Margaret Park, MD

Panelists discuss how clinicians should approach OSA evaluation by clearly defining what brought the patient in, establishing that sleep apnea encompasses more than just breathing issues, taking a comprehensive snapshot of current symptoms, and framing the sleep study as the beginning rather than the end of the treatment process.

Panelists discuss how they are excited about future treatments like orexin agonists and nighttime approaches to sleep-wake balance, but express concern that insurance barriers and approval difficulties may prevent patients from accessing even the most effective new medications.

Panelists discuss how solriamfetol distinguishes itself from existing wake-promoting medications through its dual dopamine-norepinephrine reuptake inhibition, with patients reporting they "feel better" on it beyond just improved wakefulness, while emphasizing careful dose titration to minimize adverse effects like anxiety and cardiovascular changes.

Panelists discuss how they select between wake-promoting medications (modafinil, armodafinil, and solriamfetol) by explaining neurotransmitter mechanisms to patients while acknowledging that practical factors like insurance coverage and accessibility often drive treatment decisions more than theoretical mechanisms.

Panelists discuss how they approach measuring sleepiness in patients with OSA, with emphasis on trusting patient reports over relying solely on objective tests like the Epworth Sleepiness Scale, which they view as a useful screening tool but inadequate by itself due to patients often minimizing their symptoms.

Panelists discuss how FDA-approved medications like modafinil, armodafinil, and solriamfetol serve both therapeutic and diagnostic purposes in treating residual sleepiness, with responses varying across different sleep disorder populations but consistently helping patients recognize their true level of impairment.

Panelists discuss how approximately 20% to 30% of patients compliant with CPAP therapy still experience pathological sleepiness, requiring clinicians to plant early expectations about potential need for additional pharmacological treatment and address patient disappointment when CPAP alone isn't sufficient.

Panelists discuss how excessive daytime sleepiness significantly impacts patients' work productivity and quality of life, yet many patients rationalize their symptoms as normal or fail to recognize the severity of their condition, making thorough clinical questioning essential.

Panelists discuss how to differentiate true excessive daytime sleepiness from general fatigue or tiredness, emphasizing the importance of collaborative care with other specialists to address underlying mood disorders and comorbid conditions that may complicate diagnosis.

Panelists discuss how the traditional profile of older, overweight men with thick necks remains valid for OSA risk, but clinicians must also recognize that less obvious cases in younger, smaller individuals can be easily missed and require more sensitive screening approaches.

Panelists discuss how obstructive sleep apnea affects potentially up to 1 billion people globally, with excessive daytime sleepiness being a common but often underreported presenting complaint that patients may not recognize or admit to experiencing.

Margaret Park, MD, and Russell Rosenberg, PhD, DABSM, provide clinical pearls and the future treatment landscape for the management of narcolepsy.v

Drs Margaret Park and Russell Rosenberg share considerations for the use of solriamfetol, lower-sodium oxybate, and pitolisant in narcolepsy for various patient populations.

Key opinion leaders in sleep medicine discuss the pitolisant studies and their experience using the drug in clinical practice.

Margaret Park, MD, and Russell Rosenberg, PhD, DABSM, provide insight on novel FDA-approved treatment options and their impact on the narcolepsy treatment landscape.

Margaret Park, MD, leads the discussion on setting and managing patient expectations for treatment in narcolepsy.

Expert sleep specialists review the case of a 22-year-old man who is diagnosed with excessive daytime sleepiness and type 2 narcolepsy and his challenges with treatment.

Drs Margaret Park and Russell Rosenberg illuminate challenges patients and providers face with narcolepsy medications, including potential substance abuse with scheduled substances.

Russell Rosenberg, PhD, DABSM, and Margaret Park, MD, review the optimal treatment selection of pharmacologic options for the management of patients with narcolepsy.

Expert sleep specialists explore the use of nonpharmacologic treatment approaches for the management of narcolepsy.

Drs Margaret Park and Russell Rosenberg discuss challenges in the diagnosis of narcolepsy.

Key opinion leaders in sleep medicine discuss patient recognition of cataplexy symptoms in narcolepsy and their approach to narcolepsy diagnosis.

Russell Rosenberg, PhD, DABSM, and Margaret Park, MD, review the case of a 15-year-old girl who presents with excessive daytime sleepiness and share clinical impressions on diagnosis and treatment.

Experts in sleep medicine evaluate the impact of narcolepsy on a patient’s quality of life and expand on which symptoms appear to be most debilitating.

Margaret Park, MD, defines typical signs and symptoms of narcolepsy and differentiates between the 2 main types of disease.