Pilots And Sleep Apnea
July 18, 2013
Question:
I know somebody who is a pilot. They can not be diagnosed with sleep or it is immediate disability and they can’t pilot the plane. MY question is have you ever done the MAD for this type of person without the diagnosis? What would the liability be if you said it was just for snoring?
Dr. Smith:
This is one reason we have ambulatory (home) monitors, so we can rule out anything more severe. I would insist on at least this, and you can keep it away from insurance and any official diagnosis. The liability would be pretty heavy if he fell asleep at the controls, thinking he was cured, when in fact you had created a “silent apneic”, so you really need to get at least a Level 4 study done on this patient.
Seratonin & Sleep
July 11, 2013
Question:
Maybe Kent or Norm can let us all know about the biophysiology behind the research that is now showing the effects that Seratonin has on sleep disordered breathing.
Dr. Smith:
Oddly enough, seratonergic agents and precursors to seratonin such as L-tryptophan have been studied for more than 25 years as meds to HELP OSA. In fact, L-tryptophan was shown to decrease obstructive events AND increase REM back in 1983, but it’s been on and off the market several times for various reasons related to side effects.
Currently, several of the big boys in pharmaceuticals are working on seratonin ANTAGONISTS in the sleep aid market. So, there’s money to be found in them there pills…..