This episode of the “Sleep Review Conversations” podcast previews the AADSM annual meeting which will be held June 2 to 4 in Boston. We speak with Sheri Katz, DDS, chairperson of this year’s meeting, and Michael Decker, PhD, who will be speaking on Saturday, June 3, about sleep disorders and the brain.
Hosted and produced by Rose Rimler, associate editor of Sleep Review
Run time: 23:54
Rose Rimler, Sleep Review associate editor (RR): Hello and welcome. You’re listening to “Sleep Review Conversations,” a podcast from healthcare media company Allied 360. This is a special episode, a preview of the American Academy of Dental Sleep Medicine meeting, which meets Friday, June 2nd through Sunday, June 4th in Boston. First we’ll hear from Dr Sheri Katz DDS, the meeting chairperson, for an overview of what to expect this year.
Rose Rimler: I thought we could start out with just kind of an overview of the size and the scope of the conference. So, do you have an idea of how many people will be attending, and how many will be presenting and speaking, and an idea of the number of folks from industry who will be there exhibiting?
Sheri Katz: We’re expecting approximately 1,200 dentists and exhibitors for this annual meeting, and the exhibits showcase booths of oral appliance manufacturers, dental labs, software companies, and different practice management organizations. The speakers are going to be coming from every aspect whether it’s research or clinical. We even have somebody that’s wonderful, he just published a book called Wild Nights, and his name is Benjamin Reiss. He’s a literature professor at Emory University, and he writes about why the modern world forgot how to sleep and he writes historical and literature perspective of why is sleep frustrating for so many people and why do we spend so much time and money managing and medicating sleep.
So, we’re trying to bring in sleep from many aspects to appeal to different people in our audiences. It’s going to be a little light, but it should be, you know, really enlightening.
RR: The exhibit hall will be open every day. Can you talk a little bit about some of the exhibits that will be on display?
Katz: The exhibits, they’ll be open every day, and we have built in some time for the attendees to go down to the exhibit hall or to be in the exhibit hall at the same amount of time because it’s going to highlight all of the most recent products in dental sleep medicine. All of the different oral appliances and their manufacturers, which labs are focused just on sleep and making contact with these labs. It’s really important to know who your technicians are, getting to know people, especially for new dentists or for the people that are doing dental sleep medicine full time. It’s always nice to be able to check out what the latest and greatest is and make contacts with these laboratories.
Also, there are different software companies that will be there for medical records, billing companies, and practice management organizations to help us pull our practices together.
RR: Are there any trends to watch out for this year?
Katz: Trends? I don’t know about in the exhibit hall other than really state-of-the-art equipment. But, as far as the lectures go, I’m seeing a trend in a lot of new things that we’ve never really had people speak about, like functional therapy. A lot about epigenetics and genetic possibilities of our patients and predictability of who will be successful with oral appliance therapy. And presentations of research that we haven’t seen. So, our attendees who think they are just going to be going and listening to lectures on oral appliances, titrating, and the same old thing year after year are in for some big surprises because we have some speakers tackling this from a totally new and fresh perspective.
RR: I’d love to hear about more about some of the speakers who will be at this year’s conference and what they’ll be presenting.
Katz: So our keynote speaker we chose because of her work is on phenotyping characterization of who the oral appliance responder would be, that’s Kate Sutherland, she is coming from Sydney, Australia. Many people have this overriding problem in their practice where we’re treating patients seemingly successful with our oral appliances but they’re still remaining sleepy. And Dr Lynn Marie Trotti is coming to speak about hypersomnolence, she is a prominent researcher in the field. Dr Rye is going to talk about patients that have restless legs syndrome and how this impacts our evaluation and treatments. Someone is coming and talking about craniofacial development and we have people talking edentulous patients in oral appliances, about side effects. We have so much that we’re covering, that I think there is something for everyone. From the new dentist to people that have been doing oral appliance therapy for 20 years.
I also don’t want to forget to mention Dr Michael Decker who is doing some amazing research on oral imaging in sleep disorder patients and he is going to discuss all the findings and implications of his research also.
RR: What about pediatric sleep medicine? Is that going to be discussed?
Katz: That will be discussed. That is where Dr Roberts is going to be talking about craniofacial development. Dr Susan Redline is going to be speaking on the evolution of obstructive sleep apnea in children and their prognosis for spontaneous resolution of obstructive sleep apnea with large trials that she’s working on.
Of course there will be people speaking on….Dr Bream will be speaking on the top 10 oral appliance therapy papers of the year. There’s going to be a lot of practice management talks on, for instance, one on audit updates, billing dental sleep medicine, and how to network and what dentists need to know about that. So kind of an update on what’s happening with third-party payers. Dr Berley is going to speak about standard of care in dental sleep medicine from a legal perspective. And we have someone speaking about sleep in women’s health, Dr Khosla. Sleep bruxism by Dr Lavigne.
We’ve got a whole well-rounded program.
RR: Yeah, it sounds like everything is going to be covered from basic research to clinical applications and even the business side of things.
