OVERVIEW

The Ohio State University Sleep Symposium is organized by The Ohio State University Wexner Medical Center (OSUMC) and will be held on Sep 24, 2021.

Course Overview:
Sleep health varies across populations, and more information regarding sleep related healthcare disparities between populations has come to light recently. Data supports that there is an increased burden of disease in minority populations (such as decreased sleep time), however minority populations are more likely to be underdiagnosed with sleep conditions.

Obstructive sleep apena (OSA) is well recognized as a prevelant disease impacting patients' long term quality of life, morbidty and moratility. Growing reseach points to OSA being a heterogenous disorder consisting of multiple phenotypic subgroups, with different therapeutic goals and prognostic implications. While the association between cardiovascular disease (CVD) and OSA is clear, CPAP therapy does not have high quality RCT data to prove its efficacy over time. Current data suggests that cluster analysis/subgrouping (especially by defining a sleepy subtype) may link CPAP with reduced CVD. It is therefore important for sleep providers to understand how to indentify subtypes and what/if any changes to clincial practice are appropraite.

OSA is an independent risk factor for strokes. Post-stroke treatment of OSA with CPAP has mixed results even today, leaving providers difficult in interpreting the literature as there are minimal trials that are sufficiently powered to draw conclusions. As the prevalence of OSA may surpass 70%, it is important to understand the current literature to properly manage this population. Additionally, OSA in the pediatric population is approached differently. Tonsillectomy with adenoidectomy is the preferred treatment (rather than CPAP for adults), and as infants additional considerations regarding apparent life-threatening events/brief resolved unexplained events (ALTE/BRUE) need to be addressed.

Parasomnias, circadian rhythm disorders, and hypersomnia disorders can be treated with medications, however this approach is not always the best option and behavioral approaches are unique for each condition. Use of cognitive behavioral therapy or psychotherapy can have variable treatment response for parasomnias, with limited data available to guide treatment decisions. Additionally, effective use of behavioral therapy in the context of telemedicine makes it timely to learn about what strategies can be employed for patients with hypersomnia or circadian rhythm disorders via video or telephone encounters.

Restless leg syndrome is a common complaint in the sleep medicine clinic, with several treatment options which vary in risks and benefits. In particular, the approach to managing augmentation can be challenging as there are no clear established guidelines. Additionally, proper use of opiates in this population is also difficult to determine given the opiate epidemic.

Objectives:
At the end of this activity, learners will be able to:
• Describe health care disparities in their patient populations with regards to sleep medicine.
• Describe the different OSA phenotypes and how that may shape their approach to OSA management.
• Describe the association between OSA and stroke
• Describe normal pediatric sleep and common sleep issues in pediatric patients.
• Describe behavioral strategiesto treat patients with parasomnias, hypersomnia, and circadian rhythym disorders.
• Demonstrate how to manage complicated RLS and insomnia patients.