Future of Sleep Treatment With Dr. Chelsie Rohrscheib

December 6, 2023

#FuturePsychiatryPodcast discusses novel technology and new ideas in the field of mental health. New episodes are released every Wednesday on YouTube, Apple Podcasts, etc.

Summary

This episode shows a conversation between Dr. Bassi and Dr. Chelsie Rohrscheib, where they discuss the prevalence of sleep disorders and the importance of diagnosing and treating them. They also explore the features and benefits of the Wesper device, a home sleep testing technology that aims to make sleep testing more accessible and accurate. The conversation covers the challenges in the field, future growth opportunities, and the potential use of psychedelics in mental health treatment. The episode emphasizes the significance of addressing sleep disorders and the role of technology in monitoring and improving sleep health.

Chapters / Key Moments

00:00 Introduction

02:59 The Mission of Wesper: Revolutionizing Sleep Testing Accessibility

05:11 Wesper’s Innovative Technology and Patient-Centric Approach

08:19 Wesper’s Versatility: Beyond Sleep Disorders

12:48 Evolving Diagnostic Capabilities and the Complexities of Sleep Disorders

14:35 Post-Baseline Sleep Data: Charting the Path Forward

16:50 Monitoring Sleep Perception with Wesper

20:28 Enhancing Patient Engagement and Provider Satisfaction

22:13 Comprehensive Sleep Data Interpretation at Wesper: Patient Choice

24:09 Future Challenges and Expansion in Healthcare

26:38 Hospital vs. Home Sleep Studies

30:00 Incorporating Sleep Assessment into Mental Health Practice: Innovations and Recommendations

31:23 Revolutionizing Mental Health: Psilocybin and Emerging Innovations

35:20 Outro

 

 

Introducing Wesper

Wesper is a startup that aims to make sleep testing for sleep disorders more accessible to people around the world. Traditionally, individuals had to undergo overnight sleep studies in a hospital, which were costly and time-consuming. Wesper, however, offers a user-friendly and affordable alternative. Their FDA-cleared device utilizes two tiny, flexible biosensors that are placed on the abdomen and thorax to monitor position, airflow, blood oxygen levels, respiratory effort, and more. This comprehensive data collection allows for accurate sleep disorder diagnosis and longitudinal monitoring.

Dr. Rohrscheib highlighted several advantages of using Wesper for sleep testing. Firstly, the ease of use and comfort of the Wesper device make it accessible to individuals of all ages, including senior citizens. The flexibility and accuracy of the biosensors provide a precise picture of a patient’s sleep patterns over time, eliminating the limitations of a single-night study. Longitudinal testing also enables healthcare providers to monitor patients’ progress and treatment efficacy effectively.

The Integration of Sleep and Mental Health

Sleep plays a crucial role in mental health, and nearly every mental health disorder has a sleep component. Dr. Rohrscheib emphasized the necessity of addressing sleep issues alongside mental health treatment. By using Wesper, mental health professionals can evaluate their patients’ sleep patterns, identify underlying sleep issues, and incorporate them into the care plan. This comprehensive approach ensures better treatment outcomes for patients.

Innovations in Sleep Diagnosis

While Wesper provides accurate and comprehensive sleep testing, Dr. Rohrscheib acknowledged that it may not detect every sleep disorder entirely. However, they are continually improving their technology and considering integrating questionnaires to screen for additional sleep disorders. The field of sleep medicine is continually evolving, and Wesper aims to stay at the forefront.

Challenges and Future Directions

One of the main challenges for Wesper is integrating into hospital systems, as many physicians are still resistant to home sleep testing. Dr. Rohrscheib believes that the key to overcoming this challenge lies in demonstrating the accuracy and effectiveness of Wesper’s technology compared to traditional hospital sleep studies. Additionally, Wesper is actively exploring partnerships with other areas of healthcare, such as cardiology and mental health, where sleep plays a significant role in patient outcomes.

