October 14, 2014

The End of Sleep Medicine (Part 2)

"You can have any color you want, as long as it is black." - Henry Ford

My earlier posts paint an uncertain picture about the future of sleep medicine as it relates to the diagnosis and treatment of obstructive sleep apnea. That said, I see that there are a number of inescapable realities. I have listed them below and included my thoughts about them. How the sleep medicine community chooses to deal with these realities and possibly others will likely dictate the future of sleep medicine.

Reality #1 - Obstructive sleep apnea (OSA), a chronic condition, is far more prevalent than originally imagined and is likely to become even more common due to the rising incidence of obesity and aging of the population. To call it an epidemic is no longer hyperbole.

The number of people suffering with sleep apnea varies depending on who you ask. But whatever number you believe, it is a very large getting larger.  And if you include children the figure are staggering. Something needs to be done to address the 80% who remain undiagnosed and the 50% who are nonadherence due to ineffective treatment.

Reality #2 - The consequences of untreated OSA are more than just reduced quality of life and excessive daytime sleepiness. The effects of OSA impact most, if not all, organ systems in the body.

Current medical research is showing connections between sleep apnea and other diseases, such as some forms of Cancer, Alzheimer's and ADHD in children.  These comorbid conditions arise in part from the chronic intermittent hypoxia that occurs during the apneic events. The connection with hypertension and other cardiovascular disease is solid and that alone warrants finding ways to prevent sleep apnea if possible or to treat it effectively to mitigate further injury.

Reality #3 - There is more  technology available to diagnose and treat OSA and will continue to increase in variety/sophistication in the coming years, including at some point a pharmaceutical intervention.

Diagnostic technology for “out of center testing” continues to improve and while it is unlikely to ever replace in-lab polysomnography insurance companies are now requiring a home test first to determine a diagnosis of OSA. Positive Airway Pressure therapy machines look less and less like medical devices and wireless communication contained in them is facilitating greater ease in monitoring adherence to therapy. Oral Appliance Therapy for mild to moderate OSA has evolved as well making it an acceptable first line treatment. Greater precision  for surgical options is improving the rate of success. Other therapies are in development as well to address the broad range of disease that present.

Reality #4 - The number of Board Certified Sleep Medicine Physicians is not increasing at rate to keep pace with the increasing number of people who need care.

The problem of a narrowing pipeline of physicians is also a problem in other specialities as well, including primary care. The need for appropriately trained allied health professionals, such as those Credential in Clinical Sleep Health to work with primary care and with sleep medicine specialists is great. These physician extenders are the key to getting the undiagnosed into treatment, and to insuring they are adherent. Dentists also have a role to play in screening patients for OSA and with appropriate training treating that portion that will respond to OAT.

Reality #5 - Deductibles and co-pays for health insurance coverage will be set at such a point now that many of the expenses associated with diagnosing and treating OSA will be out-of-pocket or using a health savings account.

There are a number of changes in how healthcare is delivered in the United States, among them is the financial participation required by the consumer. Affordability of diagnosis and treatment will play a role how, particularly those in safety sensitive positions like transportation, chose to proceed.

The future holds great possibilities for the field of sleep medicine, but success is contingent on a willingness to adjust to a changing landscape and to accept that there is plenty of work to go around. It is fair to say that the last sleep apnea patient is not walking through the door and that black is not the only color available.


Cathy said...

I agree, sleep apnea is becoming more and more prevalent due to obesity. The scary part is that so many children are now obese and I wonder how many children unknowingly suffer from sleep apnea because of it. I think that the sleep apnea community needs to come together to make testing more common.

Unknown said...

My aunt has had sleep apnea for years. In the last couple years, they have come out with some amazing new technology to help with this. I was talking to her, and she was telling me how nice it is, so be able to sleep. She still has to be hooked up to machines, but she said they aren't as bulky, and not as difficult to sleep with.


Unknown said...

A great interview /w Edward Grandi and Dr. Yashu Wheeler on - The importance of sleep + Q&A ‪#‎sleep‬ ‪#‎education‬ ‪#‎lifestyle‬ ‪#‎knowledge‬ ‪#‎wellness‬ ‪#‎health‬ ‪#‎mindfulness‬ >> https://youtu.be/zvbbF9LCfE4

Mal said...


As a Sleep Apnea sufferer, it was interesting to read your great article.

What do you think about this article from Cognition Life Science, about a major breakthrough in Sleep Apnea research?


Major Breakthrough in Sleep Apnea Research brings exciting new product!
The frustration about lack of progress in Sleep Apnea research

For years scientists and doctors have been desperately involved in Sleep Apnea Research, looking for a cure to this deadly disease.

Sleep Apnea affects around 18 million sufferers in the United States, yet the only solutions on the market thus far are residential clinical studies or expensive CPAP machines.

The medical establishment’s lack of progress in Sleep Apnea research has lead to massive frustration from the millions of sufferers, as their symptoms will remain unchecked until there is an accessible product for everyone.
The breakthrough in Sleep Apnea research

Cognition Life Science have achieved a major breakthrough in Sleep Apnea Research, as they have discovered a solution that will provide hope for the millions of Sleep Apnea suffers in the United States and worldwide.

Raj Pamnani and his diligent team at Cognition Life Science have made it their quest to provide a pharmaceutical solution for Sleep Apnea.

By having this clear vision, Cognition Life Science and Raj Pamnani have invested heavily in Sleep Apnea research to reach a major breakthrough.

Cognition Life Science’s concerted efforts in Sleep Apnea Research have discovered a product that could change the way the disease is treated.

Imagine the hope this creates in Sleep Apnea sufferers?

No more residential clinical studies!
No more uncomfortable face masks or expensive CPAP machines!

Imagine if you could solve your Sleep Apnea just by taking a pill?
Why Cognition Life Science are the leaders in Sleep Apnea research

Cognition Life Science, Inc. is a pharmaceutical company from Tampa, Florida.

Their mission is to explore, acquire and develop proprietary formulations to treat major pervasive medical conditions and diseases such as:-

Sleep Disorders such as Sleep Apnea
Neurodegenerative diseases such as Alzeimer’s
Mental Acuity
Pain Management

Cognition Life Science utilise two approaches to achieve success:-

They look to collaborate with researchers and institutes developing novel formulations which address markets with annual or potential sales of over $1 billion.
They cross-reference generic drugs and expired patents to find compounds which are intended to reach the brain, with an objective to reformulate with intranasal delivery.

Cognition Life Science have already identified two prescription (Rx) drugs which meet their criteria.

The solution to Sleep Apnea Research

Given their massive strides forward in their mission, Cognitive Life Science are confident they have found a solution to Sleep Apnea available nowhere else in the market.

Cognitive Life Science have discovered a pharmaceutical product in the form of a pill that will cure Sleep Apnea, which will change the way the disease is treated.

Clearly, Raj Pamnani and his team at Cognitive Life Science will continue to progress and build on their exciting achievements in Sleep Apnea Research.

So, if you are a Sleep Apnea sufferer, an investor, or just interested in Sleep Apnea Research, can you afford not to follow the successes of Raj Pamnani and Cognitive Life Science?


Cognition Life Science

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Unknown said...

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Apu Mridha said...

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Unknown said...

Big thanks for this informative post. You can prevent this sleep disease from progressing to a life-threatening degree by doing these 5 Healthy Habits That Help Treat Sleep Apnea