The Curbsiders Internal Medicine Podcast5 Nov 2018

#123 Sleep Apnea Pearls and Pitfalls

The sleep apnea episode that won’t put you to sleep. Become a sleep apnea guru with incredible insights from Barbara Phillips MD, MSPH, FCCP an expert in pulmonary medicine, critical care and sleep medicine who is also a past president of CHEST! We discuss high-yield topics in the world of obstructive sleep apnea including: home sleep studies vs in-lab polysomnography, the importance of oxygen saturation (the T90 and ODI) when interpreting sleep study results, tricks to improve CPAP adherence, and alternatives therapies for obstructive sleep apnea. ACP members can visit https://acponline.org/curbsiders to claim free CME-MOC credit for this episode and show notes.

Full show notes available at http://thecurbsiders.com/podcast. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and produced by: Cyrus Askin MD

CME questions by: Cyrus Askin MD

Editor: Chris Chiu MD & Matthew Watto MD

Hosts: Cyrus Askin MD & Matthew Watto MD

Guest: Barbara Phillips, MD

Cover-Art & Infographic - Beth Garbitelli, MS1

Time Stamps

00:00 Disclaimer, intro, guest bio
03:00 Guest one liner, book recommendation, advice for trainees
08:10 Clinical case of sleep apnea, some basic stats, and key predictors of sleep apnea
12:38 Barriers to diagnosis and treatment of OSA
15:23 Discussion of T90, hypoxemia and sleep fragmentation
17:05 How to read a sleep study report
21:55 Home sleep apnea testing
24:15 What are the consequences of sleep apnea
28:30 What is the efficacy of cpap for lowering blood pressure and mortality
31:45 Counseling a patient who is new to cpap
33:45 Choice of mask
40:10 Do alternatives to cpap work? e.g. surgery, mandibular advancement devices
44:17 Modafinil and z-drugs
47:15 Driver’s license issues in sleep apnea
48:35 Future of sleep medicine and take home points

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