Open AirWaves Episode 6: Psychological Approaches for Improving Sleep Outcomes: COMISA, Sleep, Sport and Science-Open AirWaves Episode 6 (Video)

Video Transcription

Video Summary

In this episode of the Open Airwaves podcast, Dr. Tanya DeSanto interviews Dr. Michael Grandner, a clinical psychologist specializing in behavioral sleep medicine, to discuss sleep's crucial role in overall health, treatment of insomnia, and its impact on athletic performance. Dr. Grandner explains that sleep is a natural, non-negotiable biological state essential for life, but barriers—physical or behavioral—can disrupt it. He emphasizes cognitive behavioral therapy for insomnia (CBT-I), which targets behaviors to retrain the brain-sleep association, focusing on stimulus control and sleep restriction, rather than merely sleep hygiene.<br /><br />The discussion highlights the complex interaction between sleep apnea and insomnia, known as COMISA, where arousals caused by breathing problems trigger difficulties falling back asleep. Dr. Grandner stresses treating both conditions simultaneously or prioritizing insomnia treatment first to improve adherence to sleep apnea therapies like CPAP or oral devices.<br /><br />He explores multidimensional sleep health beyond quantity—emphasizing regularity and timing—and its link to cardiovascular risks. With athletes, he notes sleep’s profound influence on physical and mental performance, including memory consolidation key to mastering skills and play strategies.<br /><br />Dr. Grandner underscores the importance of meeting patients “where they are” to overcome barriers, normalize testing for sleep apnea, and address adherence issues compassionately. For dentists treating sleep issues, he encourages learning basic CBT-I principles to help patients manage insomnia, stressing that sometimes “less is more” and that fighting wakefulness can worsen it.<br /><br />Finally, he advocates implementation science to develop behavioral sleep interventions customized to individuals and organizations, improving sleep culture and health outcomes across populations.

Keywords

sleep health

behavioral sleep medicine

insomnia treatment

cognitive behavioral therapy for insomnia

CBT-I

sleep apnea

COMISA

sleep restriction

stimulus control

athletic performance

memory consolidation

sleep hygiene

implementation science