Conclusion

The Future of Psychiatry podcast episode featuring Dr. Chelsie Rohrscheib shed light on the importance of sleep testing, the prevalence of sleep disorders, and the innovative solution provided by Wesper. With their user-friendly device and comprehensive data collection, Wesper is revolutionizing sleep testing and diagnosis. By integrating sleep evaluation into mental health treatment, professionals can address underlying sleep issues and enhance patient outcomes. As Wesper continues to improve its technology and expand its reach, the future of sleep testing looks more promising than ever.

Resources

Transcript

Chelsie: the main issue is that sleep disorders are super common in the general public. Most people are not getting diagnosed or treated. Most people don’t even know they have a sleep disorder. It’s more prevalent than we think it is. And every year that percentage of people who have things like sleep apnea and insomnia is rising.

So it went from 10%. Now it’s closer to 20%. It’s creeping up to 26%. So. THe fact that we have so many undiagnosed, untreated people means that these chronic health conditions are going to continue to increase in the population

So welcome to the Future of podcast, where we explore novel technology and new innovations in mental health.

Bruce: I’m your host, Dr. Bassi, an addiction physician and biomedical engineer. Today we’re going to be focused on sleep, which is super important. I’m with Dr. Chelsie Rohrscheib, who is a sleep expert, neuroscientist, and sleep consultant with over 10 years of experience in the field of sleep. She holds a PhD in neuroscience with a specialty in sleep genetics.

She’s also worked in clinical trials where she oversaw sleep apnea research. She’s the founding member of Wesper, which is a startup that has a FDA cleared device to diagnose sleep issues. And to help monitor treatment efficacy over time, it measures position, airflow, blood oxygen levels, and respiratory effort to try to diagnose a whole host of sleep issues and then help monitor the treatment thereafter.

Welcome doctor.

Chelsie: Thank you so much for having me.

Bruce: Tell us a little bit about yourself and how you got involved in this discipline.

Chelsie: Sure. My background is in biomedical science. That’s where I got my start. Which is looking at medicine more broadly, but looking at the scientific aspects of medicine. through that, I started to get into research, where I specialized in neuroscience for my PhD. During my PhD, These studies, I was specifically examining brain infections and how they affected our patients.

And one of the aspects I was looking at with sleep specifically, and that’s really how I got into sleep medicine. After that, I started getting more into the genetics of sleep. So how Specific genes control sleep and affect sleep when you alter those genes. More recently, I’ve been involved in the clinical side of sleep, so more of the medical side, working with patients for a variety of sleep disorders.

The sleep disorder I primarily focus on is sleep apnea, which is the second most common sleep disorder behind insomnia. It affects 20 to 26 percent of adults in America, so it is a major health condition. Now I’m the head of sleep expert for Wesper. We are a sleep disorder testing technology. We are considered a home sleep test, so we do all the testing at home in the patient’s bed.

But we’re a little bit more than that. So we do diagnostics and we can also continuously test our patients night after night so we can follow them.

Bruce: I do often find that individuals come to us for another reason, and we uncover an underlying sleep issue that they had no idea that they had, or they’re not getting enough sleep, and that’s contributing to their inattention, lack of focus, lack of motivation.

Their low mood, their impulsivity, perhaps their cardiovascular disease, the weight gain. So sleep has so many downstream effects and actually can also predispose people to drinking alcohol and using substances. I think sleep is so critically important to talk about and make sure that people are following adequate sleep hygiene and also make sure that there’s not any underlying sleep issues as well. Tell us a little bit about Wesper’s mission and how it accomplishes that.

Chelsie: Like you said, sleep affects absolutely every system in the body the brain and body. So if there is, an organ or Any process in the body’s sleep can disrupt that process. If you’re not sleeping properly, Wesper’s first primary mission is to make sleep testing for sleep disorders more accessible to people across the globe.

