Season 8 | Episode 6
In this episode of Talking Sleep, host Dr. Seema Khosla explores growing concerns about microplastics in human health and what they may mean for patients using positive airway pressure (PAP) therapy. She is joined by Dr. Thais Mauad, a pathologist based in São Paulo, Brazil, and Dr. Michel Cahali, an otolaryngologist, whose recent research examines the presence of microplastics and inflammatory mediators in the nasal airway of PAP users and non‑users.
The conversation is framed by alarming findings from recent high‑profile studies showing microplastics in carotid artery plaque and even in the olfactory bulb of the human brain — discoveries that raise important questions about how these particles enter the body and their potential long‑term health effects. Dr. Mauad discusses her work on microplastics in neural tissue and explains how these particles may interact with inflammatory pathways, while Dr. Cahali describes their collaborative research evaluating microplastic deposition in the nasal airway.
A key focus of the discussion is whether PAP therapy itself contributes to microplastic exposure. The guests walk through their study design, control population, and findings, including the reassuring conclusion that PAP users did not demonstrate higher levels of microplastics in the nasal airway compared with controls. They also address important nuances, such as equipment age, material degradation, and how exposure may differ throughout the respiratory tract.
Beyond PAP therapy, the episode expands into a broader conversation about how plastics are manufactured, the role of additives and so‑called “forever chemicals,” and how responsibility for reducing plastic exposure has historically shifted to consumers rather than manufacturers. Drs. Mauad and Cahali reflect on what these findings mean for sleep medicine professionals and discuss practical steps the sleep community can take — from clinical practice to advocacy — to reduce plastic exposure in health care settings.
Whether you’re concerned about the safety of PAP devices, interested in emerging research on microplastics and inflammation, or looking to better understand how environmental exposures intersect with sleep health, this episode provides important scientific context and thoughtful perspective on an issue that extends far beyond the sleep clinic.
Prof. Dr. Michel Burihan Cahali, MD, PhD
Head of the Sleep Medicine and Surgery Section in the Department of Otolaryngology at Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Board-certified in Otolaryngology and Sleep Medicine.
Founding member of the International Surgical Sleep Society (USA, 2006).
Pioneered the lateral pharyngoplasty, a surgical technique developed to treat snoring and obstructive sleep apnea. This innovation significantly shifted the paradigm of sleep surgery, from the ancient palate removal concept towards the strategic repositioning of lateral pharyngeal muscles. The lateral pharyngoplasty now serves as the foundational reference for all current sleep surgery pharyngoplasties developed worldwide.
Current research focuses on upper airway muscle pathology related to sleep apnea.
Dr. Thais Mauad
Dr. Thais Mauad is a professor in the Department of Pathology at the University of São Paulo School of Medicine whose research focuses on pulmonary and upper airway pathology. Her work has advanced understanding of airway remodeling, obstructive sleep apnea, and the tissue-level mechanisms underlying respiratory disease. Through her research, Dr. Mauad helps connect pathology and sleep medicine to improve understanding of airway health and disease.
