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The White Noise Podcast

8 Episodes

64 minutes | Mar 7, 2023
Episode #11 - Hypoglossal Nerve Stimulation
In this months episode we will be discussing all things Inspire with Dr. Paul Hoff, an ENT at Michigan Medicine.  What is Hypoglossal Nerve Stimulation? Who can get it? Does it Even work? Listen as we answer all your burning questions.  Show Notes 3:00 get to know you questions 9:20 Favorite Book Best Advice 10:00 The Inspire Case 11:00 What type of sleep study? 18:20 AHI Cutofffs: 18:55 Goals of Care? 21:50 What is considered effective therapy? 24:30 Star Trial link: Upper-Airway Stimulation for Obstructive Sleep Apnea | NEJM Adhere Registry Link: Results of the ADHERE upper airway stimulation registry and predictors of therapy efficacy - Thaler - 2020 - The Laryngoscope - Wiley Online Library Define CPAP failure? 26:00 Nasal obstruction causing CPAP failure 28:00 Floppy Epiglottis causing Aerophagia? 28:30 Surgery for Aerophagia 29:30 Risks and medical contraindications 33:00 MRI compatibility? 33:30 Surgery description/length 34:30 ICD compatibility? 35:00 Avg Voltage ranges? 37:00 Removing devices 39:00 Recovery time 39:40 Incision size 40:45 Back to the case, parameters for referral 43:00 Drug Induced Sleep Endoscopy (DISE) 43:45 What percentage of patients fail DISE? 47:00 Management after Inspire placement 48:15 Inspire sync: 49:15 Battery life 11 years: 51:00 Explant 51:30 Surgical options other than Inspire 53:15 Does UPPP work? 56:00 What can we expect from surgery? 57:00 When to refer for large tonsils 59:00 Closing comments 1:01:00
67 minutes | Sep 20, 2022
Episode #10 - Trauma Associated Sleep Disorder
In this months episode we chat with Dr. Miranda Lim of OHSU about Trauma Associated Sleep Disorder. Is it a new disorder? Does it always evolve into REM sleep Behavior Disorder? Are there any treatments? Listen to find out! 
71 minutes | Aug 3, 2022
Episode #9 Patient Centered View of Narcolepsy
In this months episode we discuss narcolepsy with Matthew Horsnell. Matt is a narcolepsy patient and advocate, and we discuss his journey of living with narcolepsy.    SHOW NOTES Introduction of Guest: (5:00) Matt’s Best Advice (11:00) Matt’s Role in the sleep community (12:40) Matt’s symptoms onset (15:00) Matt’s additional symptoms (19:00) Matt’s onset of cataplexy (23:00) Cataplexy triggers (24:45) Delayed diagnosis: (27:00) Nightmares and sleep paralysis onset (31:30) One more question about sleep paralysis (34:15) Partial cataplexy (37:50) Diagnosis and Management: (39:00) Pitolisant (43:45) Strategic Napping (44:15) Bitter Pills (45:15) AASM revised Guidelines (47:22) Sodium Oxybate and Cataplexy (49:00) Finding a sleep physician to manage narcolepsy (55:00) Sleep apnea (60:30) MSLT (62:15) Treat Clinically (65:00) 4 pillars of management (66:00) Patient request/feedback (68:00) Academic vs private practice (71:30)     Links to articles and guidelines referenced in this episode are included  Trotti LM. Central Disorders of Hypersomnolence. Continuum (Minneap Minn). 2020 Aug;26(4):890-907. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine clinical practice guideline
63 minutes | Aug 11, 2020
Episode 8- A psychodynamic approach to parasomnia
Join us this month as we discuss parasomnias with psychologist Dr. Alan Eiser. 