Traditionally, people have had to go into a hospital for an overnight sleep study. It’s very expensive. It can take forever to get an appointment especially in America. If you don’t have the right insurance coverage, you may not be able to get a sleep study at all. So there’s a lot of factors that inhibit people from getting tested for sleep disorders, even though sleep disorders are so incredibly common in the general public.

So Wesper is very comfortable. It’s very affordable. It’s very easy to use and set up. And again, like I said earlier, you can retest over and over as many times as you want. And because we allow longitudinal testing the data we collect is more accurate. So we have a very precise picture of what your sleep looks like typically, as opposed to a single night.

In hospital sleep study where you’re not in your bed, you’re in a foreign environment. wiTh all those factors combined we’re making the sleep testing process

Bruce: So I know that there’s basically two electrodes that’s involved with Wesper and they pair to a phone, a smartphone. One electrode sits right underneath your right breast and the other one, and correct me if I’m wrong, the other one sits right above your belly button, and it monitors your position, your blood oxygen level, and it uses those metrics to diagnose a sleep issue.

Tell me a little bit more about why an individual would choose to use Wesper versus I know the field of sleep diagnosis is very competitive space to break into. What does Wesper do differently? Why is it at the forefront of the future of psychiatry?

Chelsie: Sure. The nature of Wesper’s technology is that the biosensors we use are two tiny little passes that, like you said, go on the abdomen and thorax. They’re flexible. So when you put them on, they flex with the body and they’re very comfortable. Once they’re on, you don’t even know they’re there.

Very easy to fall asleep. This is important for people who have a lot of sleep anxiety or people who are highly arousable. And what I mean by highly arousable is somebody who’s very sensitive to environmental factors and things like that, waking them up at night. They’re just a lot easier to use than most.

They collect a wide variety of data. Like you said, respiratory metrics, heart rate, sleep metrics, body temperature, position metrics, we collect sound, so we can tell if you’re snoring or if there’s a disturbance in your bathroom. And the possibility to use this technology for other things.

So it’s very adaptable. What makes us very different is we’re very accurate. Compared to an in lab. Yes. We’re just as accurate as an in lab studies that we have 95 percent correlation. The other thing that makes Wesper for super unique is our longitudinal data collection capabilities. Most sleep tests are limited in the number of tasks you can actually perform.

Wesper can perform unlimited tax reasonable easy to charge. If you want your patient to collect data for a week, you can do that a month. You can do that even a year. We’ve had patients who have collected over 350 tests at this point without any issues at all. So not only does that allow you to test and diagnose your patient, but it also allows you to monitor your patient.

In the long term, which is very unique. Finally, we are very focused on the patient journey. So we actually involve your patient in the health care process. Doctors and providers get their own clinical reports, their typical medical report they would get with any sleep test, but our patients. In the app, also get a easy to understand a patient report, which is similar to something you would see in like a consumer wearable like Fitbit.

It’s very interesting, interactive, and this uses a lot of psychology to keep the patient motivated.

Bruce: You mentioned that the data can be used for a whole host of other things. What were you referring to with that?

Chelsie: Sure, so we have providers that use for insomnia tracking. We have providers and help our mental health care that use our device to track their patient sleep because sleep and mental health. I always say they’re married right? Almost every single mental health disorder has a sleep component to it.

That means we see sleep disruption and dysfunction with nearly every mental health disorder. We also see it with things like autism and ADHD as well. And we know that if sleep is dysfunctional, it makes treatment for these disorders very difficult. We need to obviously treat the mental health disorder, but we also need to proactively address sleep issues as well to get the best outcomes for your patient.

So we have a lot of mental health providers that use our device to evaluate their patient’s sleep in the long term .

Bruce: two criticisms of at home sleep studies that I’ve heard of before, not Wesper, but in general, is that I’ve heard that they tend to underestimate sleep issues compared to the gold standard of being in a lab, which it sounds like you also addressed. And then the other one is that it’s really a one and done, maybe two night.

