Talking Sleep

David Kent, associate professor and sleep surgeon at Vanderbilt focused on upper airway neurophysiology and device treatments. He breaks down differences among hypoglossal nerve stimulators. Short takes cover bilateral versus unilateral designs, external rechargeable power and timing strategies, respiratory sensing and MRI tradeoffs, and evolving multi-target approaches.

Michel Cahali, an otolaryngologist studying CPAP effects on the airway, and Thais Mauad, a pulmonary pathologist who detects microplastics in human tissues, discuss microplastics in nose, lungs, and even the olfactory bulb. They explore how plastics enter the body, methods to study deposition, surprising findings about PAP therapy, inflammation links, material additives, and steps to reduce exposure in healthcare and daily life.

Dennis Aukley, inpatient sleep program builder and professor, and Reena Mehra, physician-scientist and AASM guideline co-author, discuss the new AASM inpatient OSA guidelines. They cover in-hospital screening strategies, which patients and units to prioritize, inpatient PAP use, consult and navigator models, discharge planning and follow-up, and practical steps to operationalize inpatient sleep care.

David McCarty, a Colorado-based sleep medicine physician and CMO at REBIS Health, shares his altitude expertise. He discusses how low CO2 and loop gain drive central events, patterns across elevations, and mixed obstructive-central presentations. Practical topics include testing and device adjustments for travelers, mask and pressure strategies, and treatment options like oxygen, acetazolamide, and ASV.

Atul Kular, medical director and sleep trials expert, and Mark Boulas, sleep‑disordered breathing researcher, discuss hypnotic use in untreated OSA. They compare drug classes, unpack lemborexant trial design and respiratory outcomes, and debate treatment sequencing for COMISA. The conversation highlights DORAs, REM effects, OTC risks, and practical prescribing considerations.

Mathias Baumert, biomedical engineer from the University of Adelaide with expertise in sensors and algorithms. Cathy Goldstein, neurologist from the University of Michigan focused on clinical and regulatory perspectives. Michael Chee, sleep researcher from the National University of Singapore who led wearable guidance. They discuss regulatory boundaries, practical limits of wearables, TATS (time attempting to sleep), validation needs across populations, and future sensor applications.

Christine Won, Yale sleep medicine leader and AASM committee member; Shirine Allam, Emory professor and fellowship director; Rami Khayat, Penn State sleep division chief. They walk through how the new AASM guidelines were made. They discuss CPAP across CSA types. They debate BPAP backup rates and ASV safety. They cover oxygen, acetazolamide, and phrenic nerve stimulation as treatment options.

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Safwan Badr, the newly appointed editor of the Journal of Clinical Sleep Medicine and sleep medicine physician at Wayne State University, for an in-depth review of the most impactful articles published in JCSM during 2025. Dr. Badr discusses his vision for the journal and the editorial selection process, then guides listeners through key research findings shaping clinical practice. The conversation highlights both highly popular papers and important studies that deserve more attention from practicing clinicians.  A significant focus is placed on research confirming that traditional 4% hypopnea criteria and CMS definitions systematically underestimate sleep apnea in women, with expanded diagnostic criteria helping mitigate these gender disparities. The episode explores groundbreaking research on sleep architecture and Alzheimer's disease, examining how lower slow wave sleep and REM sleep correlate with brain atrophy in AD-vulnerable regions, particularly the inferior parietal lobe.  Consumer sleep technology receives critical examination through a meta-analysis comparing wrist-worn devices to polysomnography, revealing significant limitations in accuracy. Dr. Badr discusses implications for physicians and consumers who increasingly rely on these devices. Mental health intersects with sleep medicine through research showing that nightmares and insomnia in the acute aftermath of trauma predict suicidal ideation—nearly half of acute trauma patients with both conditions experience suicidal ideation within two months, highlighting urgent need for early interventions.  Additional topics include Canadian research on CBT-I effectiveness during pregnancy and findings from the TODAY study examining obstructive sleep apnea's relationship with glycemic control and cardiovascular risk in young adults with youth-onset type 2 diabetes. Whether you're looking to stay current with evidence-based practice changes, interested in emerging research on sleep and neurodegeneration, or seeking to understand gender disparities in sleep medicine, this year-in-review provides essential updates. 

In this special live episode recorded at Sleep Medicine Disruptors in Austin, Texas, host Dr. Seema Khosla sits down with two standout innovators whose technologies captured the spirit of disruptive innovation in sleep medicine. Dr. Jason McKeown from Neurovalens and Dr. Onur Kilic from Bairitone Health present groundbreaking approaches to treating insomnia and personalizing obstructive sleep apnea therapy. Dr. McKeown, a neurologist, introduces his FDA-cleared non-pharmacological treatment for insomnia using vestibular nerve stimulation. He explains how the technology works, why stimulating nerves in this manner is safe, and how it differs from vagus nerve devices. The conversation explores the relationship with cognitive behavioral therapy for insomnia (CBT-I), addresses the placebo effect question, and clarifies whether this is a long-term solution or temporary intervention. Dr. McKeown discusses contraindications including pregnancy and Inspire therapy, potential side effects, and ideal patient populations. Dr. Kilic presents his sensor technology that enables non-invasive assessment of airway collapse location and severity—what he calls an "anatomic PSG." This innovation addresses a critical challenge: predicting which patients will respond to specific treatments like oral appliances, Inspire, or PAP therapy based on individual anatomical collapse patterns. Using a cheek-mounted sensor, the device identifies obstruction levels, differentiates between primary and secondary collapse sites, and detects collapse at the velopharyngeal level. The discussion explores whether this represents a scalable alternative to drug-induced sleep endoscopy (DISE), how it integrates with OSA endotyping, and practical applications during titration studies to identify optimal pressure ranges and guide combination therapies. Both innovators emphasize moving beyond one-size-fits-all approaches toward personalized, anatomy-based treatment selection. Whether you're interested in non-pharmacological insomnia treatments, precision medicine approaches to OSA, or the future of sleep diagnostics, this episode showcases innovative thinking driving the next generation of sleep medicine. Join us for this exciting live conversation from Sleep Medicine Disruptors.

Dave Singh, researcher-clinician in craniofacial development and founder of REMA Sleep, discusses craniofacial sleep medicine as an anatomy-driven approach to OSA. He covers cranial base phenotypes, palatal expansion for adults and children, tongue posture and retraining, lateral pharyngeal wall collapse, and practical assessment techniques for personalized, team-based care.