From the evolving technologist to going beyond the AHI, to the new HSAT devices, to the rise of AI auto-scoring solutions: these are the biggest trends to note from SLEEP 2022!
What a wild week it was in Charlotte to kick off the month of June! A major thank you to the Associated Professional Sleep Societies (APSS), and of course to the AASM and Sleep Research Society, as well. The event was outstanding, and after two years of virtual meetings, it felt great to be surrounded by so many of the sleep industry’s greatest thought leaders. The sessions and poster presentations were intriguing, thought-provoking, and innovative. Extra curricular activities, like the RTSleepWorld/Sleep Lab Magazine Happy Hour (a blast!), EnsoData customer appreciation event, and many other exciting evening activities, were extremely enjoyable in the warm Charlotte air. But enough preamble, let’s dive into the trends, the sessions, and everything in between from SLEEP 2022.
Four Trends Observed at SLEEP 2022
The conference is always full of innovative discussions and presentations, and this year was no exception. Throughout the multi-day event, a few trends emerged in the presentations, posters, and on the exhibit hall floor (though some have been trending longer than others).
- The Average Technologist Looks Different. Demographically, sleep technologists are getting younger, evidenced by 60% of RPSGT test-takers being under 40 and nearly 25% of the RPSGTs are slated to retire in the next five years, as referenced in April at the Southern Sleep Society 2022 Conference. At the same time as this demographic shift toward youth, technologists have also reported an increase in their patient-facing activities, from pre-test screening to post-test treatment education. So as technologists’ roles expand rapidly, how will young technologists adapt to the changing landscape as they play a key role in delivering positive patient sleep outcomes?
- Bed utilization rates are a challenge for sleep labs all over the country. From not being able to get patients in for a study to challenges with the treatment options leading to testing delays, to referrals slowing this summer, conversations throughout the SLEEP 2022 conference often shifted to bed utilization rates.
- HSAT Devices are evolving rapidly. Between you and me, taking time to check out the new (and updated) devices was one of the highlights of the conference. Wearability and ease-of-use were prominent features of new devices, including the next-generation DREEM 3 headband and less bulky devices like the Onera STS patch-based solution.
- Auto Scoring is the talk of the town. Between major players on the research side (like former AASM President Nathaniel Watson, MD. speaking at the Cadwell booth on the clinical value of total sleep time) and the excitement surrounding EnsoData’s artificial intelligence (AI) sleep scoring solution, EnsoSleep, auto-scoring solutions were impossible to avoid at SLEEP 2022.
With those four trends highlighted, we’d like to hear from you in the comments or on social media: what other trends did you observe at SLEEP 2022?
With that, let’s jump into a few of the many excellent sessions this year.
Sessions from SLEEP 2022
The sessions were well attended, and for good reason. Starting with Dr. Susan Redline’s keynote presentation on going beyond using only the AHI, it was a busy week. We touch on a few highlights from that presentation, plus three others in this post, including Narcolepsy detection, enhanced OSA screening tools, and finally the AASM’s AI in Sleep Medicine panel. Let’s kick it off with the keynote.
Keynote Presentation: Retiring Our Procrustean Bed: Recognizing the Myriad Pathways that Sleep Apnea Increases Cardiovascular Risk
AHI is just a number and it can’t describe all possible conditions. That was one of the biggest takeaways that Dr. Redline emphasized. Variability in clinical settings means that patients with the same AHI can have drastically different symptoms and outcomes. With that in mind, there’s an important need to tailor diagnosis and treatment pathways for each patient.
Beyond creating consistent pathways, Dr. Redline emphasized the many other data points and information that is captured in a sleep test. However, when we focus only on AHI, we miss important metrics, like REM/NREM, recovery time, and other physiological consequences. Redline highlighted how OSA manifests differently in male and female patients. She presented a study that showed that AHI-based risk prediction didn’t show the same association levels with cardiovascular diseases in women as in men. There are gender-based differences in Apneas/Hypopneas, event durations, and symptoms, among other factors. While Dr. Redline’s chat definitely set up the conference for discussions around all things sleep, the focus on going beyond the AHI was a clear tone-setter.
Re-Imagining The Diagnosis of OSA, Sanjay Patel, MD
Dr. Sanjay Patel’s session touched on the immense challenge of obstructive sleep apnea (OSA). Worldwide, there are over 900M people with OSA. The presentation posited that it is impossible to treat them all, so let’s aim to focus on impacting patients instead of merely diagnosing them all.