Type of evaluation and then you’re done with that usage of the at home sleep study But it also sounds like Wesper you can continue to track does that ability to continue to track the patient’s treatment over time make the device more expensive because it is reusable or can you talk a little bit about the cost or the trade off there of being able to track longitudinally over time

Chelsie: That’s a really good question. So the criticism of home sleep, that’s not as accurate. Used to be an accurate criticism, but sleep tests are getting more accurate. Every single year. Sleep tests are practically in line with the hospital studies. Now, however, you bring up a really good point, which is a single study is not necessarily representative of a patient’s typical sleep.

So clinical studies have shown that. About 70 percent of patients have variation in their sleep from night to night. I’ll use sleep apnea as an example. If we looked at sleep apnea patients and we tested them over multiple nights, As opposed to a single night, we would find that roughly half of those patients can have both normal looking tests where no sleep apnea is present and abnormal looking tests where they are positive for sleep apnea.

This means that patients are at really high risk for being misdiagnosed if we base their sleep study off of a single night. by Incorporating longitudinal testing as standard and sleep medicine. This is removing this risk completely. And the more test your patient is able to take, the more accurate the data is going to be as far as not only what sleep disorders they have, but how severe their sleep disorders are as well.

This allows us to not only confirm that our patients have a sleep disorder, but it allows us patients more effectively. As far as cost we are currently working on a subscription model, so our patients pay a low cost every month, and that allows them unlimited testing. As for provider based models, that really depends on the hospital, the provider.

Bruce:

There’s a provider model as well. So the provider would be paying Wesper and then deciding how to use those devices with their patients. Is that how it works?

Chelsie: Yeah, so generally, We’ll offer a per test for Wesper. But again, compared to other sleep tests and hospital sleep studies, we’re very affordable.

Bruce: Nobody really talks about that in regard to the quote unquote gold standard of doing a in lab sleep study. It always feels your sleep study was normal in the lab. That was the best thing that they could have measured.

Therefore you don’t have it when it’s probably highly possible that it was a very uncomfortable experience. The individual didn’t get a typical night’s sleep in the lab, but I never really hear that being taken into consideration when evaluating the data from the laboratory sleep study.

Chelsie: I think it’s a pretty well known issue in sleep medicine. The issue really has to do with like insurance and what insurance will allow you to bill for. Hospital sleep studies are incredibly expensive and most of the time we simply cannot bill for multiple nights. So home sleep tests, just because they’re a lot cheaper., they’re easier to run,

Bruce: Are there certain diagnoses that are more difficult or challenging with Wesper such as periodic limb movement syndrome that might be difficult to pick up with your study versus some other study that has a video input?

Chelsie: That’s a really good question. We’re actually developing periodic limb movement for our device. The nature of our sensors is they can be placed anywhere on the body, including the legs things like periodic limb movement disorder you have to follow a very. That of criteria as outlined by the American Academy of sleep medicine.

So periodic limb movement, not only is looking for movement on the limb, but they have to move in a certain rhythm over a certain period of time and you also have to determine that the limb movement was not caused by something else, like sleep apnea, for instance. These are all things that need to be considered.

There’s always going to be challenges with developing that technology, and of course, Wesper is not going to be able to detect every sleep disorder. There’s over 80 sleep disorders, and Wesper, just by the nature of some of these sleep disorders, Wesper really can only just, potentially. Diagnose a handful of them.

Most sleep disorders are diagnosed through questionnaires. You don’t even need a sleep study for them. We could possibly integrate questionnaires into our system as well that recover those sleep disorders as well.

Bruce: There are many different types of sleep disorders, and I’m sure they all vary in prevalence and it sounds like if an individual starts off with Wesper and over, what’s the recommendation, a couple of weeks of time, if there’s no underlying issue, what would be the next step?

Chelsie: So we recommend that our users take three to six tests to start for a baseline data collection. Three is pretty much the minimum amount of tests you want. Six is the kind of like the ideal number. And that gives us a pretty good understanding of what your sleep looks like normally. Our patients have the option of consulting with me.

