The Coach, The Expert and The President
1h 21m | Sep 14, 2020In this episode
- Beth Wyatt’s “rest instead of sleep” approach when sleep will not come
- Breath awareness, racing thoughts and reducing pressure at bedtime
- Why chronic insomnia is rarely solved by another generic sleep-hygiene tip
- How Beth ended up with a mild sleep-apnea diagnosis when she expected narcolepsy or hypersomnia
- The first-night effect in polysomnography
- Neil’s repeat sleep-lab experience and the modern correction on pramipexole for RLS
- Short naps, comfort and feeling safe enough to sleep
- How COVID-19 changed Beth’s coaching work and her clients’ sleep
- Listener Amy’s questions about upper airway resistance syndrome
- Why UARS is now considered part of the OSA spectrum rather than a separate disease
- RERAs, arousal-based scoring and why AHI can miss part of the clinical story
- Whether cone-beam CT can diagnose an airway-related sleep problem
- Small or recessed jaws, anatomy, loop gain, airway muscles and arousal threshold
- Why permanent dental or surgical intervention deserves caution when the diagnosis is uncertain
- What to do when an airway-focused treatment has not worked
- Why the patient’s own symptoms and treatment response belong in the decision
- The 936-million global OSA estimate
- The 2020 open-source framework for validating consumer sleep trackers
- Michael Grandner’s argument that sleep stages are useful human categories, not perfect boundaries in nature
- How hypnodensity and multisensor wearables later followed the direction Michael predicted
- The prediction that Alzheimer biomarker testing would become easier — and the 2025 blood-test milestone
- The 2020 white-noise systematic review and what newer evidence says now
About Beth Wyatt
Beth Wyatt is a sleep coach, author, podcaster and meditation teacher. She is the author of The Calm & Cozy Book of Sleep: Rest + Dream + Live and host of the archive of The Calm & Cozy Podcast. Her current coaching work focuses particularly on sleep in midlife, including stress and hormonal change.
About Dr. Atul Malhotra
Atul Malhotra, MD, is a professor of medicine and sleep-medicine specialist at UC San Diego Health whose research focuses on obstructive sleep apnea, respiratory physiology, OSA endotypes, treatment adherence and personalized approaches to sleep-disordered breathing.
About Dr. Michael Grandner
Michael Grandner, PhD, is a clinical psychologist and behavioral sleep-medicine specialist at the University of Arizona, where he directs the Sleep and Health Research Program and the Behavioral Sleep and Circadian Medicine Clinic. He later served as president of the Society of Behavioral Sleep Medicine and is now a past president of the organization.
MENTIONED
Sleep Coach Beth
Beth Wyatt’s current sleep-coaching work and resources.
The Calm & Cozy Book of Sleep
Beth’s 2020 book from Rock Point/Quarto.
Behavioral Treatment of Chronic Insomnia
The AASM clinical guideline supporting multicomponent CBT-I and advising against sleep hygiene as a stand-alone treatment.
2025 VA/DoD Insomnia and OSA Guideline
Current evidence-based guidance for chronic insomnia and obstructive sleep apnea.
First-Night Effect in Polysomnography
A 2024 review of how the first night of sleep monitoring can alter sleep architecture.
AASM Restless Legs Syndrome Guideline
The modern guideline that conditionally recommends against standard pramipexole use because of augmentation risk.
RLS and PLMD treatment guideline
Dr. Atul Malhotra
UC San Diego Health profile and current clinical work.
Atul Malhotra at UC San Diego Health
Upper Airway Resistance Syndrome and OSA
The 2023 international consensus statement explains why UARS is no longer treated as a separate diagnostic entity and why RERAs still matter.
International Consensus Statement on OSA
Arousal-Based Scoring in OSA
The AASM position statement on hypopneas, RERAs and respiratory disturbance index.
Global Prevalence of Obstructive Sleep Apnea
The 2019 analysis, coauthored by Malhotra, estimating 936 million adults aged 30–69 with mild-to-severe OSA.
Read the global prevalence study
OSA Endotypes and Phenotypes
Malhotra and colleagues on airway anatomy, muscle responsiveness, ventilatory control and arousal threshold.
Standardized Framework for Testing Sleep Trackers
The open-source validation framework Michael was excited about in this episode.
Hypnodensity and Probabilistic Sleep Staging
A modern approach to representing stage ambiguity rather than forcing every epoch into one perfectly clean box.
World Sleep Society Recommendations for Consumer Sleep Trackers
The 2025 recommendations on fundamental sleep measures, proprietary metrics and responsible tracker use.
Noise as a Sleep Aid
The 2020 systematic review of white and continuous broadband noise discussed with Michael.
2025 White-Noise Meta-Analysis
Newer randomized-trial evidence showing benefits in some populations while retaining substantial heterogeneity.
FDA-Cleared Alzheimer’s Blood Test
The 2025 milestone that followed Grandner’s prediction that Alzheimer biomarker testing would become easier and less invasive.
