“That's taxpayer’s money that is going to support research and development and pilot projects to develop a food system that is based on environmental destruction and greed and disregard for animals, fish, and any of the other marine mammals that might be around it.” - Andrianna Natsoulas Andrianna Natsoulas is the campaign director for Don't Cage Our Oceans, an organization that exists to keep our oceans free from industrial fish farms. Offshore finfish farming is the mass cultivation of finfish in marine waters, in underwater or floating net pens, pods, and cages. Offshore finfish farms are factory farms that harm public health, the environment, and local communities and economies that rely on the ocean and its resources. Don’t Cage Our Oceans are a coalition of diverse organizations working together to stop the development of offshore finfish farming in the United States through federal law, policies, and coalition building. And, although it is not yet happening, right now the US Administration and Congress are promoting this kind of farming, which would be nothing short of disastrous for the oceans, the planet and the people and animals who live here. dontcageouroceans.org…
The aim of this sleep medicine podcast is to provide health care professionals who deal with sleep related issues with the most up to date clinical information when. We use expert interviews with leaders in the field of sleep medicine to help guide learning and grow clinical practice. We also try to have some fun along the way.
The aim of this sleep medicine podcast is to provide health care professionals who deal with sleep related issues with the most up to date clinical information when. We use expert interviews with leaders in the field of sleep medicine to help guide learning and grow clinical practice. We also try to have some fun along the way.
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 e fficacy - 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…
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!
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…
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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