I’m the staff sleep expert to go through their data with a fine toothed comb and I can identify things that would indicate that you might have insomnia you might have Sleep apnea or a wide variety of other sleep disorders as well. But just because patients have, that come to us have usually been struggling with sleep problems for a really long time the majority of them do have Sleep disorder, whether that is insomnia or sleep apnea or another, very few have no sleep issues at all.

And there’s always ways to improve sleep. So if an individual is positive for a sleep disorder, then we will route them to the appropriate pathway. Usually that’s a sleep physician who will then go through their tasks, confirm that they have a sleep disorder. They’ll meet with that sleep physician. thEy will get their diagnosis and potentially go on a therapy and then we can also track them afterward to see how they’re going on their therapy. What kind of improvements they’re making if there’s no obviously disorder, but they are still having sleep issues. We can consult with them on how to make some lifestyle improvement. So improve their sleep hygiene use techniques to deal with things like anxiety and stress before bedtime.

If we suspect it’s another problem altogether and sometimes. Disfunction can occur because of other health issues. Things like mental health problems immune system issues, hormonal problems, things like that, then we would make the recommendation that they see a specialist

Bruce: One of the most interesting sleep disorders and I forget the exact phrasing of it is where an individual thinks that they’re not sleeping, but they actually did sleep. They think that they had insomnia, but they actually were sleeping for some portion of the night. How would Wesper go about evaluating that if it could without having an EEG to detect.

Whether or not they’re in any sort of sleep rhythm. Is it really accurate to extrapolate from body movement positioning alone to detect something like that?

Chelsie: Yeah, so that’s a good question. So what you’re talking about is a condition where that’s very common in insomnia, where a patient perceives that they were not sleeping when they actually were, and a lot of times this happens because we have four stages of sleep. We have three non REM stages, stage one through three, with stage one being the lightest stage and stage three being the deepest stage.

And then we have a REM sleep stage when we’re dreaming. So stage one sleep is very light and it feels like you’re awake. So you do have Some level of awareness of your surroundings, but your brain is actually actively in sleep. So people who are highly sensitive can perceive this as being awake.

Now, the way Wesper might. detect this is we can accurately predict when somebody is not only asleep, but whether they’re in light sleep, deep sleep, or REM sleep. And we base this off of a few parameters. So first we look at their respiration because people’s respiration changes depending on what sleep stage they’re in.

So somebody in light, Sleep might have a slightly lower respiration. Somebody in deep sleep is going to have a very low rate of respiration. And then somebody in REM sleep, their respiration is going to be all over the place. It can be fast, it can be slow, but it changes very frequently. We also look at heart rate, which is very similar to how it changes to respiration.

We look at body movement, and we can also detect things like your core body temperature and things like that. So all that information taken together gives us a fairly accurate assessment of when you were asleep and when you’re awake even though we cannot monitor your brain waves directly like an in house.

I will throw it out there that wearables will never be as accurate for sleep wake protection as an in hospital sleep study.

Bruce: Would it be helpful to add another electrode behind somebody’s ear or something like that in a less intrusive place, something to get those brain rhythms that way to more closely link the data between the movement and the brain wave itself?

Chelsie: It’s certainly possible. It’s not something that we’re technically looking into at this time. The only issue with that is monitoring brain activity from one area of the brain doesn’t really give you an accurate representation of what is happening in the brain globally. So that might not give you enough accuracy to say for certain that somebody is asleep or awake or if they’re in specific stages.

So it’s really more about taking all of Those metrics that I mentioned earlier, and using an algorithm that has trained itself to very accurately identify when somebody is asleep versus awake. One of the ways we do that is we take our artificial intelligence, our algorithm, and we train it against hospital PSG sleep studies that have already been conducted so our algorithm can look at somebody who we know for sure was asleep because they had the PSG.

Bruce: What kind of feedback do you get from either patients or clinicians about the system and how have you incorporated that to make any sort of adjustments improvements thereafter?

