The White Noise Podcast

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Latest Episodes:

Episode #11 - Hypoglossal Nerve Stimulation Mar 07, 2023

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

Episode #10 - Trauma Associated Sleep Disorder Sep 20, 2022

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!

Episode #9 Patient Centered View of Narcolepsy Aug 03, 2022

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

Episode 8- A psychodynamic approach to parasomnia Aug 11, 2020

Join us this month as we discuss parasomnias with psychologist Dr. Alan Eiser.

Episode 7 - OSA and cardiovascular disease Apr 29, 2020

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 intro
3:00 best advice
6:50 pick of the month
12:12 discussion begins
12:30 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 afib
19:30 arrhythmia and auto-cpap
21:30 heart failure and preserved EF
22:50 why does OSA predispose to atrial fibrillation
26:00 anti arrhythmic drugs for afib with co-morbid sleep apnea
29:00 minutes coughing can be edited if you want
29:30 rate or rhythm control for afib?
31:00 fatigue or sleepiness?
32:20 Other sleep related arrhythmias
32:36 Non sustained ventricular tachycardia
33:00 Sustained ventricular tachycardia
36:00 arrhythmia and management on the sleep end
37:40 Long QT
38:00 Chronic afib
38:30 sinus pause
39:30 AV block
42:00 2 Lead ECG problems
43:00 medicare games
44:30 positional therapy
47:15 virtual visits discussed vs face to face

48:30 screening afib for OSA
50:33 compliance and non compliance - sleep heart health study
51:00 Meta –review JAMA
52:40 arrhythmia and cpap, when will my arrhythmia improve?
54:30 treat sleep apnea prior to cardioversion?
58:50 PVC’s
1:01:00 7 pvc/minute
1:02:00 PACs?
1:03:00 bigeminy or trigemini?
1:04:20 oxygen nadir and oxygen desaturation index
1:12:30 using oxygen nadir to reach the patient
1:15 wrap up

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