Sleep Month in Review: June 2024

The first week of June, sleep experts met and presented on an array of topics at SLEEP 2024, the 38th annual meeting of the Associated Professional Sleep Societies. Topics spanned from obstructive sleep apnea (OSA) to how sleep impacts cardiovascular health, anxiety, and immune health.

Later in the month, the US Food and Drug Administration (FDA) approved pitolisant for excessive daytime sleepiness in pediatric patients. Along with the FDA news, this month in review will recap a handful of interviews conducted at SLEEP 2024 in case you missed it.

FDA Sleep Updates

FDA Approves Pitolisant for Excessive Daytime Sleepiness in Pediatric Patients

The FDA approved of the supplemental New Drug Application for pitolisant (Wakix) tablets to treat excessive daytime sleepiness in pediatric patients aged ≥ 6 years with narcolepsy, announced by Harmony Biosciences on June 24, 2024.

Pitolisant, a selective histamine 3 (H3) receptor antagonist/inverse agonist, works by increasing the synthesis and releases histamine to promote wakefulness in the brain. The FDA decision was based on a phase 3 trial which evaluated the safety and efficacy of pitolisant in pediatric patients aged 6 – 17 years with narcolepsy who either have or do not have cataplexy. The mean adjusted difference in the Ullanlinna Narcolepsy Scale total score from baseline to the end of the double-blind period was -6.3 in the pitolisant group and -2.6 in the placebo group (95% confidence interval [CI], -6.4 to -1.0; P = .007).

SLEEP 2024 Recap

Sleep Apnea Coverage

Lourdes DelRosso, MD, PhD: Goals, Insights from the “Count on Sleep” OSA Project

Lourdes DelRosso, MD, PhD, from the University of California San Francisco spoke about the multiyear “Count on Sleep” educational campaign, spearheaded by the American Academy of Sleep. The campaign aims to educate providers, public health professionals, and patients about OSA.

Jennifer Martin, PhD: Boosting CPAP Adherence in Women with Sleep Apnea

Jennifer Martin, PhD, from UCLA, discussed the barriers standing in the way of CPAP adherence in women with sleep apnea. Women may view putting on a mask as “one more challenge,” as Martin said, on top of healthcare responsibilities, supporting their family, dealing with mental health struggles, and keeping up with healthy diets and exercise.

M. Safwan Badr, MD: What are the Novel Treatments for Central Sleep Apnea?

M. Safwan, MD, from Wayne State University, broke down the differences between OSA and CSA and how their treatments compare. CPAP can treat both OSA and CSA, and some novel treatments for CSA include phrenic nerve stimulation and pharmacological therapy.

Sleep’s Impact on Immune Function, Cardiovascular Health, and More

Sairam Parthasarathy, MD: How Sleep Disturbances Impact Immune Function

At SLEEP 2024, Sairam Parthasarathy, MD, from the University of Arizona, explained when people have sleep disruption, the white blood cells T lymphocytes, and B lymphocytes do not function as well. Studies have shown when the blood cells do not work properly, individuals have immune dysfunction.

Allison Brager, PhD: Exercise’s Impact on Cardiovascular Health, Circadian Clock

Allison Brager, PhD, from the Walter Reed Army Institute of Research, said exercise is the most significant impact on the cardiovascular health in relation to the circadian system. Exercise can provide many sleep benefits: improving cardiovascular performance and stabilizing the circadian clock if the exercise is done the same time every day.

Treating Sleep-Related Anxiety with Michael Grandner, PhD

Michael Grandner, PhD, from the University of Arizona, described the differences between sleep-related anxiety with other types of anxiety. “Sleep related anxiety is a little different on its own because it can perpetuate itself by directly making it more difficult to sleep,” he said.

Josiane Broussard, PhD: Meal Timings Impact on Sleep

Eating close to bedtime can change sleep architecture and impair your sleep, Josiane Broussard, PhD, from Ludeman Family Center for Women’s Health Research at Colorado University, told HCPLive. Research suggests restricting food consumption to a 12-hour eating window can improve sleep.

Restless Leg Syndrome

John Winkelman, MD, PhD: When to Use Low-Dose Opioids for Restless Legs Syndrome

John Winkelman, MD, PhD, from Massachusetts General Hospital said the first line treatment for restless legs syndrome—dopamine agonists—may be making a patient’s condition worse in the long-term. Patients may need to turn to low-dose opioids for a more effective treatment option.

Research Gaps in SLEEP Health

Ghada Bourjeily, MD: Research Gaps on Sleep Issues During Pregnancy

Ghada Bourjeily, MD, from Brown University, said the most common sleep issues during the third trimester of pregnancy include insomnia and restless legs syndrome. More research needs to be done to understand how a mother’s sleep impacts the health of the fetus in the womb and longer term.

Sleep Updates at American Diabetes Association Meeting

Atul Malhotra, MD: Tirzepatide for Obstructive Sleep Apnea and Obesity

Tirzepatide (Zepbound), a dual GIP/GLP-1 receptor agonist, could bring a new era of management for OSA. Results of the SURMOUNT-OSA trial showed the benefit of tirzepatide in OSA and obesity with a change in AHI of 27.4 events per hour (95% CI, -31.6 to -23.2) from baseline to week 52.

“This study marks a significant milestone in the treatment of OSA, offering a promising new therapeutic option that addresses both respiratory and metabolic complications,” lead author Atul Malhotra, MD, from the University of California San Diego School of Medicine, told HCPLive.