Full Transcript Sponsor Intro and Welcome 0:00 Sleep Tech Talk is brought to you by Fisher and Pike. 0:04 Fisher & Pike Health Care is a leader in CPAP mass design and innovation for over 20 years. 0:10 Their unique technologies have benefited millions of OSA patients through their top CPAC mass. 0:15 These advancements continue to further enhance patient experience and outcomes. 0:19 Sleep tech talk is sponsored by React Health. 0:22 Within our Luna PAP device line, each offering is FDA approved, encompassing CPAP, APAP by-level and by level ST models. 0:31 Our thoughtfully selected array of PEP interfaces and accessories complement our LUNA PAPP device-line while accommodating diverse patient requirements. 0:39 Lights out. 0:51 you Welcome everyone once again to another episode of Sleep Tech Talk, the sleep podcast with your hosts and friends, Emerson Kerr, 1:08 Robert Miller, and me, Dr. 1:10 Gerald George Moneykerob. 1:11 Folks, thank you once for all the love that you've provided us. 1:16 We've got an amazing show for you, but we just want to say thank so much for the support. 1:21 Be sure to share the show with even more people out there. 1:26 all the sleep professionals and the Sleep Curious, make sure you share it with them and continue showing us the love.
Dr. Raj Dasgupta's Path Into Sleep Medicine 1:34 We can't thank you enough for that. 1:35 But we also wanna give a huge shout out to our sponsors without whom we can keep doing what we're doing. 1:41 Shout out them, be sure to check them out as well. 1:44 With that being said, Emerson, what's going on today? 1:48 Well, Jerry, we are lucky as always, but especially today we've got a good friend coming in, Dr. 1:54 Raj Dasgupta. 1:56 A lot of our listeners have probably seen him pop up on The Doctors in the past when that show was around, and he's frequently seen on CNN and sharing 2:06 advice about sleep. 2:07 So Dr Dasgupa, Doctor Raj, thank you for joining us today. 2:12 We are thrilled to have you with us. 2:15 You've had quite a history and quite quite the story in sleep. 2:19 One of the things we love to start off with is just how did you get here? 2:22 What made you think of sleep medicine when you were in medical school? 2:26 Yeah, well, you know what? 2:28 It wasn't one of those stories where like, hey, from the minute I did med school, I got to go into sleep medicine. 2:33 It was a journey. 2:34 You know, it started off with internal medicine, and I gotta tell you, that's one my favorite things in the whole world is kind of like the base of all 2:41 of medicine and able to integrate. 2:43 And I feel that that is what sleep is all about, integrating it with different organs in your body. 2:47 So I didn't my internal med residency, then afterwards I do a pulmonary critical care fellowship. 2:53 And then I thought, hey, that's going to be that. 2:55 And that'll be it. 2:56 I'm done with all these years of fellowship. 2:58 But at the time, it's amazing how time just flies. 3:02 Sleep was a very, very big topic. 3:04 Many of my mentors and colleagues were like, Hey, are you going asleep? 3:07 And as naive as I was back then, I said, well, sleep has got to all about OSA and breathing. 3:14 That's why I went into pulmonary. 3:16 So I did a fellowship at Henry Ford. 3:18 They are awesome. 3:19 And I realized during my training that sleep is a lot more than just breathing. 3:24 Sleep is about parasomnias and insomnia and movement disorders and nocturnal seizures and narcolepsy and oh my god it goes on and on. 3:33 And it just became such a big passion of mine because one of my many like sayings would be whatever happens during the day is going to affect you at night 3:41 and vice versa. 3:42 So it gives you kind of like the complete package but Anything good that happened to me especially in the media world happened because of sleep So I always 3:51 want to be so respectful and it's just a great way to make friends It's a greatly to relate to patients. 3:57 So thank you sleep for letting me be a part of you and Being part this amazing podcast Well, thank you for joining us. 4:05 You know, one of the things that I would imagine you have to do, I mean, you're on call with these major, the major networks and you know you, 4:13 have stay up to speed on what is the latest subject? 4:16 What are the, latest topics? 4:18 You, know what are, them the hot topics right now?
Practical Sleep Topics and Media Work 4:20 So when you are getting ready for these shows and kind of staying at the speed, on, what's next, What's hot? 4:27 what do you feel like are hot, topics, right, now in sleep medicine? 4:30 Sure. 4:31 You know, I think the hot topics are going to be things that are super, super practical. 4:36 So I actually just did one for ABC News here in LA. 4:40 And the topic was, you guys are gonna love this one. 4:43 It was you know when you walk into your home after work and you see that couch, are you Emerson falling asleep on the couch instead of the bedroom and why? 4:53 Tell me, is that not the cool topic right there? 4:55 So I had to talk about why are people falling asleep on their couch and not their bed? 5:00 And I think that's practical because I could see you guys and a lot of people listening going, dude, that totally mean right? 5:05 There. 5:06 And the question is always going to be, well, why is your couch so comfy or why's your bedroom not? 5:12 You know and is it because of your bed partner that's snoring too much? 5:16 Is it Because of Your cute little dog that jumping in your better that nocturnal cat that not falling asleep? 5:22 Or is our primary sleep disorder that you possibly have or is your bet just not meant for sleeping? 5:28 You Know so but of course the big overall theme of that segment was I just think many of us are just sleep deprived for a variety of reasons and And I 5:38 think that anytime you're falling asleep on the couch too often, that that should be a signal that are you getting the two cues of sleep. 5:46 And of course, you can ask me, what are those two queues? 5:48 Are you in the good quantity of asleep? 5:51 And are getting good quality sleep? 5:53 Quality sleep, of courses, are we getting to the deep stages and REM sleep And what is a classic disorder that does not give you good quality sleep? 6:03 Of course, OSA, obstructive sleep apnea, which 40 to 50 million people have in our country. 6:09 So these are like just timely topics that I love when people are nodding their head and kind of relate to it and the things that people all the time. 6:18 Okay, so I have to admit you surprise me because I thought maybe you're going to talk about wearables or pharmaceutical treatments of obstructive sleep apnea, 6:26 but not the quality of your couch and the difference in the quantity in your bed room. 6:33 Oh man, I'll give you another one. 6:34 The one I just did with the Huff Post the other day. 6:36 Have you guys ever heard of T-Rex hands? 6:41 I love it. 6:42 They're like, yeah, dude. 6:43 Dr. 6:44 Jerry knows I'm talking about dude It's like if you're sleeping with dinosaur hands arms. 6:49 So what does that mean? 6:49 It''s kind of like you know, you can't oh, I guess you CAN see me This is weird. 6:52 This podcast is like video not like my my low-budget Anyway, it's like this and you're sleeping like that Is that a good thing and bad thing? 7:04 And a couple things I took I wanted to do that Actual interview because you know my son Aiden he has autism It's moderate to severe and a lot of autistic 7:13 kids or kids with special needs do sleep in that position I want to comment about that but for adults like me and all you guys I'm talking to you that 7:21 when you have your hands like long-term Man, you could get some nerve damage, some shoulder damage some neck pain. 7:27 So just got to be careful You know what I mean? 7:29 But it has a catchy name and things that are very popular have catchy names So yeah, this is another example of things are really fun to talk about in 7:36 the media I'll throw another one out there and you're gonna roll your eyes. 7:39 I know Robert's gonna role his eyes They made me comment about something called the sleepy girl mocktail. 7:45 Have you heard of that? 7:48 Absolutely I have not I'd love to hear more about this All right, Dr. 7:55 Cherry. 7:56 Supplements and other things, what are the hot topics out there? 8:02 This Sleepy Girl Mocktail, and this has been popular for about a year and even more than that, was a combination of using tart cherry juice and mixing 8:10 it up with some magnesium and you put it in a seltzer water. 8:14 And tart cherry juice are one of the many things that kind of make you sleepy because it kind breaks down into something that resembles or close to melatonin. 8:21 So I remember before I did the interview, I wanted to make sure I tried it. 8:25 You know what I mean? 8:26 Because I don't want to be just talking. 8:28 I think I have Trader Joe's down here in LA. 8:31 And I got some tart cherries. 8:32 Of course, it's not like a little sample size. 8:34 It's like, you know, a good half gallon. 8:44 And now I'm stuck with this whole half gallon of tart cherry juice I can't get rid of. 8:49 But when you mix it up in there, for some people it works. 8:52 And a lot of people, when they want to inquire about sleep, they wanna know just practical things. 8:57 Things I could just help out or things I do on a rough day. 9:00 So I love fun topics. 9:03 It's not always gonna be about a wearable or about something super technical, but things that just people are curious about and maybe I can make a little 9:11 difference in their day or specifically their night. 9:15 So how in the world did you get into this sort of, you know, get the media presence that you have today?
