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Aiming to Avoid a Medical Tsunami

Prabhat Soni, MD, FCCP, DABSM, DABOM, DABAARM, puts his six board certifications to work for one missiona healthier world. By Katie Griffith
Prabhat Soni, MD, FCCP, DABSM, DABOM, DABAARM
of a sick tree. Cutting this branch will not make the entire tree healthy. The comorbidities of obesity remain unaffected until patients lose weight. Finding that he could help patients in multiple ways using CPAP combined with weight loss prompted Soni to get the board certification in bariatric medicine. I believe I am a more successful sleep physician now because I know sleep disorders better than before, explains Soni. I use CPAP and weight loss together, and I see better results. Patients are happier than before because they lose weight, they feel good, and they sleep better. If a clinically obese patient loses 10% of their body weight, obstructive sleep apnea improves by more than 50%. This is very positive because weight loss might be able to cure the OSA, he says. When patients lose weight, they feel happier, especially when they find that their blood pressure and blood sugar are also controlled, he adds. Sonis mission is to improve lives by treating sleep conditions through combined therapies such as CPAP, weight loss, and oral appliances. He has an oral appliance specialist to whom he sends his patients, to customize the device for the greatest success. I see all kinds of patients, including teenagers, but the majority of them are between 30 and 60 years of age or older. They are usually suffering from sleep apnea and insomnia, says Soni. Everyone who comes in to my office who is obese and has sleep apnea goes on a weight loss program. The facility does many home sleep tests, and they are generally for one of two reasons: either the patients do not sleep well outside of their home, or they are unable to get to the facility. If the home sleep test returns positive, Soni then brings them in for a test in the facility. Our sleep testing facility is like a five star hotel, says Soni. The patients who come in are happy here. They feel like they are on vacation instead of at a sleep lab. As a board-certified sleep physician, Soni supervises the sleep lab, which is located directly in front of the emergency room of a local hospital. If a patient experiences an urgent medical problem while at the lab, they can go directly to the ER without waiting for an ambulance.

rabhat Soni, MD, FCCP, DABSM, DABOM, DABAARM, is one of Sleep Review s Best of Sleep Medicine doctors this year; however, he could wear that title in many other fields of medicine as well. Soni received his fifth and sixth board certifications, in obesity medicine and antiaging medicine, over the last year after finishing fellowships in bariatric medicine and in stem cell medicine. These two certifications are new additions to the line of sleep, pulmonary, critical care medicine, and internal medicine. When I realized that the large majority of patients who were going in for bariatric surgery had obstructive sleep apnea (OSA), I wanted to help fix the entire problem by breaking the link between OSA and obesity, says Soni, director of the Sleep & Weight Loss Institute and assistant professor at Weill Medical College, Cornell University, New York. Obstructive sleep apnea is just one branch

Rita Carpenter Soni, PhD, RPSGT, the wife of Dr Prabhat Soni, receives an award at the House of Lords, London.

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A Medical Tsunami
Because of the growing obesity problem in America and worldwide, especially among children, what we are currently faced with is a potential medical tsunami, says Soni. This tsunami is affecting us, and will affect us, in many ways, creating morbidities ending in disabilities, loss of production, and increased medical expenses, which could damage the world economy. If we dont take action, it will soon be too late to control this medical tsunami. Soni is particularly concerned about sleep disorders among children. Children who demonstrate ADHD symptoms actually may be suffering from sleep apnea. Because of this, Soni sees a need to create awareness about sleep disorders among this patient population. To do this, he often distributes informational flyers and gives presentations on the relationship between sleep, obesity, and poor school performance at schools near his facility. He is also performing sleep studies on children who are obese and who are doing poorly in school. We have to pay attention to the health of our children who are our nations future leaders, he says. Most of the obese children we treat have parents who are also obese, which means we have to treat the whole family.

It is a family problem where the root is in the bedroom and kitchen, Soni explains. Kids watch TV late at night and dont get enough sleep, and parents cook unhealthy food to eat. This means we have to address the whole family environment, not just sleep with CPAP. The weight loss plan prescribed by Soni requires a lot of teamwork. It involves a psychologist, a nutritionist, and more frequent encounters for the patient with Dr Soni. A regimented active lifestyle is also a large part of the equation.

Spreading the Message

Soni is dedicated to educating general physicians about OSA and its link to obesity. He often does community lectures on sleep apnea and weight loss because he has a special interest in improving the lives of those in his community. I want to make the public and general physicians aware of the link between obesity and OSA, he says. Most physicians do not ask their patients Are you having trouble sleeping? Are you waking up tired every day? and the patients do not know that it is something they should report to their general physician.

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My community knows me very well, and I do help them a lot. I go out of the way to help them because it makes me happy, says Soni. Soni is also going global with his mission. He often has groups of sleep physicians from India come to visit his facility. He takes time to help educate them further on sleep medicine and successfully running a sleep facility. Then, when they return to India, Soni helps to supervise these physicians as they begin their own businesses and impact lives abroad. His efforts have not gone unnoticed. Last year, Soni was honored by the NRI (Non-Resident Indian) Welfare Society of India with the Hind Rattan Award. Each year, about 30 nonresident Indians and people of Indian origin are selected for the Hind Rattan Award, which is also known as the Jewel of India. According to Soni, the NRI Welfare Society of India also recently awarded the Mahatma Gandhi Pravasi Medal to Soni and his wife, Rita Carpenter Soni, PhD, RPSGT. His recognition in the United States and abroad has earned Soni an international reputation.

I will be a part of a research team that will investigate shifting the balance between energy-burning brown fat and white fat. This could eventually lead to new treatments of obesity with pharmaceuticals, explains Soni. His approach is clearly across multiple disciplines of medicine, and he encourages everyone in medicine to see the ways in which the medical tsunami can be avoided. What we need to focus on now is curing the obesity problem. The solution does not lie within just one person or one country. It is a global problem; it is a family problem. It is an environmental and behavioral problem. If we as medical professionals do not educate people, nothing will change. We all have a responsibility to unite and work together to avoid what is a potential medical tsunami. n
Katie Griffith is a freelance writer based in Manhattan Beach, Calif. She can be reached at sleepeditor@allied360.com.

Addressing Root Problems

Sonis current focus lies on awareness and screening for sleep apnea while also educating as many people as he can about these conditions and their repercussions. He is currently working with a few scientists on addressing the obesity epidemic through stem cell research. Soni and colleagues aim to help OSA sufferers through one of the roots of the problemobesity. Prabhat Soni, MD, FCCP, DABSM, DABOM, DABAARM 2519 Avenue O Brooklyn, NY 11210 (718) 787-1900 www.SleepToBeSlim.com

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