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The vast field of sleep medicine is always evolving. Listen to Talking Sleep, a podcast of the American Academy of Sleep Medicine (AASM), to keep up on the latest developments in clinical sleep medicine and sleep disorders. Our host, Dr. Seema Khosla, medical director of the North Dakota Center for Sleep in Fargo, will take an in-depth look at issues impacting the diagnosis and treatment of sleep disorders. Episodes will feature conversations with clinicians, researchers, sleep team members and other health care experts working to help us sleep well so we can live well.
Episodes

Friday Jul 25, 2025
Predicting RBD Phenoconversion via Autonomic Reflex Testing
Friday Jul 25, 2025
Friday Jul 25, 2025
In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Luca Baldelli, a neurologist from the University of Bologna and Treasurer-Elect of the International REM Sleep Behavior Disorder Study Group, to discuss breakthrough research on predicting which RBD patients will develop neurodegenerative diseases.
Building on the AASM's updated RBD guidelines, Dr. Baldelli presents compelling evidence for using simple autonomic reflex testing to identify patients at highest risk for phenoconversion to conditions like Parkinson's disease and dementia with Lewy bodies. His research demonstrates that objective autonomic testing, particularly orthostatic assessments, can reveal early neurogenic orthostatic hypotension that precedes overt neurodegeneration by years.
The conversation explores practical clinical applications: How can sleep medicine practitioners implement these screening protocols? What constitutes abnormal autonomic function in RBD patients? How do we interpret changes over time, and when should patients be referred for neurological evaluation? Dr. Baldelli shares his longitudinal monitoring framework that could transform how we counsel RBD patients about their future risk.
This episode addresses critical questions about biomarker development in prodromal neurodegeneration, the timeline of autonomic changes, and evidence-based approaches to patient discussions about prognosis. Dr. Baldelli also discusses current research initiatives and potential therapeutic interventions for high-risk patients.
Whether you're a sleep medicine physician, neurologist, or researcher interested in neurodegenerative diseases, this episode provides essential insights into improving early detection and patient care in RBD.
Join us for this informative discussion that bridges sleep medicine and neurology to enhance clinical decision-making and patient outcomes.
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