Dr. Robert Auger on Sleep Medicine

This  Mayo Clinic Medical Edge Weekend episode features Mayo Clinic physician Dr. Robert Auger on sleep medicine.

Medical Edge Weekend 2-27-10

10 Comments

  1. Posted February 20, 2010 at 7:38 pm | Permalink

    I’ve been recently diagnosed with fibromyalgia and also seem to have a wheat sensitivity. After Vitamin D & no gluten I feel light years better, but I’m still dragging and folks have mentioned to me the real culprit might be sleep apnea.

    I’ve been hesitant to pursue my sleep health because 1) I always thought it was very good. 2)I don’t think I can lay still all night to wear a mask or anything.

    Am I miles off the mark in my misconceptions? How would one go about being studied for apnea (note: I’m in St. Paul and my health ins. expires in June)

    • Dana Sparks
      Posted March 21, 2010 at 6:32 pm | Permalink

      Annie – Dr. Auger wrote this response. “If you receive sufficient sleep on a nightly basis and remain unrefreshed, you should further pursure professional consultation regarding the possibility of a sleep disorder. This would further enable a study that assesses whether or not you have sleep apnea. Although most people would rather not wear a CPAP (the ‘mask’ used to treat obstructive sleep apnea) most patients adjust to it over time.”

  2. Posted February 26, 2010 at 8:28 pm | Permalink

    I am interested to know if the doctor is going to discuss the stand that the Mayo Clinic has on home sleep testing compared to traditional PSG testing?
    Also, is there going to be any dicsussion on Oral Appliance therapy as an option to CPAP and or Surgery, and what the outcomes have been like for patients who choose this route on a compliance basis.
    Lastly, if its possible to understand what the sleep doctor feels is the main reason that OSA is still so un-diagnosed among primary care physicians it would be great to hear the opinion. It still blows my mind at how many people are walking/falling asleep their whole lives without ever having a diagnosis/screening from primary care with regards to OSA. Of course there are 80 plus other sleep disorders, but since OSA seems to be the reason why 85% or more referrals are sent to sleep docs in the first place, thats the reason for the OSA specific questions. This breathing problem is costing our healthcare system way too much!
    thx,
    Adam

    • Dana Sparks
      Posted March 21, 2010 at 6:45 pm | Permalink

      Adam – Dr. Auger wrote this response, “Published parameters regarding the use of portable monitoring(in lieu of PSG monitoring) have been provided by the American Academy of Sleep Medicine and can be viewed at the following link:
      http://aasmnet.org/Resources/ClinicalGuidelines/030713.pdf. Mayo’s use of portable monitoring reflects these professional guidelines, but limitations may also be incurred by an individual’s third-party payor. We presently use one portable monitoring device (according to patient preference and other considerations) for those with a high pre-test probability of obstructive sleep apnea.
      As a general rule, oral appliances and surgical options should be reserved for those with mild to moderate sleep apnea only.
      Although these therapies are overall less effective than CRAP(which represents the “gold standard”), compliance may be better with these non-CPAP alternatives.
      I do not have a good explanation as to perceived underdiagnosis of obstructive sleep apnea, but recognition of sleep disorders overall seems to be improving.

  3. Posted February 27, 2010 at 9:38 am | Permalink

    Could you please comment on the relationship between sleep and chronic pain? Is there any advice you can offer for people with chronic pain as regards their sleep habits?

    Thanks very much!
    -Zac

    • Dana Sparks
      Posted March 21, 2010 at 6:49 pm | Permalink

      Zac – Dr. Auger wrote this response, “The relationsship between sleep and chronic pain is bidirectional. Those with chronic pain clearly experience increased difficulties initiating and maintaining sleep. On the other hand, there are studies that show that pain perception is increased and that pain threshold is reduced with sleep disturbance. People with chronic pain may also take medications (such as narcotic analgesics) that can increase daytime sedation and exacerbate or induce sleep disordered breathing. My advice would be to pursue a multidisciplinary approach, i.e. through both a pain rehabilitaion center and a sleep center.

  4. Posted February 27, 2010 at 10:24 am | Permalink

    I wonder about dietary supplements and sleep. Is folic acid has any role in helping to sleep?

    • Dana Sparks
      Posted March 21, 2010 at 6:53 pm | Permalink

      George – Dr. Auger wrote this response, “I admittedly know little about the association between dietary supplements and sleep. As I mentioned on the show, melatonin is classified as a “dietary supplement” and is used both as a hypnotic and chronobiotic. I am not aware of any role of folic acid with respect to sleep.”

  5. Diane Tate
    Posted February 27, 2010 at 10:37 am | Permalink

    Is Ambien an addictive drug? How long should someone use this medication?

  6. Dana Sparks
    Posted March 21, 2010 at 6:59 pm | Permalink

    Diane – Dr. Auguer wrote this response, “Ambien (zolpidem) has very low-abuse potential in those without concurrent addiction histories. Although physical withdrawal is not routinely described, one could become “psychologically dependent” if the medication was effective, and he./she had difficulties sleeping without it.
    Regular-release Ambien is technically not approved for longer than approximately 1.5 months. Two similar medications (Ambien CR and Lunesta) are approved for indefinite use, however, which simply reflects the fact that affiliated companies chose to fund long-term studies, which in turn enabled them to secure an indication for indefinite use by the FDA.
    There are open-label studies showing that regular-release Ambien is safe and effective in the long-term.”


%d bloggers like this: