In 2023, the NeurologyLive team spoke with hundreds of people and posted hundreds of hours of interview clips. The staff spoke with neurologists, investigators, advanced practice providers, physical therapists, advocates, patients, pharmacists, and industry expertsanyone involved in the process of delivering clinical care.

These conversations were had with individuals from all over the world, both virtually and in person. The team attended more than a dozen annual meetings of medical societies, each time sitting down with experts on-site to learn more about the conversations driving care and the challenges being overcome.

From those in the field of sleep medicine, we learned much this year: recent updates to restless legs syndrome care; the challenges in managing narcolepsy's secondary symptoms; CPAP's effects in other neurologic disorders; heart health associations with sleep; and more.

Here, we'll highlight the most-viewed expert interviews on NeurologyLive this year. Click the buttons to watch more of our conversations with these experts.

The chief of the Sleep Disorders Clinical Research Program at Massachusetts General Hospital provided insight on new updates to the management of restless legs syndrome, including removing dopamine agonists as first line treatments.

WATCH TIME: 8 minutes

"Dopamine agonists are not first line treatments. The reason for that is theres substantial evidence that dopamine agonists when used for restless legs syndrome are associated with an augmentation of symptoms, a worsening of the underlying disorder."

The pediatric neurologist and sleep medicine specialist at Geisinger Medical Center provided commentary on the current unmet needs for patients with narcolepsy, including improvements in treatment options.

WATCH TIME: 3 minutes

"The reality is the disease is characterized, at a minimum, by a pentad of symptoms, which is excessive daytime sleepiness, cataplexy, sleep-related hallucinations, sleep paralysis, and disturbed nocturnal sleep.

The associate professor in the department of neurology and neurosurgery at McGill University discussed results from a study on the long-term use of continuous positive airway pressure treatment among patients with multiple sclerosis and sleep apnea presented at MSMilan 2023.

WATCH TIME: 5 minutes

"Our study indicates that CPAP treatment in patients with MS and sleep apnea is associated with a reduction in fatigue and an improvement in physical quality of life, offering potential benefits for long-term symptom management. Clinicians should consider exploring sleep apnea as a factor contributing to fatigue and poor sleep quality in patients with MS, as adequate treatment may lead to noticeable symptom improvement."

The medical director of SleepMed in South Carolina discussed the need for more overall awareness of poor sleep and the risk factors associated with worsened heart health.

WATCH TIME: 3 minutes

"Its critical to get the word out. We need to understand whats happening biologically, in terms of sleep homeostasis, sleep wake processor, and how thats controlled. What are the set points of heart rate and blood pressure? How are they modified? [We need to] Get the message out."

The cofounder and chief product development officer of Zevra Therapeutics talked about the phase 1 clinical trial of KP1077 for narcolepsy and potentially using it to treat other conditions..

WATCH TIME: 5 minutes

The biggest thing with this study is it is will help us inform study designs for future research. We are looking for the appropriate dosing regimen [of KP1077] and what will work best for patients with narcolepsy.

The senior vice president of medical and clinical affairs for Avadel Pharmaceuticals provided commentary on recently published research supporting once-nightly sodium oxybate (Lumryz) in narcolepsy regardless of the subtype.

WATCH TIME: 5 minutes

"Ensuring that clinicians are having conversations with patients with narcolepsy routinely, and asking about the more subtle presentation of cataplexy, is important. Many patients have their diagnosis changed from NT2 to NT1."

The associate professor, department of medicine, division of neurology, Institute of Medical Science, University of Toronto, talked about the importance of establishing normal values for sleep studies, particularly the multiple sleep latency test, to help with effectively diagnosing sleep disorders.

WATCH TIME: 5 minutes

The purpose of this study was to perform a larger and pretty comprehensive meta-analysis on the mean sleep latency derived from the MSLT (Multiple Sleep Latency Test). We also wanted to look at the impact of things like age, sex, body mass index, other sleep metrics. In addition, we wanted to investigate different methodological variables, such as sleep onset definitions, and sleep study features, as well other markers preceding the sleep study and see if that did affect the mean sleep latency on the MSLT that was performed.

The duo from Indiana University School of Medicine discussed the ongoing research initiatives to better understand sleep disorders among pediatrics, and ways to improve approaches like cognitive behavioral therapy.

WATCH TIME: 4 minutes

"There is a tendency in medicine and in society to focus on the need to eliminate screens and/or to assume that screens are causing the insomnia. This can be very minimizing to kids with insomnia because it implies that theres a simple solution and that a lifestyle factor is causing the insomnia."

The professor of neurology at UMass Chan School of Medicine discussed the various impacts Daylight Savings Time has on sleep quality and overall health in children and adolescents.

WATCH TIME: 3 minutes

"But what a lot of people don't realize is the long-term effects during the 8-month period on Daylight Saving Time. We may blame it on other things, but what we know is that those hour later sunrises and sunsets are associated with about a 10% increase rate of cancer, at least a 10% increase risk of obesity, and increased risk of heart disease."

The sleep epidemiologist and assistant professor at the Rollins School of Public Health at Emory University discussed the multi-level effort needed to improve sleep issues seen in individuals most impacted by social determinants of health.

WATCH TIME: 3 minutes

"The other piece is, how can we modify some of our recommendations to fit disadvantaged communities. For example, we say to sleep in a dark, quiet room, but we know that everyone cant do that because of safety issues. Adjusting the recommendation to say, put a light on in a hallway or somewhere else in the house."

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NeurologyLive Year in Review 2023: Most Watched Interviews in Sleep Disorders - Neurology Live