How Media Opportunities Led to TV Appearances 9:22 You probably are one of the most recognizable, on-screen physicians, I would think, in this country and the fact that your involved in sleep medicine just 9:32 makes it all the better for all of us. 9:34 Well, Robert, next time I see you I'm going to give you a big hug. 9:37 Thank you for saying that. 9:39 But the truth is, like Emerson mentioned, I was on the Doctors TV show when it was still around. 9:47 And I remember my first episode was when, you know, it wasn't supposed to be me. 9:51 So I think they wanted some other sleep doctor to come on, but something happened. 9:55 and they were filming on the Paramount Studio lot in Melrose, which is about maybe not too far from USC. 10:02 And they just come across my name. 10:04 I had some videos in there because I'm always doing teaching. 10:06 They're like, hey, Dr. 10:07 Raj, do you want to come on this show? 10:09 And I was like sure, I am in. 10:11 When do want me to Come? 10:12 How about in a few hours? 10:13 I said WTF? 10:15 What do And I'm like, and by the way, what do you want me to do on your show and what's the topic? 10:23 And it was something called exploding head syndrome. 10:27 And of course, right away I go to Wikipedia, like what the hell is this dude? 10:32 But anyways, if you want to be on media, that is something. 10:36 And I didn't know how fun it would be. 10:37 I mean, you gotta say yes. 10:39 Because if say no, it's gonna be someone else. 10:42 So I never been on TV before, I went down there, and you know what? 10:46 I got my five minutes, loved it, thought that would it. 10:50 Then long story short, two weeks later they called me back. 10:54 About a month later, they call me again. 10:56 Before the show stopped, 60, 70 times and I became their go-to sleep and pulmonary guy and that kind of led to the probably my big break. 11:06 What was that? 11:07 There was a show called Chasing the Cure on TNT and TBS. 11:10 It was hosted by Ann Curry and i was her main doc. 11:15 I loved it and then no one happened in 2020. That's The pandemic, I'm so angry, pandemic. 11:22 And it was a live show, so it changed a lot. 11:25 But I am always grateful because like I mentioned earlier, sleep opened up all these doors for me. 11:30 A sound sleep calls for a high-performing mask. 11:33 Introducing F&P Nova Nasal with SwingFit Headgear. 11:36 From fitting and seal to minimal noise and draft, it's performance defined. 11:41 Go to fphcare.com forward slash nova nasal to learn more. 11:46 That's awesome. 11:47 And just to thank your heads, your career started around exploding head syndrome. 11:55 Go figure, no, totally go figure. 11:57 We gotta bring this guy back. 11:59 If he could be an exploding head syndrome expert in, you know, 15 minutes notice or a couple hours notice, we got to bring him back! 12:07 Oh, and you would have loved it, dude, because you always want to make things a little interactive and funny. 12:10 And so the first thing I think I said on the show was like, everyone out there, don't worry, your head's not going to explode. 12:20 But how do you come up with these things, these obscure things but are still very interesting? 12:28 For example, I've heard the whole cocktail thing, but I never heard it called as a sleepy girl cocktail. 12:35 But to get these very fun topics, but understanding the science behind it.
