Alon Avidan, MD, MPH: Promising Sleep Therapies

Given the global turmoil that is being reported on in various media and the ongoing effects of the COVID-19 pandemic, it's no wonder that the number of individuals struggling with sleeplessness has steadily increased in recent years.

Despite this, Alon Avidan, MD, MPH, Director of the UCLA Sleep Disorders Center, believes that recent advancements in sleep medicine could help patients and doctors alike dream of a brighter future.

In an interview with HCPLive, Avidan spoke of the contributing factors of sleeplessness across the world as well as promising new therapies for a variety of sleep disorders including narcolepsy.

“We know that since the COVID-19 that the rates and the prevalence of insomnia and sleep-wake patterns have changed,” Avidan said. “While the data is still being assembled, just anecdotally we've seen a lot more patients presenting with anxiety, worrying about sleep, worrying about a lot of different things that have to do with the pandemic, and now with the war raging in in Eastern Europe, these are really unprecedented times, (and) people often have difficulties with sleep durations and sleep regularity.”

Though patients might be experiencing trouble falling asleep and maintaining a healthy sleep schedule, Avidan urged that they do to not accept these changes as part of a “new normal” and instead seek professional help.

Cognitive and behavioral therapy have been shown to be very effective in patients with sleep disorders, and the widespread adoption of telemedicine in recent years has increased access to sleep care across the country.

For patients affected by obstructive sleep apnea (OSA) formal sleep evaluations are recommended still, though Avidan noted that the process of managing the condition has been made easier in recent years to at-home testing.

Regarding insomnia, he noted a brand-new mechanism of action in the form of orexin hypercritical receptor agonists that alter brain arousal at night and improve activity in patients who have difficulties with hyper-vigilance at night.

For narcolepsy, hypocretin receptor analog replacement therapies are being considered, with projected approval in the US by next year.

“The landscape of management is really increasing and improving; the ability to discern that there are specific sleep disorders that patients may experience that when modified can help improve and promote better health and particularly better brain health are really, really exciting,” Avidan said. “I feel excited about this because as a neurologist we often like to see that by treating sleep we can actually improve the lives and the quality of life of people with sleep in the setting of neurodegenerative or other neurologic conditions.”

Avidan noted that the evaluation and management of these conditions not only improve sleep, but also prevent patients from developing neurodegenerative diseases that have been linked to sleep disorders such as insomnia and OSA.

In addition to new and upcoming therapies, he spoke of the possibilities that remote care offer will inform the next decade of sleep health.

“I think being able to also validate and measure the patient's compliance with therapy and see how they do pre- and post-therapy, being able to do that to the comfort of the patient's home will give us a little bit more precision about whether or not the treatment that we're providing is going to be effective,” Avidan said.