76 minutes | Apr 29, 2020
Episode 7 - OSA and cardiovascular disease
Join us this month as we discuss OSA and cardiovascular disease with Dr. Peter Farrehi, a cardiologist at the University of Michigan. We focus on arrhythmias, but do delve into other topics as well. We hope you enjoy! Time Stamps 00:45 intro3:00 best advice6:50 pick of the month12:12 discussion begins12:30 What should we be looking for on a sleep ECG?14:00 See the patient or do the sleep study first?16:38 should every patient with afib get a sleep study?17:15 STOP BANG screening and afib19:30 arrhythmia and auto-cpap21:30 heart failure and preserved EF22:50 why does OSA predispose to atrial fibrillation26:00 anti arrhythmic drugs for afib with co-morbid sleep apnea29:00 minutes coughing can be edited if you want29:30 rate or rhythm control for afib?31:00 fatigue or sleepiness?32:20 Other sleep related arrhythmias32:36 Non sustained ventricular tachycardia33:00 Sustained ventricular tachycardia36:00 arrhythmia and management on the sleep end37:40 Long QT38:00 Chronic afib38:30 sinus pause39:30 AV block42:00 2 Lead ECG problems43:00 medicare games44:30 positional therapy47:15 virtual visits discussed vs face to face 48:30 screening afib for OSA50:33 compliance and non compliance - sleep heart health study51:00 Meta –review JAMA52:40 arrhythmia and cpap, when will my arrhythmia improve?54:30 treat sleep apnea prior to cardioversion?58:50 PVC’s1:01:00 7 pvc/minute1:02:00 PACs?1:03:00 bigeminy or trigemini?1:04:20 oxygen nadir and oxygen desaturation index1:12:30 using oxygen nadir to reach the patient1:15 wrap up
74 minutes | Sep 6, 2019
Episode #5 Pediatric Obstructive Sleep Apnea
Show notes will be up shortly. Thank you for your patience!
52 minutes | May 2, 2019
Episode #3 Nightmare Disorder Part 2
This episode was written and produced by John Barkham, MD, Mohan Dutt, MD, and Alok Sachdeva MD. Join The White Noise Podcast in part II of their discussion on nightmare disorder. In this episode we speak with Dr. Todd Favorite, an expert in the treatment of PTSD and nightmare disorders. Show Notes Season 1-Episode 3- Nightmare Disorder Part 2 Time Stamps 0:00 – Introduction 0:30 – Get to know Dr. Favorite 2:45 – Pick of the Month Paths of Glory by Jeffery Archer 5:00 – Clinical Case 6:45 – Initial Evaluation 8:00 – Nightmares in the setting of post-traumatic stress disorder 16:00 – Dream rescripting 22:00 – How to evaluate success 28:00 – Choosing the right patient 30:00 – How to address nightmares with patients 38:00 – Scoring systems 39:45 – More information on dream rescripting 42:00 – Co-therapy with medication 45:00 – How to be successful 47:00 – Medication vs nightmare reduction therapy Dr. Favorites Recommended Reading List Davis, J.L., Treating Post-Trauma Nightmares : A Cognitive Behavioral Approach. Springer Publishing Co. NY Favorite, T.K., Conroy, D. (2018). Psychosocial Treatments for Trauma-Based Nightmares. Psychiatric Times, Sept 2018  Swanson, L., Favorite, T.K, Arnedt, T., Horin, E. (2009).A Combined Treatment for Nightmares and Insomnia in Combat Veterans: A Pilot Study. Journal of Traumatic Stress, 22(6): 639-642. Krakow,.B. , et.al. (2001). Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors With Posttraumatic Stress Disorder A Randomized Controlled Trial. JAMA, August 1, 2001—Vol 286, No. 5 Mysliwiec, V., O’Reilly, B., Polchinski, J., et.al. (2014). Trauma Associated Sleep Disorder: A Proposed Parasomnia Encompassing Disruptive Nocturnal Behaviors, Nightmares, and REM without Atonia in Trauma Survivors.Journal of Clinical Sleep Medicine, Vol. 10, No. 10 Disclosures The authors of The White Noise Podcast do not have any financial disclosures.
58 minutes | Mar 26, 2019
Episode #1 Delayed Phase Sleep Wake Disorder
Hi Join The White Noise Podcast in a discussion of the diagnosis and management of Delayed Sleep Wake Phase Disorder (DSWPD) with special guest Dr. Cathy Goldstein, an expert in circadian rhythm disorders in Ann Arbor, Michigan and Chair of the Artificial Intelligence in Sleep Medicine subcommittee of the American Academy of Sleep Medicine (AASM). CLICK HERE TO CLAIM CME CREDIT Show Notes – Season 1, Episode 1 – Delayed Phase Sleep Wake Disorder Definitions: 1. Dim light melatonin onset (DLMO): 2. Phase response curve 3. Phase angle 4. Tau Clinical Pearls Diagnosis of delayed phase sleep wake disorder starts with…
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