Meaningful Cases: Narcolepsy and Complex Patients 12:40 You know, there are a ton of sleep gurus out there that come up with all this kind of garbage about how you can sleep better. 12:47 But you're an actual physician and you know the signs behind. 12:50 So how do you come with these topics and ideas in order to help people sleep So I am super spoiled because of all these great things we talked about. 12:59 There are different companies out there and one of my main nicest, biggest company that does really cool things for me is called Sleepopolis. 13:07 And I love them and I'm their chief medical advisor. 13:11 A lot of these different queries that come out, whether it be through HuffPost or Women's World or CNN, you name it. 13:19 they go to a central hub and they kind of like say, hey, Dr. 13:22 Raj is here and he's not busy here, and you can address these things. 13:25 I just think that when you look at topics that you want to talk about, I think it's things where you're not going to go and make an appointment and wait 13:36 in a big line to about your jet lag with your sleep doctor. 13:39 Sometimes you need to realize that some of the first-line defense are going to be things that you hear on a podcast like here or things you read in a nice article. 13:48 So I think it's always the 1st step. 13:50 Don't get me wrong, I definitely have my super dorky moments. 13:53 And what would be a big dwork moment is GLP-1 agonists. 13:57 You know, that's one of hottest medical topics out there. 14:01 For those who don't know GLPs have different brand names out here. 14:05 We're not getting paid for this anyone, but there's like Ozemptics and Wegoobies and Zephounds and Manjaros. 14:11 and the big thing is is that you know people are using those for weight loss and recently they got FDA approved for OSA specifically talking about test 14:20 parotide which i believe is going to be a set bound so so many people have been asking me about what's the mechanism of action and how does it work and 14:27 what do i think about it for osa so ii think that when you do media iIthink it's easier to be yourself and try to be funny when you're comfortable with 14:35 the science. 14:36 And I think that's why I love doing these fun topics, because of the fact that I always feel comfortable, with internal messing background. 14:44 I know that if I get put in, you know, back in a corner and someone's asking me something that, oh, where did that come from? 14:50 I feel confident to have that live conversation. 14:53 So, I, think, that is how it all comes together. 14:57 Sleep Tech Talk is sponsored by React Health. 15:00 Within our Luna PAP device line, each offering is FDA approved, encompassing CPAP, APAP by-level and by level ST models. 15:09 Our thoughtfully selected array of PEP interfaces and accessories complement our LUNA PAPP device-line while accommodating diverse patient requirements. 15:17 You know, thinking of dorky moments, I'll go a little deeper. 15:19 What about meaningful? 15:20 You'll have topics come your way. 15:23 I'm sure you thought, okay, this is a deeper than I normally go. 15:26 what sort of one maybe stood out in your past where you go, This one meant a lot to me, was very meaningful, and did some digging for you to maybe even 15:36 some soul searching, so to speak. 15:37 But it was something that meant to you as a topic you were able to cover. 15:41 Oh my God, that was actually just recently. 15:43 So if you were to ask me in my sleep room, what is one of the disorders that I'm very passionate about? 15:52 And it's narcolepsy. 15:53 I think hypersomnia is such an important topic. 15:58 Narcolepsy is often underdiagnosed, misdiagosed. 16:02 And I have many patients that love dearly. 16:04 But I wanted to talk about one in particular, because you asked me what made me take a deeper dive. 16:10 I have a patient who has narcolepsy that is 101 years old. 16:16 Yeah, I'm not even joking. 16:18 And, you know, true story. 16:20 I actually am really happy to tell this story, so I was giving a lecture one time about narcolepsy, and this was many, many years ago. 16:29 After the lecture, apparently the patient and the family came up to me. 16:35 We shook hands, said hello, we wanted to actually see me as a patient. 16:40 And I really, really wanted to. 16:42 And because of insurance and all these different things that factor in, we never really connected. 16:47 I would say fast forward years later. 16:51 Years later, they finally got an appointment to see me, but by that time I switched hospital systems. 16:57 So they missed it. 17:00 At the hospital system I am right now, a patient got admitted because was having recurrent episodes of what everyone else was calling syncope, 17:10 but it wasn't syncopy, it was cataplexy. 17:13 And it catapslex because she has narcolepsy. 17:16 If you are that age and you obviously if you're going to have an episode of catapse that would make you fall, you worried about a lot of things like breaking 17:25 your bones. 17:26 So what do we do in someone who is 101? All of us will have a couple of core mobilities once you get that age. 17:32 How do you treat it? 17:33 Do you give a stimulant to the 101 year old? 17:35 You give some like sodium oxide to that? 17:38 I mean, it's so hard. 17:40 And you know, of course, I always love Talking to colleagues, talking to people who are smarter than me, figuring out what's the best thing for that individual patient. 17:50 But it just reminded me and what happened was I saw that patient not as a sleep physician, but as being with my internal medicine team and they recognized 18:02 me from years past and there were so excited and I'm like, I am here now and she follows me in my sleep clinic and this is one of the cases where We're 18:14 talking to others, we're having multidisciplinary, talking with the family to see what we can do to help her out in a way where some of the medications 18:22 we use for most individuals may not be the best for her. 18:26 That one was really special to me and it's something I almost wanted to share with others. 18:32 Do we have a moment? 18:33 I'll tell you one other cool case. 18:34 Can I tell another cool Okay so this one was really cool so does everyone heard of have you guys heard the Inspire device? 18:41 Does that ring a bell? 18:42 You know that that hypoglossal nerve blah blah. 18:45 So anyways I got a really super cool patient who I love dearly who has Inspired device and doing well no worries it treated all the obstructive sleep apnea 18:55 but then Suddenly he was not having the refreshing sleep, feeling tired during the day, things weren't right.
