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NeuroNow - Diagnosing Sleep Disorders? There's an App for That

NeuroNow Summer 2014

Diagnosing Sleep Disorders? There's an App for That

Date: June 12, 2014

Rachel Salas, left, and Charlene Gamaldo are developing an app that can help care providers who aren’t sleep medicine specialists to diagnose and treat sleep problems in their patients.
Rachel Salas, left, and Charlene Gamaldo are developing an app that can help care providers who aren’t sleep medicine specialists to diagnose and treat sleep problems in their patients.

Millions of Americans have chronic, undiagnosed and untreated sleep disorders. However, with the current nationwide shortage of sleep medicine specialists, few of these potential patients will get the care they need, even if they’re already seeing other doctors. It’s a problem that neurologists and board-certified sleep physicians Charlene Gamaldo and Rachel Salas have long pondered.

“There’s no way to capture all these patients, no way that we can see them all,” Salas says.

But with the proliferation of smart devices, including cellphones and tablets, the doctors say, they’ve hit on a promising solution. With a team of colleagues, they’re developing an app that can educate other care providers (who didn’t train in sleep medicine yet often see patients with sleep complaints) on how to screen, triage and counsel their patients with the most common sleep disorders.

The app, which they’ve named My Sleep Script, has two parts. The first is an interactive education module to teach doctors, nurses and other members of a patient’s care team the basics about six common sleep disorders in 10- to 15-minute “elevator” talks. The lectures, which use the real voices of Gamaldo and Salas, are delivered by animated avatars of the two doctors—a touch that the physicians hope will appeal to a younger generation of providers who are more likely to use their cellphones and other smart devices as medical tools.

After care providers pass a short quiz on each section of the first part, Gamaldo explains, the app unlocks a second part that they can use as a diagnostic checklist to identify patients with symptoms suggestive of a sleep disorder that requires an immediate formal evaluation. For patients that the app flags as having less serious sleep problems, My Sleep Script recommends self-help strategies that care providers can suggest for patients to put into practice immediately—as soon as they go to bed that night.

“Just like when you see your dentist and he reminds you how to floss,” Gamaldo says, “this part of the app suggests things you can implement tonight to improve your overall sleep environment and sleep quality.”

For patients whose results on the checklist suggest a more serious problem—“Those we should have seen yesterday,” says Gamaldo—the app pulls up a referral form to send them to a sleep medicine specialist.

Salas and Gamaldo say that the app—developed in collaboration with a multidisciplinary team including an artist, software developer, behavioral sleep medicine specialist and department administrators—will make its debut in the offices of doctors who see patients often secondarily affected by sleep issues. Consequently, they’re currently piloting My Sleep Script with Johns Hopkins providers who specialize in caring for patients with HIV, movement disorders, headaches and urological problems. If these providers show in surveys that the app is helpful, Salas and Gamaldo plan to expand its availability throughout Johns Hopkins and, ultimately outside the institution.

“Not everyone has the time or interest to get certified in sleep medicine,” Gamaldo says. “Nonetheless, our app can serve as a novel tool to help all providers to fill this provider supply and service demand, so we can collectively work towards improving the sleep and overall health of our patients.” 


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