Dr. Patel argued that when patients have reduced access to the care they need, there is a mirrored reduction in the corresponding enthusiasm for change in that patient population’s PCPs. In situations where PCP screening isn’t as effective for OSA as it is for insomnia, what can be done?
Dr. Patel suggested focusing on those who will benefit the most from proper treatment. Specifically, those with high sleepiness levels. Why? This patient population – the excessively sleepy OSA patients – were at a higher risk for cardiovascular risk than the general population. This is especially impactful for certain comorbidities. Let’s look at Type 2 Diabetes as an example from the presentation.
Accurate OSA screening in patients with Type 2 Diabetes can result in a 57% decrease in the overall cost of care for that patient. But screening is only one part of the puzzle. It can take almost half a year to get on PAP right now, (the median of clinics referenced in the presentation have wait times over 145 days). How can PCPs be encouraged to push for more screening when there’s no urgency on the treatment end?
That’s a challenge we’re all looking to address in sleep medicine, and one Dr. Patel so astutely educated us on at SLEEP 2022.
Smart Sleep: A Guide to Choosing Artificial Intelligence Solutions for Clinical Practice
In the panel-style discussion of artificial intelligence, many of the industry’s premier sleep and AI thought leaders answered questions from the audience on both artificial intelligence (AI) and machine learning (ML).
The panelists included: Anuja Bandyopadhyay, MBBS, MD, Azizi Seixas, PhD, Hao Cheng, MD, Jaspal Singh, MD, Maryann Deak, MD, Ambrose Chiang, MD, and Charles Bae, MD. Here are a few of the takeaways gathered from the session, in no particular order:
- The AASM AI committee has a goal of supporting and partnering with clinics to help them choose AI tools that best fit their practice.
- When choosing an auto-scoring AI solution, you need to treat the decision like hiring a new RPSGT. Getting a new technologist aligned with your specific scoring preferences requires testing and pilots. You want to partner with an organization that values usability and can establish ROI quickly.
- When considering an auto-scoring solution, AASM panelists recommended testing scoring algorithms rigorously while using multiple devices to prevent dataset shifts and artificial biases.
- The panel also emphasized how much data is found in sleep studies: “We have access to vast amounts of data that we need to take advantage of to create a paradigm shift in sleep medicine.”
- AASM panelists highlighted the ability of AI to help solve the issue of access by improving screening options: “AI can pick up on changes that human eyes cannot see.”
- However, despite the optimism, AASM panelists hammered the need for novel validation methods: “We are creating algorithms based on an outdated gold standard.”
- Finally, panelists discussed the next frontier for AI in sleep medicine: “Personalized diagnosis and treatment using AI models is the future.”
This panel session was an extremely valuable hour for folks who are interested in approaching the new wave of auto-scoring solutions.
The Neurobiology of Narcolepsy: What Sleepy Mice Can Teach Us About Sleepy People, Thomas Scammell, MD
To close out our recap of SLEEP 2022, let’s look at an interesting presentation from Dr. Thomas Scammell, MD. This session focused on Narcolepsy, addressing the impact of orexins on sleep health.
For those who didn’t attend the session and aren’t in the know, an orexin is “a peptide produced in neurons of the perifornical, lateral, and posterior hypothalamus, which project to both cortex and virtually all subcortical arousal systems to promote the awake state,” per ScienceDirect.
In layman’s terms, orexins can help promote wakefulness and suppress REM. More clinically, type one narcolepsy can be caused by the loss of orexin-producing neurons. When exacerbated, patients can even develop cataplexy.
Cataplexy, or the loss of muscle control which is often triggered by sudden, strong emotions such as laughter, fear, anger, stress, or excitement, can worsen as a patient loses out on valuable REM sleep. In short, the loss of the orexin-producing neurons results in sleepier people.
In response, drug manufacturers are aiming to activate receptors to promote wake and suppress cataplexy. We are excited to see how new options impact this area of sleep medicine. It’s just one of many fronts that sleep medicine researchers and professionals are continuing to progress the impact of sleep medicine.
See you at SLEEP 2023 in Indianapolis!
What else stood out at SLEEP 2022? Did we forget to mention anything? Let us know in the comments down below. And if you felt the FOMO, make sure you join the fun next year at SLEEP 2023 in Indianapolis. See you there!
Steven Miller earned his degree in Journalism & Mass Communication from University of Wisconsin-Madison, graduating in 2012. He currently serves as the Marketing Manager, Story Teller, & Diversity, Equity, and Inclusion Committee Chair at EnsoData. You can connect with him on LinkedIn.