AASM Membership Sections Newsletter Issue #2
Beverly Fang, MD
Dr. Fang completed her under-
graduate degree from Stanford
University, her medical training at
Albany Medical College, and her
general psychiatry residency at
University of Maryland/Sheppard
Pratt program. She is currently
working as a staff physician in
sleep medicine at UC Davis Medi-
cal Center in Sacramento, CA.
Fahd Zarrouf, MD
Dr. Zarrouf completed his medical
training and psychiatry residency
at Damascus University/ Medi-
cal School Hospitals in Damas-
cus, Syria. He then completed a
combined internal medicine and
psychiatry residency at West Vir-
ginia University/ Charleston Area
Medical Center- Charleston, WV.
He completed a Sleep Medicine
Fellowship at the Cleveland Clinic
Foundation, Cleveland, OH. He is
currently working as an Assistant
Professor of Medicine-MUSC, at
AnMed Health, Anderson, SC. He
is Chief of Psychiatric Service and
Medical Director of Transcranial
Magnetic Stimulation Center in
Internal Medicine, Psychiatry, and
Behavioral Medicine at the Lung
Sleep Center.
Rebecca Quattrucci Scott, PhD
Dr. Scott completed her under-
graduate degree at Notre Dame
College in Manchester, New
Hampshire. She then completed
her PhD in Health Psychology at
Yeshiva University/Albert Einstein
School of Medicine in New York.
She also completed her clinical
work in sleep disorders medicine
at The Sleep Disorders Center,
Columbia Presbyterian Medical
Center in New York City. She is
currently working as a sleep disor-
ders specialist at New York Sleep
hyperarousal took a greater number of capsules of either placebo or zolpi-
dem across one year of nightly use (Roehrs, Randall, & Roth, 2012a)
may help inform treatment decisions. Clinicians may predict response
to insomnia treatments based on level of hyperarousal (Sanchez-Ortuno,
Carney, Wyatt, & Edinger, 2012), which appears to affect daytime symp-
toms more than sleep itself (Edinger, Means, & Krystal, 2012)
Novel treatments:
High resolution, relational resonance-based electro-
encephalic mirroring (HIRREM) was tested in 20 insomniacs and showed
benefits in Insomnia Severity Index (ISI) scores (Tegeler et al., 2012). A
single session CBTI (2.5 hours) in a group setting was effective in 303
patients (Gulley et al., 2012). A new selective melatonin (MT2) receptor
ligand for insomnia is being examined by (Comai et al., 2012) and Lore-
diplon, a novel pyrazolopyrimidine hypnotic drug is being investigated by
Santos et al., 2012)
Suvorexant 30-40 mg, an orexin receptor antagonist
was tested in primary insomniacs (n=522 suvorexant and n=259 placebo).
Suvorexant modestly improved sleep and was effective over a year with-
out rebound or withdrawal (Herring et al., 2012). Esmirtazapine maleate
mg, an investigational dual 5-HT2 and H1 receptor antagonist was
tested in 463 subjects. There were improvements in sleep duration, onset,
and maintenance (Ivgy-May, Amari, Pathiraja, Rowe, & Roth, 2012); this
was safe and well tolerated (Ivgy-May, Roth, Amari, Pathiraja, & Walsh,
2012). (
Vermeeren et al., 2012) is also studying this medication.
Changing clinical practice:
Screening: (Basta, Vgontzas, Fernandez-
Mendoza, & Singareddy, 2012) do not recommend routine testing for
OSA in insomnia, except when clinically indicated. Risk factors for
insomnia included mental health and poor sleep, but not apnea. 2) Treat-
ment: When targeting pre-sleep arousal, consider that insomnia rumina-
tion is distinct from both depressive rumination and worry. (Harris, Car-
ney, & Zalai, 2012) suggest that strategies focused on depressive or worry
specific cognitive content may not benefit those with insomnia. Targeting
ruminations rather than beliefs may be of benefit. Cognitive content may
differ by sex; female patients tended to have more negative emotions pre-
sleep, whereas males have more pre-sleep arousal about control over sleep
Hantsoo, Khou, & Ong, 2012)
Psychoeducation: Insomnia patients
appear to get less sleep (Berkowitz Sturgis, Jackson, Gehrman, Grandner,
Perlis, 2012a) and this is related to prolonged SOL, WASO, and subjec-
tive report of problems with sleep duration (Berkowitz Sturgis, Jackson,
Gehrman, Grandner, & Perlis, 2012b). Idiopathic insomniacs report
spending less time in bed and fewer total sleep hours compared to adult
onset insomniac (Bremer et al., 2012)
Steering Committee Profiles
SLEEP 2012 Summary continued