Mayo Clinic Center for Sleep Medicine

While less common than its cousin, Parkinson's disease, multiple system atrophy is commonly associated with severe sleep disturbances, at least one of which may be life threatening. In this podcast we discuss how to identify these disorders, their significance and management.

Hallucinations at night may be frightening and distressing.  Some may indeed indicate serious disease but most are harmless.  In this podcast we discussed different types of nocturnal hallucinations, their causes and the conditions with which they may be confused.

Sleep specialists are often asked to initiate non-invasive ventilation for patients with amyotrophic lateral sclerosis. The guest on our podcast today, Dr. Peter Gay, a world expert in this area, provides very helpful practical information to guide this process.

Most headache sufferers are well aware of the relationship between their disorder and sleep. In in this podcast, we discuss how understanding this association may assist our patients with both their pain and their sleep disturbances.

Alzheimer disease is the most common form of dementia. In this podcast, we discuss the intimate relationship between sleep, sleep disorders and Alzheimer disease.

Idiopathic hypersomnia is sometimes regarded as the stepchild of narcolepsy. But it may be more common than its better known relation. In this podcast, we discussed the diagnosis and management of this elusive disorder. 

Narcolepsy most commonly starts in adolescence. But how it presents and how it is diagnosed may be different from an adult presentation. In this podcast, we discuss narcolepsy and its management in childhood and adolescence.

Although obstructive sleep apnea is most common in older adults, it can also be seen in children, often resulting in severe morbidity.  In this podcast, we discuss how to identify sleep apnea in the pediatric population and approaches to its management.

Parents of children with insomnia know how distressing this condition can be.  In this podcast, we discuss possible causes and how best to help children and families.

Being unable to fall asleep until well after midnight and preferring to sleep until at least mid morning causes serious impairment to school and work attendance and performance.  In this podcast, we discuss the nature of delayed sleep-wake phase disorder and approaches to management.

Anyone who has traveled across time zones has experienced jet lag and there are many online suggestions for counteracting the effects. In this podcast a circadian rhythm expert discussed what measures are most likely to help.

About a fifth of U.S. workers do shift work. This podcast examines how sleep professionals can best help shift workers perform and live optimally.

How can sleep professionals help advocate for later school start times for adolescents? In this podcast we meet a sleep specialist who was successful in his efforts.

Insufficient sleep is an epidemic in modern life. But how long should we optimally sleep? Is biphasic sleep healthy? This podcast addresses issues of optimal length and timing of sleep and the consequences of sleep deprivation.

The AASM recommendation that laboratories use the 3%/arousal definition of hypopnea is in conflict with the definition used by CMS. This podcast explores practical scenarios raised by this issue.

A sleep specialist discusses his personal struggles and successes with using CPAP

How can we help commercial drivers and yet protect the public?

How can we most optimally but safety serve commercial and private pilots?

Should all patients who have suffered a stroke be checked for sleep apnea? A neurologist with expertise in this area discusses the problem.

We discuss why most trials have shown negative results and what changes are needed for future studies.

Is OSA a single disorder? The future for patients may lie in the identification of different physiologic subgroups.

Has the advent of GLP-1 agonists changed the management of OSA? We discuss the trials and the reality.

Oronasal and jaw surgeries for OSA have changed considerably. An expert surgeon discusses their role in the management of the disorder.

A surgeon and a sleep specialist discuss the reality of this widely advertised procedure.

A specialist dentist discusses oral appliances as an alternative for the management of mild to moderate OSA

The diagnosis of REM sleep behavior disorder needs, in addition to dream enactment behavior, a determination that EMG activity is excessive during REM sleep.  But what is excessive?  In this podcast, we discuss how a practicing polysomnographer can make this determination.

Should we tell patients with dream enactment behaviors of their risk of developing Parkinson’s disease or related disorders? And, if so, how should a health care provider deliver this information? In this podcast, we explore ethics and empathy.

When we diagnose REM sleep behavior disorder, we know that there is a risk of the development of Parkinson's disease or related conditions. But how great is the risk?  In this podcast, we discuss how a healthcare provider can help estimate a patient’s risk with specific questions and examination findings.

In the last two podcasts, we discussed how REM sleep behavior disorder can evolve to Parkinson's disease or related conditions and whether we can test for this risk.  In this podcast, we explore the current state of the art in developing possible interventions to prevent this progression.

