Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc

Neurologist, Sleep Medicine Physician (former Harvard Sleep Fellow). Adjunct Clinical Assistant Professor, McMaster University. Exciting sleep studies to share!

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

Dear Twitter followers,

May I ask you to complete a brief survey on how I can improve this medical education twitter. It should take less than 1 minute.

Thank you in advance,

https://t.co/TQsz6pwS80

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

@aleclastra @JustinFiala @KaraDupuy @MichelleCao18 @CHESTSleep @AASMmembership REM! V-Shaped desaturation, with resp event clustering. Also large HR variability suggest a responsibility intact autonomic system

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

Anyone who is here, and wants to meet up for a coffee, please message me :)

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

Very excited to be at the SLEEP meeting in Indianapolis!! @SLEEP2023

[Michael Mak @mak_mike]

@SleepyNeuroDoc
Using Twitter as means of collaborative sleep education.

[Michael Mak @mak_mike]

Great work by @SleepyNeuroDoc to disseminate helpful sleep cases and data via Twitter @CanSleepSociety

[CAMH Education @camhEdu]

“We know that almost all psychiatric conditions have some sleep component to them.”

CAMH physiatrist Dr. Michael Mak (@mak_mike) joined Dr. @DavidGratzer on #QuickTakes to discuss his work treating sleep disorders.

🔊LISTEN:
https://t.co/r6tNqxyjq9

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

I’m so excited to be at the Canadian Sleep Society conference in Ottawa!!!

#CanadianSleepSociety #CSS

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

Thank you everyone for the overwhelming support in completing this survey!! 🙌

If you have not yet completed this survey, I would really appreciate it if you could do so to help me improve this educational Twitter.

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

Dear Twitter followers,

May I ask you to complete a brief survey on how I can improve this medical education twitter. It should take less than 1 minute.

Thank you in advance,

https://t.co/TQsz6pwS80

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

EXCITED after my first time being interviewed by a podcast about sleep! I talk about stimulus control, circadian rhythm management, etc. Your patients might find this helpful.

Please pardon my first-timer jitters 🤓🤣😴

https://t.co/8hSiPcElaT

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

@JustinFiala @DescallarEd Definitely not easy on your circadian rhythm

Shift-workers = heroes

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

@JustinFiala @DescallarEd I normally tell my shift work patients don't light block until they are safely at home, then maximum light block until they go to bed… ie with sunglasses, as not just blue but all light matters 😎, block as much light as possible within limits of safety

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

@MilanNigam2 Thank you!! 🙌🙌

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

Vagus Nerve Stimulation induced respiratory changes in patient with epilepsy + OSA, "pseudo-periodic breathing"! Titration PSG, 5 min epoch. VNS stimulation results in elevated chin tone, increased breathing rate, lowered airflow and breath effort and no desaturation. #VNS #apnea

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

VNS in some patients can induce or worsen hypopneas / apneas, which can be obstructive or central. At first glance, this looked like periodic breathing, but it is actually induced by VNS. In complex cases, this highlights the importance of compliance waveform data. #OSA #epilepsy

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

CPAP compliance data show vagus nerve stimulation induced respiratory changes in patient with epilepsy + OSA. Residual AHI =11.8, but on waveform inspection, this is all due to #VNS stimulation, and the cycle of each event perfectly matches the duty cycle of the VNS stimulation

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

@drsleepykarin looks amazing!

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

@PhdNeil Dear Neil, please note, the paper I retweeted in neurology highlights the association of different sleep sx with stroke, which is why in my clinical practice, it is important to assess these symptoms carefully (including long sleep duration) so these patients aren’t neglected.

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

Great point! Adult patients that can objectively sleep for >9hr is a massive flag. Suggest possible sleep pathology resulting in long sleep duration but poor quality of sleep… and need further investigation!

[Elissaios Karageorgiou @E_Karageorgiou]

People with less <5 hours of #sleep per day as well as people with sleep apnea have x3 the risk of #stroke. For >9 hours of sleep or snoring alone the risk was x2 larger. Tell your patients and treat them early! https://t.co/Etv55gmU7k

[Richard Liu, MD, FRCPC, DABPN, CSCN (EEG), MSc @SleepyNeuroDoc]

@PhdNeil Thanks for sharing your personal experience. Obviously there are physiological long sleepers. Which is why I said “possible” sleep pathology. Dx include sleep disordered breath, sleep mvt disorder, central hypersomia etc. you dont investigate your patients that sleep that long?

[Atul Malhotra, MD @AtulMalhotra13]

#obstructive sleep apnea: Finally a randomized study of hypoglossal nerve stimulation for #OSA published in JAMA Otol. congrats to co-authors. pivotal study ongoing. #ucsd #sleep #livanova @atscommunity #ATS2023
https://t.co/31djg9mml8