Daniel J Levendowski

Daniel J Levendowski
Advanced Brain Monitoring · Sleep and Awake EEG

BS, MBA

About

149
Publications
36,354
Reads
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2,539
Citations
Additional affiliations
September 1996 - present
Advanced Brain Monitoring
Position
  • CEO
June 1991 - May 1995
Myo Diagnostics, Inc.
Position
  • VP Research and Development
Description
  • Invented diagnostic procedure to assess back muscle dysfunction
Education
September 1987 - June 1989
University of California, Los Angeles
Field of study
  • Masters in Business Adminstration

Publications

Publications (149)
Article
Introduction Non-REM hypertonia (NRH) was recently reported to be independently associated with the synucleinopathy-mediated neurodegenerative disorders: dementia with Lewy Bodies/Parkinson Disease Dementia (DLB/PDD), Parkinson Disease (PD), and isolated REM sleep behavior disorder (iRBD). In this NRH investigation, we included progressive supranuc...
Article
Introduction The severity of REM sleep without atonia, a prodromal biomarker for synucleinopathy-related neurodegenerative disorders, is influenced by selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine retake inhibitor (SNRI) use. This study investigates whether SSRI/SNRIs similarly impacts the severity of Non-REM hypertonia...
Article
Introduction Decreased sleep spindle oscillations were previously associated with cognitive decline in older adults, increased tau levels, and phenoconversion to dementia in patients with Parkinson disease (PD). We analyzed quantitative sleep spindle measures to determine if this biomarker was associated with particular neurodegenerative disorder s...
Article
Introduction Increased non-REM hypertonia (NRH) and decreased sleep spindle-durations were found to be independently associated with patients broadly characterized as presumed Parkinsonian-spectrum disorder [i.e., dementia with Lewy Bodies/Parkinson Disease Dementia (DLB/PDD), Parkinson Disease (PD), progressive supranuclear palsy (PSP), or isolate...
Conference Paper
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AIM: Decreased sleep spindle oscillations were previously associated with cognitive decline in older adults, increased tau levels, and phenoconversion to dementia in patients with Parkinson disease (PD. We aimed to analyze whether quantitative sleep spindle measures were associated with particular neurodegenerative disorder syndromes. METHODS: Slee...
Conference Paper
Full-text available
Aim: The severity of REM sleep without atonia, a prodromal biomarker for synucleinopathy-related neurodegenerative disorders, is influenced by selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine retake inhibitor (SNRI) use. This study investigates whether SSRI/SNRIs similarly impacts the severity of Non-REM hypertonia (NRH), a...
Conference Paper
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Investigational use of sleep spindle duration and non-REM hypertonia to characterize/subtype neurodegenerative disorders
Conference Paper
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Functional settings articulated to a custom oral appliance impacts treatment efficacy
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Survey results from patients using positional therapy
Article
Neurodegenerative disease (NDD) is associated with sleep disturbances, including decreased stage N3 and REM sleep and reduced spindle activity. Further, supine sleep position may impact NDD risk by altering glymphatic clearance. This study evaluated conventional and exploratory sleep metrics in the differentiation of subjects with normal cognition...
Conference Paper
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Introduction: Clinical recognition of isolated REM sleep behavior disorder (iRBD) during routine laboratory polysomnography (PSG) can be challenging even with detailed assessment of REM sleep without atonia (RSWA). This investigation compares two PSG-based iRBD diagnostic approaches with a novel biomarker, non-REM sleep with hypertonia (NRH), that...
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Purpose Assess the impact of custom oral appliance (CA) fabrication settings on treatment outcomes. Methods CPAP-intolerant patients completed a two-night home-sleep-apnea study (HSAT); Night1=baseline, Night2=Apnea Guard® trial appliance (AG). The AG vertical-dimension-of-occlusion (VDO) selection was based on tongue-scallop (women=5.5/6.5 mm, me...
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Purpose Evaluate the sleep staging agreement between polysomnography (PSG) and Sleep Profiler (SP) in patients with suspected isolated REM-sleep-behavior-disorder. Methods Twenty-six patients with reported dream-enactment-behavior (Site1=16, Site2=10; 27% women; age 64±13 years) underwent a diagnostic PSG with simultaneously recorded SP. A registe...
Article
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Purpose Compare agreements between polysomnography-based (PSG) diagnosis of isolated REM-sleep-behavior-disorder (iRBD) and Non-REM-Hypertonia (NRH), a novel biomarker independently associated with synucleinopathy-related neurodegenerative diseases. Methods Sixteen patients with histories of dream-enactment-behavior (DEB)(women=38%; age:64.6±13.0)...
