Sleep is an essential component of health and wellness; yet, many people experience disruptions in their sleep-wake cycle that are severe enough to impair physiological and psychosocial functioning. Disorders of the sleep-wake cycle, such as obstructive sleep apnea, narcolepsy and hypersomnia, as well as associated syndromes such as cataplexy and excessive daytime sleepiness, represent significant health problems with short- and long-term consequences. Sleep disorders have been associated with metabolic effects, changes in circadian rhythms, proinflammatory responses, and psychiatric, neurologic, pulmonary, and cardiac conditions, as well as decrements in neurocognitive domains. Likewise, sleep disorders can negatively impact work performance and attendance, and may contribute to increased injuries and accidents, creating a significant economic burden, as well as increased health care utilization and more frequent and longer hospitalizations.

Given the significant impact of sleep disorders, the identification and implementation of safe, effective therapies is paramount. The CME Outfitters Sleep Disorders Hub is designed to provide clinicians with the latest clinical practice guidelines, diagnostic strategies and tools, and scientific updates on current and emerging therapies to optimize the management of sleep disorders. In addition, the Sleep Disorders Hub also provides patient education tools to empower patients to make informed decisions about their care.

CME/CE activities

Hitting Refresh on Excessive Daytime Sleepiness: Managing Patients with Narcolepsy and Idiopathic Hypersomnia

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Virtual Symposium | Friday, June 11, 2021 | 6:15 PM – 7:45 PM ET | This CME Outfitters virtual symposium will take place during the AASM SLEEP 2021 virtual conference. Expert faculty will discuss the spectrum of EDS across the subtypes of narcolepsy, strategies to apply data from recent clinical trials to treatment decision-making, and the impact of emerging agents for the management of EDS in patients with IH.

Lose a Little Sleep, Lose a Lot of Life

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This CMEO Journal Club activity is the first in a three-part series that focuses on the presentation of EDS and evidence-based measures to assess its impact on QoL so that clinicians might better educate patients on the significance of detecting and treating EDS.

Because “Good Enough” is Not Ok: Examining the Need for Novel Therapies in the Management of EDS in OSA and Narcolepsy

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In this second installment of a 3-part journal club series on making sense of the latest clinical data on EDS in obstructive sleep apnea (OSA) and narcolepsy, featuring expert faculty discussing the factors to consider when making treatment selections for patients and how best to personalize treatment strategies, including which patients would be ideal for JZP-258, transitioning patients from one therapy to another, and dosing considerations.

Putting Data into Practice: Applying the Latest Clinical Evidence to Management Strategies

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The final installment of this 3-part journal club series hosted by CME Outfitters highlights the latest clinical evidence on novel therapies for EDS in obstructive sleep apnea (OSA) and narcolepsy and how to incorporate this evidence into optimal treatment planning to reduce the burden of EDS.

Laying to Rest Challenges in Managing Excessive Daytime Sleepiness in Patients with Obstructive Sleep Apnea or Narcolepsy - An Augmented Reality Experience

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This CMEO OnDemand webcast examines the impact of EDS on clinical outcomes, QoL, and psychosocial functioning as well as the subsequent need for early detection and effective treatment. In order to apply the latest scientific updates in sleep medicine, this symposium will feature Augmented Reality, enabling expert faculty to walk clinicians through the core physiological mechanisms involved in sleep and the means by which current and novel therapies exert their clinical impact. By navigating recent clinical trial data on these therapies, clinicians should be better able to apply the latest evidence to practice, optimizing the management of EDS in patients with narcolepsy or OSA.

I Shouldn't Be This Sleepy: A Look into EDS

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In this CMEOCast podcast episode, expert faculty discuss how to recognize the burden imposed by EDS in patients with OSA or narcolepsy, the use of evidence-based tools to improve detection, and strategies for identifying patients in whom it is appropriate to initiate treatment for EDS.

Matching Treatment Choice to the Pathophysiology of Sleep

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In the second episode of this CME Outfitters podcast series on EDS, expert faculty will focus on identifying key neurotransmitters involved in the sleep-wake cycle and recognizing how therapies targeted to those key neurotransmitters exert their therapeutic effect on EDS in narcolepsy and OSA.

Differentiators When Choosing Novel Treatment Options for EDS


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This CMEOCast podcast focuses on developing personalized, effective strategies to reduce EDS in patients with OSA or narcolepsy, including an overview of data on incorporating the use of safer, lower sodium alternatives to mitigate EDS without imposing cardiovascular burden.

