Sleep Medicine Network
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Hospital to home tracheostomy care
Patients with tracheostomies require comprehensive planning to avoid adverse events. Technological improvement has enhanced our ability to support these patients with complex conditions in their home settings. However, clinical practice guidelines are lacking, and current practice relies on a consensus of expert opinions.1 2 3 Once a patient who has had a tracheostomy begins transitioning…
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Post-intensive care syndrome and insomnia
There has been a recent interest in post-intensive care syndrome (PICS), as an increasing number of patients are surviving critical illness. PICS is defined as “new onset or worsening of impairments in physical, cognitive, and/or mental health that arises after an ICU stay and persists beyond hospital discharge.1 We know that poor sleep is a…
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Is it time to embrace a multinight sleep study?
Since the 1960s, sleep researchers have been intrigued by the first-night effect (FNE) in polysomnography (PSG) studies. A meta-analysis by Ding and colleagues revealed FNE’s impact on sleep metrics, like total sleep time and REM sleep, without affecting the apnea-hypopnea index, highlighting PSG’s limitations in simulating natural sleep patterns.1 Lechat and colleagues conducted a study…
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The not-so-silent night: Challenges in improving sleep in inpatients with Dr. Vineet Arora
Q: Are there interventions that can be readily implemented to improve sleep quality for hospitalized patients? Dr. Arora: A patient’s first night in the hospital is probably not the night to liberalize sleep; you’re still figuring out whether they’re stable. But by the second or third day, you should be questioning—do you need vitals at…
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Seasonal variations in sleep architecture
Do you feel like you sleep worse in the spring and have more difficulty keeping your schedule on track? There are new data to support the way you feel based on our deeper understanding of seasonal variations in sleep architecture. Patients in a recent study had 43 minutes less total sleep time and approximately 30…
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CPAP in overlap syndrome: Unveiling the evidence
The overlap syndrome (OS), which refers to the co-occurrence of OSA and COPD, was first described by Flenley in 1985 (Flenley DC. Clin Chest Med. 1985;6[4]:651). Over the years, numerous studies have demonstrated an increased risk of hospitalization and mortality in patients with OS (Brennan M, et al. 2022;1-10). Despite these findings, limited evidence exists…