Conference Paper
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Background: Neurodegenerative disease (NDD) is associated with sleep disturbances, including decreased stage N3 and REM sleep and reduced spindle activity. Further, supine sleep position may impact NDD risk by altering glymphatic clearance1,2. This study evaluated conventional and exploratory sleep metrics in the differentiation of subjects with no...
Article
Full-text available
Aim: Produce empirical support for further enhancements to a therapy selection protocol for obstructive sleep apnea (OSA) patients intolerant of positive airway pressure. Methods: A retrospective analysis was conducted in 101 men and 69 women patients. Two-night home sleep apnea studies were conducted at baseline and with a trial oral appliance. Tw...
Article
Study Objective: The goal of the study is to compare the treatment response achieved with a trial oral appliance (OA) to that obtained with a custom OA. Methods: A within-subject, repeated-measures, case-control design was performed in which 193 patients were fitted with an Apnea Guard® trial OA (AG), with the vertical dimension of occlusion (VDO)...
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This abstract received a 2020 AADSM Clinical Research Award.
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Atypical EEG patterns not consistent with standard sleep staging criteria have been observed in medical intensive care unit (ICU) patients. Our aim was to examine the relationship between sleep architecture and sedation in critically ill mechanically ventilated patients pre‐ and post‐extubation. We performed a prospective observational repeated mea...
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Objective: Evaluate the concordance between overall and positional oxygen desaturation indices (ODI) and apnea-hypopnea indices (AHI) according to two different definitions for positional obstructive sleep apnea (POSA). Methods: A total of 184 in-home polysomnograms were edited to simulate Level III home sleep apnea tests (HSAT) with the auto-sc...
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The study characterizes treatment outcome responder phenotypes using oral appliance therapy and/or supine avoidance.
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We compared the frequency of oral appliance (OA) treatment response using a) the conventional criteria of 50% AHI reduction and < 10 and b) a criterion intended for use with a trial appliance. This approach was used for a therapy delivery model that provided cost containment for patients who would not benefit from OA and avoided denial of care for...
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This study compared the efficacy of a custom oral appliance (OA) to that achieved with a trial OA. The Custom OA was fitted based on the conventional technique for jaw forward advancement while the Trial OA used a predictive method for selecting the optimal jaw forward position.
Conference Paper
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The proportion of dental sleep medicine patients that slept more than 2 h/night at baseline and while wearing a custom oral appliance (OA) and trial OA was investigated. Variability in supine sleep time and the association between the % time supine and supine time was evaluated.
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Background: The characterization of sleep in those with neurodegenerative disease (NDD) is essential in understanding the potential neurobiological mechanisms that underlie the connection between sleep disruption and NDD manifestations and progression. Objective: Explore the inter-relationships between NDD and age, sex, diagnosis of obstructive...
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Objective Submentalis electromyography (sEMG) and frontalis electromyography (fEMG) muscle activities have been used to assist in the staging of sleep and detection of disruptions in sleep. This study was designed to assess the concordance between sEMG and fEMG power, by and across sleep stages. Methods Forty-three records with simultaneous acquis...
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Evaluated differences between head, neck and chest positions in the measurement of supine sleep.
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Investigation of sleep biomarkers that distinguish patients with neurodegenerative disease from those with normal cognition
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Abstract Objective/Background Systematically compare four criteria for Positional Obstructive Sleep Apnea (POSA) based on AASM 2007 and 2012 hypopnea scoring definitions. Patients/Methods 142 records acquired by in-home polysomnography (Sleep Profiler PSG2TM) were retrospectively analyzed using AHI based on the American Academy Sleep Medicine 2007...
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Introduction: Auto-scored in-home polysomnography accuracy can be impacted by the signal quality associated with self-application. This study evaluated when the auto- and edited-findings were equivalent. Materials and Methods: This retrospective analysis was conducted in 218 consecutive Sleep Profiler-PSG2TM studies (Advanced Brain Monitoring) tha...
