – is worse than if they were unaware.
  • I close reminding you all that we are only seeing the tip of the iceberg. There are still millions in need of our help. I hope you will be part of the future of sleep medicine and insure that all will enjoy the sleep we enjoyed as babies.
  • I close reminding you all that we are only seeing the tip of the iceberg. There are still millions in need of our help. I hope you will be part of the future of sleep medicine and insure that all will enjoy the sleep we enjoyed as babies.
  • Future of sleep medicine madrid5

    1. 1. The Future of Sleep Medicine, A Lay Perspective
    2. 2. Disclaimer - Renuncia I am not a doctor, nor do I play one on television. 2
    3. 3. Agenda Sleep Medicine as it is Sleep Medicine as it should be 3
    4. 4. 4
    5. 5. Sleep Apnea is an equal opportunity condition 5
    6. 6. Sleep Medicine As It IsAwareness Diagnosis Treatment Missing is Follow-up/Support 6
    7. 7. The patient can often fall through a crack as large as the Grand Canyon 7
    8. 8. Sleep Medicine – The Future The Internet Awareness The General Practice Doctor or Dentist should be the trusted source to his patients, particular those at high risk of sleep apnea. 8
    9. 9. Sleep Medicine – The Future Screening Awareness Limited Channel Full PSGDiagnosis 9
    10. 10. With some patients it is easy to know whether they have sleep apnea TRIAGE 10
    11. 11. Sleep Medicine – The Future Screening Awareness Limited Channel Full PSGDiagnosis TRIAGE 11
    12. 12. Sleep Medicine – The Future Behavioral Changes Awareness “Adjunctive” TherapyDiagnosis Major Intervention Treatment Integration 12
    13. 13. Sleep Medicine – The Future Awareness Acclimatizing Acceptance Diagnosis Adherence Treatment The General Practice doctor or Dentist should provide Follow-up ongoing support to his apnea patients. 13
    14. 14. Impossible Dream? • Awareness – Trusted Sources • Diagnosis – Triage • Treatment – Integration • Follow-up – Support 14
    15. 15. There is much work to do – we have reach the only the tip 15
    16. 16. Remember the goal is to sleep like babies – Thank you Edward Grandi - egrandi@sleepapnea.org 16

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