October 4, 2023 —Two papers about research conducted by Dr. Anuj Chandra, M.D. and his team at the Advanced Center for Sleep Disorders in Chattanooga have been accepted for the World Sleep Congress, being held October 20-25 in Brazil.

“Most sleep research is done by academic centers, not by sleep medicine practices,” said Dr. Chandra. “Despite being a busy private practice, our team wanted to do this research, both to help us treat our own patients and to help patients everywhere.”

One paper is about Dr. Chandra’s patients with Inspire, an FDA-approved upper airway stimulation system that uses a surgically implanted impulse generator and sensing lead to help patients with sleep apnea breathe normally during sleep. This paper was co-written by Dr. Chandra and two providers on his staff: Dr. Inisha Shrestha, M.D., MPH and Dennis Prok, PA-C.

Dr. Chandra became the first sleep medicine physician in the Chattanooga area (and only the second in Tennessee) approved to work with Inspire in 2020. Since then he has worked with many Inspire patients to get them ready for surgical implantation and to fine-tune the device after surgery.

Research by Dr. Chandra’s team showed that their patients using Inspire experience significant benefits, both while they sleep and during the day. The study covered 15 randomly selected patients who had received the Inspire device, had it adjusted after several months, and then were retested to measure their sleep apnea. On average, Dr. Chandra’s Inspire patients experienced 23 fewer episodes of breathing stoppage during sleep. In addition, when they were questioned about how sleepy they felt during the day, their scores on a standard test of daytime sleepiness improved by an average of 5.46 points on a 24-point scale.

“National data shows that Inspire works well, but to the best of our knowledge, no one had looked at these patients in a community setting,” said Dr. Chandra. “In an academic center, the paradigm is different, because there are research teams dedicated to following patients. In the community setting, there are different variables and different resources. We wanted to make sure that our patients in Chattanooga are benefiting from it.”

“We are happy with those numbers,” said Dr. Chandra. “All of our Inspire patients had previously failed with CPAP, and they all did significantly better on Inspire. We feel we can confidently proceed with this therapy, and we will continue to monitor patients with objective measures.”

The other paper accepted for the Congress is about CPAP treatment, which stands for “continuous positive airway pressure.” Many people find it difficult to continue with CPAP treatment, which requires a patient to sleep while wearing a mask (even a small one) that is connected to a bedside machine that pumps air into the mouth and/or nose throughout the night. 

“Many patients with CPAP machines may not be able to use them as much as they should, sometimes taking off the mask after a few hours or not even attempting to use the machine some nights,” said Dr. Chandra.

Dr. Chandra worked with several other sleep researchers to measure the effectiveness of an information tool designed to increase patients use of their CPAP machines. The research looked at a total of 138 of Dr. Chandra’s patients who were newly diagnosed with sleep apnea and prescribed CPAP treatment. These patients were given a 41-item information tool that provided information about their CPAP treatment — including how to use and clean the machine and about the benefits of CPAP treatment — and asked them to make a commitment to using their CPAP machines.

“After using the information tool patients had statistically significant improvements in their compliance with CPAP therapy, meaning that they used the CPAP machine more hours per night and used it more nights,” said Dr. Chandra.

The World Sleep Congress is a program of the World Sleep Society, a nonprofit, professional membership organization dedicated to advancing sleep health worldwide by engaging the global community of sleep physicians, researchers, and professionals as well the public. For more on the World Sleep Congress, visit worldsleepsociety.org