Diagnosis and Treatment of Pediatric Narcolepsy with Cataplexy


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This CMEOCast podcast features the latest long-term safety and efficacy data for pediatric narcolepsy treatments, which can be utilized to develop the best possible treatment strategies for their patients.

Updates on the Management of Insomnia: Expert Guidance Through the Latest Clinical Trials on Dual Orexin Receptor Antagonists


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In this CE activity, you will learn how to reduce the burden of insomnia on patients by asking the right questions, understanding the role orexin plays in regulating sleep, and following emerging data on orexin inhibitors.
Animations

Impact of EDS: An Animated Tour

In this video, Dr. Bogan uses an augmented reality animation to describe the extensive impact EDS can have on both medical and psychiatric conditions.

Neurotransmitters Involved in the Sleep-Wake Cycle: An Animated Tour

In this video, Dr. Bogan uses an augmented reality animation to examine the regions of the brain that promote sleep and wakefulness, and the neurotransmitters involved.

Interaction of Stimulants with the Sleep-Wake Cycle: An Animated Tour

In this video, Dr. Bogan uses an augmented reality animation to describe the interaction of traditional stimulants such as amphetamines on the sleep-wake cycle. This video will also explain the differences between non-selective stimulants and selective stimulants such as modafinil and armodafinil.

Interaction of Solriamfetol and the Sleep-Wake Cycle: An Animated Tour

In this video, Dr. Bogan uses an augmented reality animation to explore how through the inhibition of dopamine and norepinephrine reuptake, solriamfetol produces its potent wake-promoting effect and improvement in the symptoms of EDS.

Interaction of Pitolisant and the Sleep-Wake Cycle: An Animated Tour

In this video, Dr. Bogan uses an augmented reality animation to explain how pitolisant increases levels of histamine in the brain to decrease symptoms of EDS and improve wakefulness, vigilance, attention, and memory.

Digital Health Tools
  • American Academy of Sleep Medicine (AASM) Sleep TM app, a mobile app that directly connects patients to sleep medicine professionals and accredited sleep centers through the AASM SleepTM telemedicine system. The app provides patients convenient access to sleep medicine services on their mobile devices. – Click Here
  • Sleep Tuner, FDA-registered sleep sensor, worn on the forehead, to measure blood oxygenation, heart rate, sleep position, and stopped breathing events. It is designed to offer the accuracy of medical sleep studies without the cost or inconvenience. – Click Here
  • ResApp, uses a smartphone to detect sleep apnea by sound, delivering a highly-scalable, accurate, and easy-to-use screening test. It uses a machine-learning algorithm to detect the severity of sleep apnea by the sound of a person’s breathing and snoring. A user can put the smartphone next to their bed and it will record their sleeping. – Click Here
  • DeepHeart, a deep neural network technology that can detect hypertension and sleep apnea. – Click Here
Patient Resources

Infographics

Healthy Sleep Duration Poster

Stop the Snore Infographic

Little Sleep, Big Costs Infographic

Sleep Apnea Hurts Hearts

Websites

Sleep Education (from the American Academy of Sleep Medicine): http://www.sleepeducation.org

National Healthy Sleep Awareness Project (from the American Academy of Sleep Medicine):  http://www.sleepeducation.org/healthysleep

National Sleep Foundation: https://www.sleepfoundation.org

American Sleep Association: https://www.sleepassociation.org

National Heart, Lung, and Blood Institute-National Institutes of Health:  https://www.nhlbi.nih.gov/health-pro/resources/sleep

Patient Organizations

American Sleep Apnea Association: http://www.sleepapnea.org

Circadian Sleep Disorders Network: http://www.circadiansleepdisorders.org

Narcolepsy Network: http://narcolepsynetwork.org

Restless Legs Syndrome Foundation: https://www.rls.org

Wake Up Narcolepsy: http://www.wakeupnarcolepsy.org/

Reading Room

Thorpy MJ, Shapiro C, Mayer G, et al. A randomized study of solriamfetol for excessive sleepiness in narcolepsy. Ann Neurol. 2019;85(3):359-370. Download PDF

Abad VC. An evaluation of sodium oxybate as a treatment option for narcolepsy. Expert Opin Pharmacother. 2019;20(10):1189-1199. Available at https://www.ncbi.nlm.nih.gov/pubmed/31136215.