There has been dramatic progress in developing specific tests for disorders such as Alzheimer disease.  In this podcast, we ask whether we are now at a point when we can (or should) test for Parkinson pathology in patients with dream enactment behaviors.

Probably the most concerning aspect of REM sleep behavior disorder is that it is often a prodrome for Parkinson's disease and other related conditions.  In this podcast we explore current concepts of how dream enactment behaviors can progress to serious neurodegenerative disorders.

While extremely rare, homicidal behavior has been reported during episodes of sleepwalking.  In this podcast, we discuss two notorious cases for which sleepwalking was offered by the defense as an explanation.  Is that what really happened?  What role should sleep providers play in such cases?

Violent and injurious behaviors do occasionally occur with parasomnias including REM sleep behavior disorder and sleepwalking.  In this podcast, we review the types of behaviors that can occur and how best to prevent them.

Sleep walking is common in childhood. What causes it and how should it be managed? In this podcast we will discuss the nature of sleepwalking and how it can best be treated.

Eating and Sleep are both fundamental biologic drives. What happens when they coincide? In this podcast, we will explore the world of sleep related eating disorder.

What is transvenous phrenic nerve stimulation?  When should we use it for patients with central sleep apnea?  Dr. Timothy Morgenthaler, a sleep specialist at Mayo Clinic, answers these questions.

Do all patients with CPAP related treatment emergent central sleep apnea need a change in management?  Dr. Timothy Morgenthaler, a sleep specialist at Mayo Clinic, answers this question.

Is CSA harmful in patients with heart failure? When should it be treated?  What is the role of augmented servo-ventilation? Dr. Sean Caples, a sleep specialist at Mayo Clinic, answers these questions.

Idiopathic hypersomnia is probably at least as common and possibly more common than narcolepsy.  In this podcast, Dr. Michael Silber discusses current approaches to its diagnosis and pharmacologic management.

Many date the start of the field of Sleep Medicine to the discovery of REM sleep by Eugene Aserinsky and Nathaniel Kleitman in 1953.  But was it actually discovered 27 years earlier by Russian investigators?  In this podcast Dr. Michael Silber discusses the fascinating story of how REM sleep was identified and what this means for Sleep Medicine.

The number of medications available to treat narcolepsy has grown dramatically in the last few years. While these have changed the landscape for patients, the future may hold even better treatments. In this podcast, Dr. Michael Silber discusses the currently available new medications and the development of orexin receptor agonists which may transform narcolepsy management.

How should we diagnose narcolepsy? In this podcast, Dr. Michael Silber explains when measuring CSF Orexin-A can be helpful and how to interpret the results.

The multiple sleep latency test was developed in 1978. While it is still the standard test used for the diagnosis of central disorders of hypersomnolence, its interpretation is complex and many factors can affect the validity of its results. In this podcast, Dr. Michael Silber discusses the practical use of the MSLT in 2024.

Cognitive behavioral therapy is the first-line therapy recommended for chronic insomnia. What does it comprise and who should teach it? Is Internet-based therapy available and effective? In this podcast, Dr. Mark Hansen discusses practical use of CBT-I for healthcare practitioners.

The search for the perfect hypnotic continues. In this podcast, Dr. Bhanu Kolla discusses the new dual orexin receptor antagonists, antidepressants and other agents used to treat insomnia.

The Z drugs are the most commonly prescribed hypnotics but are widely misunderstood. In this podcast, Dr. Bhanu Kolla discusses truth and myths for the clinician prescribing these drugs.

All of us who treat restless legs realize that current therapies are far from perfect. In this podcast, Dr. Michael Silber discusses possible future approaches, some already starting to be available.

Many physicians are reluctant to prescribe even low-dose opioids for chronic problems such as refractory restless legs. But opioid therapy can be life transforming for the correct patient. In this podcast, Dr. Michael Silber discusses the appropriate use of opioids for patients with restless legs refractory to other medications.

Patients are still presenting to sleep specialists on high doses of dopamine agonists with intense augmentation and profound insomnia. In this podcast, Dr. Michael Silber discusses how to manage patients with this distressing problem.

How do we define low iron stores in restless legs? In this podcast, Dr. Michael Silber discusses diagnosis of iron deficiency and how oral and intravenous iron should be administered in restless legs syndrome.