Chelsie: So the main feedback we get is how easy we are compared to other sleep studies. We’re super simple and we’re patient friendly. We designed our technology to be friendly for elderly patients that may not necessarily be super tech savvy. And the reason for that is because a high percentage of our patient population is they’re senior citizens, they’re older senior citizens tend to have higher rates of sleep disorders like sleep apnea. So it’s got to be very simple at that up, and it has to work consistently. And it also has to be very comfortable to where the other thing that our provider really appreciate is our longitudinal testing capabilities. That really sets us apart from other sleep tests, which are more limited in their repeat testing.

And finally, a lot of our providers are really happy with the fact that we involve our patients in their own healthcare journey. People can be very I think they can be a little bit resistant to medicine. Sometimes they can be a little bit distrusting of providers. I’m sure most of us have run into this at some point.

And so what we find is allowing the patients to be involved with their own user report really helps them understand, like, how bad their disorder is, how problematic it is, how it’s affecting them. They can actually watch their improvement in real time once they get on therapy. And this is just a huge motivator, and we find that it speeds up the testing process.

Bruce: Can a patient have a face to face visit with a sleep expert at Wesper to go over the data or is it more of a report based interpretation that gets sent back to the patient for them to read?

Chelsie: They have both options. They receive their nightly reports immediately after they stop their tests. tHey also have the option of meeting with a sleep expert. Currently, that’s me. We’ll probably bring more sleep experts on to staff eventually as we get bigger. And what I do is before I even meet with the patients, I go into their profile.

I go through every single one of their tests. I look at key indicators for sleep disorders or sleep issues. I look at their history. So our patients fill out questionnaires about themselves and what they’ve been struggling with and their main reason for wanting to test with Wesper. We also ask a series of questions before and after each test about their habits immediately before they took the test.

So these are things like, how were you feeling? Did you eat a big meal? Did you take any medications? Are you using any therapies? And then when they wake up in the morning, we’ll ask them questions like, how do you think you slept? Did have any issues last night? Do you feel like you slept better than usual? Worse than usual? Things like that. so I can really create a story and picture of our patients and then I take a good half an hour, sometimes longer than that. Do consult with our patients. I listen to what their major concerns are. We go through their tests and find detail and then I help them with a pathway forward to improve their sleep.

Bruce: I’m sure a lot of people are probably wondering whether or not it’s covered by insurance. Could you answer that question for us quickly?

Chelsie: Yep, so currently we’re not accepting insurance. That is something that we are looking into. We’re currently, any patients that come through us, it’s out of pocket. We’re very inexpensive, so it’s not a huge cost, but we would like to offer insurance coverage in the future.

Bruce: What kind challenges lie ahead for you? It sounds like Wesper is at the forefront of innovation, wanting to constantly improve. Where do you see the company growing or adding to their current setup to maybe make some improvements or expand the scope of treatment for patients?

Chelsie: So I think the main current challenge is integrating into hospital systems right now. Even though about 50 percent of patients who are getting sleep tests are tested by home sleep tests, integrating into hospitals can be a little bit tricky. A lot of physicians are resistant to home sleep testing for a variety of reasons, primarily because in hospital sleep studies are all they know.

It’s all they’ve been doing for a really long time. So there is a trust factor there. That’s a big hurdle for home free testing companies. Another issue is every clinic is a little bit different, so their requirements for what the sleep report looks like or. The patient portal. They’re all slightly different.

So being able to adapt to each clinic needs can be difficult. Not insurmountable, but it is something that takes time and effort are on our end. And because we are a small startup there’s only so much we can do at this moment, as far as where we’re going in the future, 1 of our major focuses is to get involved with other areas of health care where sleep is a major risk factor for certain diseases.

So I’ll give you an example. Cardiology is a major area where sleep often plays a huge role in a variety of disorders. Sleep apnea, for instance, is associated with almost every type of cardiovascular issue, whether it’s coronary artery disease, arrhythmias, stroke, you name it. Arrhythmias in particular, arterial fibrillation.