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Introduction Abnormal sleep patterns have been associated with increased risk for cardiovascular disease, diabetes, and neuro-degeneration. This study investigates whether references values obtained from polysomnography (PSG) can be usefully compared to sleep architecture and sleep continuity biomarkers obtained with limited-montage recordings. Me...
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Study objectives: To assess the validity of sleep architecture and sleep continuity biomarkers obtained from a portable, multichannel forehead electroencephalography (EEG) recorder. Methods: Forty-seven subjects simultaneously underwent polysomnography (PSG) while wearing a multichannel frontopolar EEG recording device (Sleep Profiler). The PSG...
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INTRODUCTION: The capacity for case‐control epidemiological investigations into the relationship between sleep duration, structure and continuity, and memory consolidation, metabolic syndromes, neurodegenerative disorders and hospital stays might be expanded by using non‐traditional sleep measurement, if the results were accurate. This is the first...
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This study investigates behavioral adaptation to vibrotactile position-avoidance therapy during sleep in patients with obstructive sleep apnea (n =135) across 15 to 52 weeks. The overall compliance, based on nights used ≥ 4 hr, was 71%. Overall regular use, that is, ≥ 4 hr/night over 70% of nights, was 88%. Poor early compliance strongly predicted...
Patent
Full-text available
Sleep mask for reducing sleep inertia. In an embodiment, the sleep mask comprises a foam layer having a shape that covers both of a human subject's eyes so as to attenuate ambient light. Visual stimulation element(s), configured to emit light, are positioned between the foam layer and the subject's eyes. In addition, a plurality of sensors position...
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The objective of this study was to investigate the feasibility of physiological metrics such as ECG-derived heart rate and EEG-derived cognitive workload and engagement as potential predictors of performance on different training tasks. An unsupervised approach based on self-organizing neural network (NN) was utilized to model cognitive state chang...
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Introduction: The transition from wakefulness to non-REM sleep is characterized by persistent elevated metabolic activity in the frontoparietial regions and thalamus in depressed patients. This study investigates sleep patterns in patients evaluated for chronic insomnia while taking anti-depressant (AD) medications (Meds) compared to those not taki...
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Introduction: The transition from wakefulness to non-REM sleep is characterized by persistent elevated metabolic activity in the frontoparietial regions and thalamus in depressed patients. This study investigates sleep patterns in patients evaluated for chronic insomnia while taking anti-depressant (AD) medications (Meds) compared to those not taki...
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Introduction: Patients evaluated for chronic insomnia may also present with different measures of depression. Some may be acutely depressed based on an elevated questionnaire response (i.e., PHQ9), others may have been previously diagnosed with a depression (Dx) and some may be taking anti-depressant medications (ADRx) for depression, anxiety or sl...
Conference Paper
Sleep deprivation and inefficiency can have a crucial impact on performance. One potential method for ameliorating the impact of bad sleep, or eliminating it all-together, is with sleep stage-dependent sensory stimulation. The effect of superficial facial heating on sleep architecture was studied in 10 subjects. A 20% decrease in sleep onset latenc...
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This study investigates night-to-night variability in sleep architecture and sleep continuity in patients being evaluated for chronic insomnia.
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The number of reported nocturnal awakenings is commonly used in the evaluation of patients with chronic insomnia. The relationship between subjective reports and objectively measured awakenings is not well understood. This study evaluates the relationship between self-reported awakenings and a range of objectively-derived awakening durations.
Conference Paper
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INTRODUCTION: This study evaluated OSA treatment outcomes resulting from use of a titration/trial appliance to define the jaw position for setting the custom oral appliance. METHODS: Twenty-three patients were fitted following a protocol that utilized a titration/trial appliance (TTA)(Apnea Guard®, Advanced Brain Monitoring, Carlsbad, CA) to dete...