Katz: Even the business side. We’ve added some things very specifically for new dentists coming together. We do have our introductory course at the beginning of the program, but we’ve also put together a brown bag lunch session during our “Lunch and Learn.” And that’s going to cover various topics on each day. They’re highlighting a new topic, such as on the first day, what happens at their first consultation appointment. The second brown lunch program is going to be choosing appropriate oral appliances. The third will be fitting the devices and designing proper follow up care for the patient.
RR: Those are designed for people who are relatively new to the field like early career dentists?
Katz: Right. People that are relatively new, that are really interested in the field.
RR: That’s a great thing to bring up because I was gonna ask you if you any advice for some attendees or early career scientists or dentists about how they can best navigate the conference. And it sounds like one piece of advice is to go those sessions.
Katz: To go those lunch sessions, it’s really going to be an outstanding program and that initial intro course. In addition to that we have a program, a First Time Attendee Breakfast, that has purposely recruited our most seasoned dentists in the field to attend and spread out to get to know each of the first time attendees and we do a lot of really good networking. It’s a friendly group of people that interested in mentoring new people coming into the field.
RR: That’s nice because sometimes its can be overwhelming if you are fairly new to a field and you go to a conference where it seems like everyone else is already an expert and, you know, knows what they’re doing. It can be kind of intimidating.
Katz: Right, it’s a large enough of conference, I mean 1,200 people is large enough, but it’s not the size of the typical ADA [American Dental Association] conference or large conferences where you are having to weed out the subjects that you are interested in. It’s concentrated, of course, in oral appliance therapy and everything there is structured for you. It’s fairly easy to follow the program and speak to people. Our administration is outstanding and they have themselves in a prominent position to help direct the attendees as well.
RR: Will there be opportunities to earn continuing education credits?
Katz: Oh, yes. We’re offering, I think, 20.5 CE credits. ADA CERP credits. That will count toward becoming a qualified dentist in the field or toward credentialing and toward accreditation. So, it’s the best place to be getting credits for your dental licensure but also toward accreditation in the field of sleep.
RR: And some people who are listening may have attended last year or in previous years. Are there any big changes that are coming that they should be aware of or anything new for them to look out for?
Katz: Well, different speakers. Up to the minute research. You know, everything changes so much in the research and the different speakers. So, I think there’s going to be something there for everybody.
RR: And you mention this a little a bit that attendees are generally pretty welcoming and friendly, are there going to be opportunities to network and socialize that are baked into the conference?
Katz: Yes, we’ve got a President’s Reception where all the attendees are invited to a social celebration to have hors d’oeuvres and a cash bar. And as I’ve said they’ve built in times into the meting, little breaks, to go to the exhibit hall and everybody gets together and different exhibitors will have different little programs.
There’s also different industry supported events. So, that’ll be written into the program as well. The attendees will be given notice ahead of time so you’ll be able to sign up for those. And they’re really a lot of fun, the industry people will generally either have hors d’oeuvres or drinks or something. And have a topic they want to present. And the numbers of people coming are smaller than at the meetings. You’ll have plenty of opportunities to meet different people and get to know other colleagues in your field from all over the world.
RR: Has the conference been held in Boston before?
Katz: Yes. I can’t remember how many years ago though. It has been and it’s been really well received.
RR: Yeah, I’ve been to Boston once and I remember walking the Freedom Trail, but I’m not the right person to talk to about everything Boston has to offer. I don’t know if maybe you have some suggestions you’d like to share?
Katz: I don’t. Of course the Freedom Trail, but, you know what I do have a favorite, a very favorite museum there that is very doable and it’s the Isabella Gardner Museum. They’ve got this great tea house and old masters….It’s just a gorgeous, gorgeous little museum in the Metro area. And that’s very accessible. There’s so much to do in Boston. People really have a good time there.
RR: Well, Dr Katz thank you so much for joining us and giving us kind of a sneak peek of this conference. And I really appreciate you coming on the podcast today.
Katz: Well thank you very much.
RR: Thanks Dr Katz.
Now let’s hear from one of this year’s speakers. Michael Decker, PhD, is associate professor in the School of Nursing and Medicine at Case Western Reserve University in Cleveland, Ohio. His talk on the effects of sleep disorders on the brain will be on Saturday, June 3, from 11:30 to 12:30. Here he is with more information.
Michael Decker: So, the presentation I am doing this year is called “Neuroimaging of the Sleep Disorder Patient: Findings and Implications.” And you have that title. And the reason I wanted to do this particular presentation is that, you know, I am both a basic scientist and a clinical scientist. And that means I have a research laboratory. So, it’s bench-to-beside. So, I do work in the laboratory, I have a variety of models that I use that help replicate what we see in human disease. And I’m also a clinical scientist, so I am interested in directly applying those findings to the human condition. So, I’m a very translational person. Whereas many scientists are only on the bench, many are only in the clinical, I tend to do both. And I was trained that way.
You know, I’ve been studying disorders of sleep since 1986. And what I have learned in these last 30 years is that many sleep related disorders lead to brain impairment. And many brain impairments can induce sleep disorders. For example, REM behavior disorder is acting out one’s dreams and that disorder tends to happen in persons who have neurodegenerative disease. So, we believe the neurodegenerative disease is the cause of the REM behavior disorder.