Inspire Device Complication and Closing Remarks 19:02 And of course, I'm going to cut to the bullet points and all this, but we found out that he developed central sleep apnea from the Inspire device. 19:11 Can you? 19:11 I know I saw the wow right there, Emerson. 19:13 It's a wow moment. 19:15 You know what I mean? 19:15 Very much so. 19:16 When you have what's called treatment induced centrals, we see that commonly from CPAP. 19:21 You can have it from mandibular advancement devices, you can't have from anything, but it's not common to have this hypoglossal nerve stimulator. 19:29 This has been years afterwards that he developed this. 19:33 Of course, I'm hanging out with my good friends from otolaryngology. 19:37 I am talking to the Inspire team. 19:39 We're talking everywhere. 19:40 It's multidisciplinary to figure out what we're going to be doing to help this individual. 19:44 And anyways, not to get super dorky medicine, we came up with the idea that we'll start a very unique type of diuretic called the cytosolamide. 19:54 And it has been used in the past for central sleep apnea, and lo and behold, the patient is doing better. 20:00 The question is, well, what exactly caused those central sleeping apneas? 20:04 And that's what we're working up as we speak. 20:05 So obviously, you got to invite me back on the podcast. 20:08 You want to hear the conclusion of it. 20:11 Well, that would be fascinating because, you know, the first time we ever crossed paths actually had to do with. 20:17 the back in the auto SV days, you did a talk for Phillips and you were talking about, the CERB-HF trial had just happened and everybody was freaking out 20:28 and were speaking about it for Philips. 20:31 And so to kind of hear you talk about that sort of brings this conversation full circle around therapy causing central apnea like that. 20:40 So that is fascinating. 20:41 We definitely want to hear the rest of that story. 20:43 Be sure to check out our clinical sponsor, Sleep Review Magazine. 20:48 More details in shortly. 20:50 And you know, I'm glad the patient's doing well and needless to say is that, you knows, one of those mottos in medicine is never going to be interesting. 20:57 But, my team, the otolaryngologist team from the university center he sees, we're all teaming up together and writing this up and presenting it. 21:06 at one of these societies, so it's gonna be good. 21:10 I have to admit, in my mind I went to the Zoll remedy of implants, he's got dual implants going on at the same time, one to treat OSA and the other one 21:21 the treat central sleep apnea. 21:23 That's hilarious, I hope everyone found that a little funny, because you know when you have something that's wrong with you as a patient, 21:29 you start Wikipedia-ing everything, and so he is like, He's like, Dr. 21:34 Raj, no one's going to put another device in me. 21:41 Doc, I'd love to keep this going, but we are out of time. 21:44 I can't thank you enough. 21:46 And yes, we need to have you back on. 21:47 We want to hear the rest of the story. 21:50 It sounds like you're going have a whole lot more for us next time as well. 21:54 Definitely. 21:56 Well, thank you once again and folks out there. 21:59 Thank you so much for joining us. 22:00 This has been an amazing show and I think it's been way too short. 22:03 But until next time we say, cheers and lights on.
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