50 percent of those patients have sleep apnea and sleep apnea is the primary cause for why patients develop those so cardiologists are starting to learn that it’s very wide to also test their patient’s sleep. Along with treating them for their cardiovascular issues mental health and psychiatry and therapy is also another big area because like we were talking about earlier, almost every single mental health disorder has a sleep component.

And if you do not fix the sleep, it’s going to be very difficult to treat your patients. So understand whether or not they have an underlying sleep disorder.

Bruce: Let me ask a follow up question about how you said that one interest was getting into the hospital systems to test sleep issues in a hospital system. Does evaluating the data of an individual who is laying in a hospital bed differ at all compared to evaluating that data of an individual who may be in their own bed due to the fact that maybe the bed is more narrow they’re more restricted by an IV, or maybe it’s tilted upward and they’re less likely to roll over on their stomach, given the fact that it’s tilt, the back is tilted upward.

How does that work? How does that vary in terms of your interpretation of that data?

Chelsie: hospitals are Not comfortable. If you’ve ever spent time in a hospital, I certainly have. I’ve even undergone two in hospital sleep studies a while ago, about 10 years ago, but they’re not comfortable. You’ve got a bunch of wires and sensors all over your body, on your head, on your nose, strapped around your chest and your legs.

It’s very restrictive to patients, so most of them have to sleep on their backs simply because they’ve got all these wires on them. Back sleeping does not necessarily promote good respiration in patients, especially sleep apnea patients. We see that sleep apnea tends to be worse when you’re sleeping on your back for most patients.

Numbers can be inflated, and it’s not really giving you an accurate look at how somebody is sleeping normally. Hospitals are also right. They’re loud. People are walking in and out of your rooms. It’s not conducive to good sleep at all. So we find that people tend to sleep lighter in hospital settings, and they also tend to get less sleep on average.

You really only need four hours of sleep to diagnose. Somebody with a sleep disorder, but still, it’s not going to give you a complete look at what their sleep looks like naturally. So really, being able to have somebody in their own bed in their house and their normal environment, it’s actually going to give you a more accurate look.

Bruce: thought it was sad and a little bit ironic when I was a medical student, and we were pre rounding at 430. And asking the whole list of questions and one of those questions being how did you sleep and patients typically looked at you like, what do you think? Because obviously I just woke them up at four in the morning to ask them a bunch of questions after they probably went hours upon hours trying to ignore all the beeping around them and all the other interruptions.

And I wish hospitals in general were a little bit better at prioritizing sleep for overall well being and recovery and healing than they are. But I think they’re getting better at that overall.

Chelsie: One thing I have noticed lately in the industry is doctors who do rely on in hospital are now starting to add home sleep tests on top of that. So they’ll do the initial and then they’ll send their patient home with a home sleep test to confirm the results or they’ll do it in the reverse where they will send their patient with a home sleep test and then follow up with a PSG later to confirm.

I think in that regard, it gives you a much better look at somebody’s sleep in a natural setting, but also with the rigorous testing of a PSG as well. So that’s a great combination. I really think it also depends on the patient and what sleep disorder you’re actually testing for.

Bruce: What kinds of recommendations would you have for somebody who is interested in innovating in the field of mental health or sleep or biotechnology?

Chelsie: So If you are somebody who works in mental health one thing that you should be assessing is sleep whether that’s through questionnaires. And I know a lot of mental health professionals do use questionnaires, but if there’s any indication that there is a sleep problem, which more than likely there will be, It’s very important that you rule out some of the more common sleep disorders, because they are so prevalent.

And you can help your patient with sleep hygiene, you can help them improve their habits, but if there is an underlying sleep disorder, you’re not going to be able to do anything until that sleep disorder is addressed. So using a technology like Wesper can help you not only screen your patients for sleep issues, but they can also help you confirm that your patient does not have a sleep disorder, or if they do get them treatment for that sleep disorder.