Black J, Swick T, Bogan R, et al. Impact of sodium oxybate, modafinil, and combination treatment on excessive daytime sleepiness in patients who have narcolepsy with or without cataplexy. Sleep Med. 2016;24:57-62. Download PDF

Schweitzer PK, Rosenberg R, Zammit GK, et al. Solriamfetol for Excessive Sleepiness in Obstructive Sleep Apnea (TONES 3). A Randomized Controlled Trial. Am J Respir Crit Care Med. 2019;199(11):1421-1431. Available at https://www.ncbi.nlm.nih.gov/pubmed/30521757.

Martinez-Garcia MA, Campos-Rodriguez F, Barbé F, et al. Precision medicine in obstructive sleep apnoea. Lancet Respir Med. 2019 May;7(5):456-464. Available at https://www.ncbi.nlm.nih.gov/pubmed/30987857.

Inoue Y, Miki M, Tabata T. Findings of the Maintenance of Wakefulness Test and its relationship with response to modafinil therapy for residual excessive daytime sleepiness in obstructive sleep apnea patients adequately treated with nasal continuous positive airway pressure. Sleep Med. 2016;27-28:45-48. Available at https://www.ncbi.nlm.nih.gov/pubmed/27938918.

Scheer D, Schwartz SW, Parr M, et al. Prevalence and Incidence of Narcolepsy in a U.S. Health Care Claims Database, 2008-2010. Sleep. 2019. Epub ahead of print]. Available at https://www.ncbi.nlm.nih.gov/pubmed/31004158.

Thorpy MJ, Hiller G. The Medical and Economic Burden of Narcolepsy: Implications for Managed Care. Am Health Drug Benefits. 2017;10(5):233-241. – Download PDF

Hein M, Lanquart JP, Loas G, et al. Prevalence and risk factors of excessive daytime sleepiness in major depression: A study with 703 individuals referred for polysomnography. J Affect Disord. 2019 Jan 15;243:23-32. Available at https://www.ncbi.nlm.nih.gov/pubmed/30223136.

Kallweit U, Bassetti CL. Pharmacological management of narcolepsy with and without cataplexy. Expert Opin Pharmacother. 2017;18(8):809-817. Available at https://www.ncbi.nlm.nih.gov/pubmed/28443381.

Mayer G, Piazzi G, Iranzo A, et al. Long-term compliance, safety, and tolerability of sodium oxybate treatment in patients with narcolepsy type 1: a post-authorization, noninterventional surveillance study. Sleep. 2018;41(9). – Download PDF

Szabo ST, Thorpy MJ, Mayer G, et al. Neurobiological and immunogenetic aspects of narcolepsy: Implications for pharmacotherapy. Sleep Med Rev. 2019;43:23-36. – Download PDF

Gentina T, Bailly S, Jounieaux F, et al. Marital quality, partner’s engagement and continuous positive airway pressure adherence in obstructive sleep apnea. Sleep Med. 2019;55:56-61. Available at https://www.ncbi.nlm.nih.gov/pubmed/30771736.

Schöbel C, Knorre S, Glos M, et al. Improved follow-up by peripheral arterial tonometry in CPAP-treated patients with obstructive sleep apnea and persistent excessive daytime sleepiness. Sleep Breath. 2018 Dec;22(4):1153-1160. Available at https://www.ncbi.nlm.nih.gov/pubmed/29956104.

Avellar AB, Carvalho LB, Prado GF, et al. Pharmacotherapy for residual excessive sleepiness and cognition in CPAP-treated patients with obstructive sleep apnea syndrome: A systematic review and meta-analysis. Sleep Med Rev. 2016;30:97-107. Available at https://www.ncbi.nlm.nih.gov/pubmed/27865102.

Gasa M, Tamisier R, Launois SH, et al. Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure. J Sleep Res. 2013;22(4):389-397. – Download PDF

Inoue Y, Takasaki Y, Yamashiro Y. Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated Japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study. J Clin Sleep Med. 2013;9(8):751-757. – Download PDF

Sukhal S, Khalid M, Tulaimat A. Effect of Wakefulness-Promoting Agents on Sleepiness in Patients with Sleep Apnea Treated with CPAP: A Meta-Analysis. J Clin Sleep Med. 2015;11(10):1179-1186. – Download PDF