Now, there is a disorder called obstructive sleep apnea, in which a person stops breathing during sleep and that causes brain impairment. So, here we have a sleep disorder that’s negatively impacting the brain. Over the last 30 years I’ve seen a large emergence of basic science and animal studies in which models have been created that replicate or emulate the human condition. And we base a lot of our treatments and a lot of beliefs on what we’ve seen in these animal models. And I was one of those persons that, you know, I’ve done a lot of basic science work to better understand how sleep disorders impact the brain. Now, what I’ve noticed over the last several years is that with neuroimaging technology becoming much better than it was even several years ago, we are now able to look into the human brain to see if the findings that we’ve seen in these models really replicate what’s happening in the human brain.
So, really the purpose of my presentation is to, as I speak with the audience, is to first just give them a brief overview of how neuroimaging technology works. For example, many people have heard what a magnetic resonance imager is, but many people don’t know what it really does or how it works. So, the purpose of my presentation is just to take a few minutes to talk about the basic principles of this is what these machines are, this is how they work. By understanding how they work, we can then better understand the images these devices give us.
So, the first part of my presentation is to just briefly update people on the technology. So, everybody in the audience will start at a common platform of, “Yes, I know what an MRI image is and I know what it’s telling me.” You know, from there I really wanted then to talk about some of the early findings that neuroimaging has enlightened us about sleep disorders. For example, neuroimaging has shown us that people who have obstructive sleep apnea have a reduction in white matter in their brain. And white matter is very important. I won’t go into all the neuro-anatomy right now, but a person with sleep apnea has structural changes in their brain. And what’s really exciting to me is recent neuroimaging studies have shown that those changes can be reversed if a person adheres to treatment.
Decker: Yeah, yeah, I mean isn’t that exciting? Because we’ve often said to people … You know in a clinical office we diagnose a person with a sleep disorder, like sleep apnea. They’re prescribed nasal CPAP, which is a machine that helps keep their airway open at night. And the people come back and we say, “How do you feel,” and we’ll give them a questionnaire. And we’ll try to, you know, assess their symptoms. But now with neuroimaging we’re actually able to quantify changes in brain structure and function that emerge following successful treatment.
RR: Yeah and I think that getting that message out will help underscore the importance of getting sleep apnea diagnosed and treated too.
Decker: Yes, yes. And it also gives the clinicians something to say is that, you know, there are studies and we can cite them because I’ve provided the references that say some of the damage induced by this disorder may be reversible. And certain studies show that it could be reversible. You know, as a patient that helps motivate people say, “I really want to stick with this treatment because I can make my brain better.” So, and this is relatively new. The techniques are not new, but this way of conveying information to patients, I think, could be helpful. To bring this research to the clinical community to say, “You know, this is what we’re seeing in the research environment and this is what you can tell your patient.”
RR: Yeah and to that point, is that who you think is going to get the most out of this? Clinicians and others who see patients or is there something in it for basic researchers as well?
Decker: Absolutely, both. And for example, many of the changes that we see with neuroimaging have never necessarily been described in the animal models that we’ve used for years and years. So to me it’s pretty exciting to say, “Gee, here are additional findings that neuroimaging is able to show us that we might’ve not been able to detect in some of the more primitive techniques that we’ve used.” Or not primitive, but the, you know, animal models.
RR: Oh, so you’re seeing changes in the brains of people with obstructive sleep apnea and other sleep disorders that you’re not seeing in animal models, like in the brains of rats?
Decker: Well, the changes may be there, but because we’re using different techniques we’re just seeing things differently. I guess is another way to say that.
RR: And what do you hope your audience will come away with from this talk? I know you only have an hour, so…
RR: Probably won’t be able to say everything you want to say.
Decker: Let’s see. What do I really want … Okay, I’m just looking at my second slide here. And what do I want people … I want them to understand, this is actually what I’ve said, to understand the extent that neuropathology identified by neuroimaging may or may not show resolution following therapy. Because there are some disorders like REM behavior disorder that with neuroimaging, we can see the part of the brain that’s damaged. But, we can never restore that part of the brain. So, in a disorder like REM behavior disorder we can tell the patient, “Yes, this is what’s going on. This is how we’re going to treat this disorder, but in this one particular instance or in this disease we’re not necessarily going to be able to reverse the damage. But we can perhaps slow down its progression. We can treat your symptoms.” Versus somebody who has sleep apnea we can say, “This is a disorder that induces a certain a level of brain damage that may be reversible.”
So, I think it helps the clinician better describe outcomes to their patients, prognosis, you know, and just I think it promotes adherence to treatment if we understand how it helps us.
RR: Thanks, Dr Decker.
And that about wraps up our special preview of the AADSM meeting in Boston this year. Thanks so much for listening.
Visit sleepreviewmag.com and click on “Resources” to see a transcript of this podcast and to check out our other podcasts, including a preview of the sleep conference which follows the AADSM meeting in Boston. And come find us in person at the meeting. Sleep Review will be represented on the Medqor booth, number 733 on the exhibit floor.