How one sleep professional has risen through the industry to promote improved national sleep healthIn 2000, Matthew Anastasi was itching for a new challenge, actively looking for a career change, and sleep came calling. When an opportunity to jump into sleep research sprang up at the University of Pennsylvania (UPenn), he took the plunge into the sleep field. According to Anastasi, this was still before the majority of the general population really cared about their sleep health. “At the time, sleep wasn’t on anyone’s radar,” he said. “People used to ask me, ‘do you listen to people snore?’ or ‘do you tell bedtime stories?’ when I said I was in sleep research. Now, people say, ‘oh I have a CPAP machine’ or ‘I know somebody who has sleep apnea’ and so in 20 years, the changes in how we view sleep are tremendous.” Over two decades, Anastasi’s career evolved from a sleep researcher, to a registered polysomnographic technologist (RPSGT), then a lab manager, to helping craft the narrative in the field of sleep, literally, with pieces like this past month’s cover story in Sleep Lab Magazine on the Implications of Medication Use in the Modern Sleep Center.
“Today, people recognize the prevalence of obstructive sleep apnea (OSA) and other sleep disorders. There are 54 million people with an AHI of 5 in the U.S.,” said Anastasi. “We need to bring better sleep medicine to our communities, and better sleep health to the patient population.”Sleep health awareness is now Anastasi’s top priority, and with two decades in the field, he’s making a lasting impact. Let’s dive in to see how.
Who is our featured sleep professional, Matt Anastasi?Sleep is quite often a “for-life” career move, and for Anastasi, the past two decades of his professional life have been centered around public sleep health. As mentioned, in 2000, he started in research at UPenn, working there for a decade and ultimately leading a small team of sleep technologists and overnight technicians. By 2010, Anastasi had achieved his RPSGT, developed curriculum for night technicians and scoring technicians, and spearheaded the university’s home sleep testing expansion program. While talking about his decade at UPenn, he reminisced fondly on his early research topics, the ones that hooked him into the sleep field in the first place. “The little research studies I was lucky enough to work on were all so interesting and unique,” he said, then going on to highlight a few that stood out, including a study on the effects of acupuncture on pain during sleep and a deep dive into determining if “morning-ness” or “evening-ness” was an inherited trait. In regards to the latter study, it turns out that it is, with Anastasi commenting: “For the morning larks and the night owls, it turns out that trait, of course, is pre-determined for you by your parents.” The process for that determination involved assembling over 2,000 pairs of twins together in the same place. He laughed, remembering the first night of the conference when he and a friend walked into the hall to see dozens of pairs of twins, and his buddy just said, “I shouldn’t have had that last drink… I’m seeing double everywhere.” Despite the jest, Anastasi was honored to be on the sleep research front line. “The studies we did helped form common knowledge about sleep,” he said with pride. “Sleep influences mood, daytime alertness, and it affects your ability to process insulin.” He added that his greatest point of pride was that many of the research studies they performed were pivotal in driving modern sleep medicine.
Moving into Sleep Lab ManagementThough his research days were full of excitement and intrigue, Anastasi really found his stride in the mid 2000s and early 2010s as a sleep lab manager, first with UPenn, then with Philadelphia-based Main Line Health, where he oversaw the multi-location, 8-bed, AASM-accredited sleep center operations and staff. From there, he jumped up to the regional level, serving as system lead of sleep operations for 10 hospitals in the Pittsburgh-based UPMC health system. Anastasi highlighted the signing of the Affordable Care Act (ACA) as a major catalyst in the sleep industry’s shift in focus and perception. He described the cascading effects of the new law, from the cost-cutting focus that spanned most of the healthcare industry, to new requirements and regulations around sleep tests, specifically with how insurers cover testing.
Prioritizing Sleep Health and Sleep EducationIn his current role with Limina Sleep Consulting, Anastasi is taking the lessons learned from his healthcare and sleep lab management experience and adding a research or evidence-based spin to his consultative work. He’s focused on bringing the research and data to the forefront, then helping explain how it is relevant for sleep technologists’ daily work lives. Per Anastasi, sleep labs spent the year drowning in information from CDC on how to handle the COVID-19 pandemic and they need specific guidance. But those who did find solutions to the challenges of COVID pushed innovation ahead at a faster rate. For Anastasi, the improved focus on overall sleep health as a country has been instrumental. The rise of home sleep apnea testing diagnostic devices has also been pivotal, especially as this year has led to the rise of disposable devices. With more options on the market for testing, and social distancing keeping testing volumes in check, the patients who are required to come in for in-lab PSG testing have progressively worsened.
In-Lab Patients are Sicker than in the PastAccording to Anastasi and many other lab owners and managers we’ve talked with over the past year, the patients visiting the lab are coming in with a much higher acuity. “What’s left in the lab is the people with additional precautions and comorbidities. For techs 5-7 years ago, set-up was fairly easy, especially without titrations. Now it’s so hard for technologists to keep up. They’re required to do so much, including the scoring, handling all the needs of the patient and all the factors related to complications. It’s no longer the healthy patients coming in. From 2015 to 2020, I’d say my sleep techs had to spend around 50% more time on patient care and education.” Due to the ACA, patients that are approved for in-lab studies are there because they have a comorbid complication, like severe obesity. This obesity might signify a type 2 diabetic or someone with hypoglycemia. Patients with comorbidities might need more medications and they might have mobility issues. For the overworked technologists, that last part is very important. “One important, but overlooked part of a sleep technologists’ day is handling and explaining the insurance process. Patients are on the hook for co-pays now more than they were ten years ago, yet they likely have no idea what they’re about to get billed for,” said Anastasi. “And when some find out, they’re out the door. For the average sleep technician, at least 50% more is expected in a 10-hour shift than in 2010. It’s a tough job.”
Providing Technologists with the Right Tools to Save TimeFor Anastasi, simplifying the job for sleep technicians has always been the top priority. He felt successful in his role as a lab manager when he was able to not only be their greatest advocate for advancement, but also the person most likely to be able to equip them with the tools they needed, as he had the power to work with his administrative staff with the UPMC health system to advocate for his team’s needs with vigor.
“I was in between administration and the sleep techs,” described Anastasi. “If my team didn’t have the supplies, if the environment wasn’t safe, if patients weren’t adequately prepared, their job was harder. Being a sleep lab manager is a difficult spot to be in, especially when overseeing multiple labs and locations, but I took great pride in being able to make the work environment better for my sleep technicians.”For Anastasi, this support often included creating a brand new curriculum to help train new techs and improve the current staff’s skill sets. Anastasi was a catalyst in getting staff up to speed and credentialed within the 18-month time period for new technicians, proudly claiming a 100% completion rate during his tenure for those tests.