So a lot of our providers. Have a Wesper for kits on hand and they will give the kids out in their standard protocol. It is written into their protocol. It is already built into what the patient is paying for and it’s just a part of their normal treatment

Bruce: Are there any types of novel treatments within the field of psychiatry or sleep other than your technology that really excites you and things think that are going to be up and coming in the future?

Chelsie: not related to sleep at all. I think what we’re doing with psychedelics is incredibly interesting especially for treatment of chronic depression. In particular I’m somebody who suffered from depression, and I know that if you’re treatment resistant, it can be a very bleak outlook for you, and it feels like nothing is working, but the information that is coming out about psychedelics things like ketamine, for instance, very promising, very interesting I’ve had colleagues working on things like ketamine therapy with amazing results.

I’m interested in seeing how this expands. I know it’s a little bit tricky with the legal process, especially in some states. I live in Michigan where ketamine therapy is, it’s legal and we have clinics. And it’s just incredibly interesting and promising to me. The other areas I’m really interested In would be things like how your gut flora and your gut bacteria affects mental health.

Bruce: Is there any data on how ketamine or psilocybin affects sleep?

Chelsie: Yeah, that’s a good question. So what we know so far, and this is very new, young research, again, it goes back to the legality of using these substances on patients. Psychedelics, ketamine affects your sleep architecture. So we know that patients that have been on it their sleep architecture, meaning how they move through each sleep stage is altered.

Now, this can be both a good and a bad thing. It can be a good thing for patients with depression, for instance, because patients with depression have too much REM sleep on average. Depressed patients go into REM sleep earlier on average than healthy patients, and they spend way too much time in REM sleep.

We I think that inhibiting REM sleep, and medications like SSRIs already do this to an extent, is actually very beneficial for patients with depression. So if psychedelics are able to do this too, meaning if they’re able to inhibit or change the way a person cycles into REM sleep this may be one of the reasons

Bruce: I’m sure we’ll have to have you on again in the future to talk about any sort of additional studies that have come along , in regard to psychedelics and its intersection with sleep issues

Chelsie: the main issue is sleep disorders are super common in the general public. Most people are not getting diagnosed or treated. Most people don’t even know they have a sleep disorder. It’s more prevalent than we think it is. And every year that percentage of people who have things like sleep apnea and insomnia is rising.

So it went from 10%. Now it’s closer to 20%. It’s creeping up to 26%. THe fact that we have so many undiagnosed, untreated people means that these chronic health conditions are going to continue to increase in the population.

If you’ve had sleep problems for years, or your patient has struggled with sleep for years, they’ve tried all the typical things, they’ve tried good sleep hygiene, they’ve tried exercising more maybe they’ve tried some insomnia techniques that we teach in Cognitive Behavioral Therapy for Insomnia, and nothing has worked. That’s a very strong indicator that your patient probably has a sleep disorder and needs help. to be tested. Sleep disorders are highly prevalent in our society, especially insomnia and sleep apnea, and they’re becoming more common. Most people are not screened, tested or diagnosed, because they don’t even know what to look out for and other professionals are not aware of the symptoms and how it might be affecting your patient.

So don’t wait, get them tested.

Bruce: It was really a pleasure having you on the show. I thought this was a really interesting , conversation to get to know you better and get to know Wesper better. I do think that there is a shortage of really good, easy to use at home sleep study tests out there. And so therefore I’m so grateful and glad that you were able to talk to us a little bit about Wesper and why it’s so valuable and the reasons that using the test long term can be so useful to patients.

So I appreciate you so much. Thank you.

Chelsie: Oh, thank you for having me.

Bruce: I’d appreciate it if you please like and share the podcast with your colleagues. It would be especially helpful for us. And if you’d like, please leave us a rating on your favorite podcatcher. If you’re a clinician, I developed a course on how to start a private practice. And for patients, I’ve also developed a course on ACT and CBT based lessons for treating and helping anxiety.

And you can find those all on our website as well. Thank you so much. And I’ll see you in the next episode.

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