CleveMed Blogs

Once more, we continue our video series of Q & A with Dr. Joseph Golish on Current & Emerging Trends in Sleep Medicine. This week’s topic of discussion is The Role of Home Sleep Testing in Long Term Disease Management of Obstructive Sleep Apnea.

Dr. Golish, is a board-certified specialist in sleep medicine and author of more than 300 publications on sleep. He is a member of the Sleep Steering Committee for the ACCP. After 35 years as a professor in The Cleveland Clinic and Co-Director of Sleep Medicine, he has left academic medicine to advance a new paradigm in sleep medicine, focusing on accessibility and affordability. His goals are the proper use of HST and fostering continuity of care, in an efficient and cost-effective manner, while preserving high quality. He is currently the Medical Director of Cleveland Medical Devices (CleveMed) and Director of Sleep Center, North Coast Clinical Trials, in Cleveland, Ohio.

This week, we continue our video series of Q & A with Dr. Joseph Golish on Current & Emerging Trends in Sleep Medicine. Here’s the BIG question: Will Home Sleep Testing Replace the Sleep Center?

Dr. Golish, is a board-certified specialist in sleep medicine and author of more than 300 publications on sleep. He is a member of the Sleep Steering Committee for the ACCP. After 35 years as a professor in The Cleveland Clinic and Co-Director of Sleep Medicine, he has left academic medicine to advance a new paradigm in sleep medicine, focusing on accessibility and affordability. His goals are the proper use of HST and fostering continuity of care, in an efficient and cost-effective manner, while preserving high quality. He is currently the Medical Director of Cleveland Medical Devices (CleveMed) and Director of Sleep Center, North Coast Clinical Trials, in Cleveland, Ohio.

Recently, I had the honor of participating in Q & A with Dr. Joseph Golish, MD, as he discussed current and emerging trends in sleep medicine. We compiled this engaging, informative, commentary into a video series, with each section answering a specific question about trends in sleep medicine. This week, Dr. Golish shares his opinion on Home Sleep Testing.

Dr. Golish, is a board-certified specialist in sleep medicine and author of more than 300 publications on sleep. He is a member of the Sleep Steering Committee for the ACCP. After 35 years as a professor in The Cleveland Clinic and Co-Director of Sleep Medicine, he has left academic medicine to advance a new paradigm in sleep medicine, focusing on accessibility and affordability. His goals are the proper use of HST and fostering continuity of care, in an efficient and cost-effective manner, while preserving high quality. He is currently the Medical Director of Cleveland Medical Devices (CleveMed) and Director of Sleep Center, North Coast Clinical Trials, in Cleveland, Ohio.

Immediately after a lunch meeting, David Sullivan (CleveMed Software Quality Engineer) tweeted: Interesting presentation on sleep science during lunch by Dr. Robert Thomas. Ilya Gotfryd (Software Engineer), from a nearby cubicle, promptly echoed: Came back from an exciting sleep science presentation. Starting to view sleep as a window. The CleveMed Twitter page announced: “Fascinating lunch meeting presentation by Dr. Robert Thomas (BIDMC, a Harvard Medical School affiliate) on ‘Sleep as Window’”. Although the lunch-time talk was much-tweeted about by the CleveMed team, it was not the main focus of Dr. Thomas’ visit.

Dr. Robert Thomas of Beth Israel Deaconess Medical Center was in Cleveland this week to partner with CleveMed in developing and commercializing a new therapeutic technology for sleep apnea. Sleep apnea has many forms, like Obstructive (OSA), Central (CSA), and Complex (CompSA). OSA is the only form with an effective treatment - Continuous Positive Airway Pressure – CPAP. However, CSA and CompSA, which are strongly linked to serious heart and lung diseases remain largely untreated. It is suspected that more than 25% of Congestive Heart Failure (CHF) patients have CSA or CompSA. Furthermore, Central or Complex apnea events often coexist with OSA, which can compromise the effectiveness of the popular CPAP therapy.

The technology, which was created by Dr. Robert Thomas at BIDMC, Boston and Mr. Robert W. Daly of Wellesley, Massachusetts, is based on injecting small amounts of CO₂ levels into the patient while applying CPAP. A major contributor to CSA and CompSA is thought to be an increased sensitivity to CO₂ levels, which causes central apneas readily when the patients fall asleep. This is especially true during CPAP since the increase in breathing lowers CO₂ in those patients; thus, triggering central apnea. “By introducing 0.5% to 1% of CO₂ during CPAP, we have found that the patient′s normal breathing is restored“, said Dr. Thomas. “The key is to prevent a drop in CO₂; there is no need to increase CO₂ above wake levels. The implications are huge. Not only will such technology bring relief of symptoms to CSA and CompSA patients, but may also improve cardiac function itself, as the restoration of normal breathing may relieve stresses on the heart. The project with CleveMed will test the benefit on patients with and without CHF and both CSA and CompSA.”

Technology completion and clinical validation on more than 100 patients will be supported by a recent NIH SBIR Fast Track grant awarded to CleveMed with BIDMC and Wayne State University as the two clinical sites.

This post is an adaptation from CleveMed News Release: CleveMed to Collaborate with Robert Thomas MD on New Sleep Apnea Therapy