Anuj Chandra, MD, is constantly on the move… running his own practice in sleep medicine in three offices in Chattanooga, Cleveland and North Georgia; reading sleep studies for most major hospitals in the area; and traveling to India, where he teaches and serves on the organizing committee for a physician education course that is bringing cutting edge sleep medicine to cities across India.

 

"People need to understand that sleep disorders can be life threatening, and that good sleep is as essential to sustain life as diet and exercise. We know from extensive research that when sleep suffers, it affects all the vital organs," said Chandra. "Sleep disorders are especially problematic in the South, where obesity and stroke rates are much higher than the rest of the country. Stroke and sleep apnea are strongly associated."

 

After graduating from the University College of Medical Sciences in New Delhi, India, Chandra finished his postgraduate degree from the University of Delhi. He subsequently did several rotations at Beth Israel Hospital in Boston, an affiliate of Harvard Medical School. He furthered his training by completing an internship and residency at the University of Connecticut, followed by a one-year fellowship at the University of Utah Medical Center in Salt Lake City. He continued his studies in sleep medicine through Stanford School of Sleep Medicine, Atlanta School of Sleep Medicine, and the American Academy of Sleep Medicine.

 

He founded the Advanced Center for Sleep Medicine in 2005. In 2010, he became "double boarded" after receiving his second board certification in sleep medicine. His wife, Lotika Pandit-Chandra, MD, who is also board certified in sleep medicine, works at the Center in addition to serving as Medical Director of the PACE program at Alexian Village for the last 12 years. She also serves as Chief of Geriatrics at the University of Tennessee Medical School, Chattanooga.

 

"Sleep medicine is driven both by technological advances and by the need for patients to feel comfortable," according to Chandra. The flagship office of Chandra's Advanced Center for Sleep Disorders, located on East Brainerd Road in Chattanooga, was built in a converted home to increase patient comfort by conducting diagnostic tests in a welcoming, home-like environment.

 

Since the Center opened in 2005, Chandra has been quick to embrace promising technologies. For example, in 2008, he began using a new FDA-approved device that improves on the CPAP (Continuous Positive Airway Pressure) machines commonly used to treat sleep apnea. The VPAP (Variable Positive Airway Pressure) Adapt SV machine uses "adaptive servo-ventilation," a new method of assisting the patient's breathing, which provides a variable amount of air depending on what the patient actually needs.

 

"When breathing becomes unstable, the machine provides just enough support to bring breathing back to normal. Studies show that this approach is much more effective than any other treatment for Central Sleep Apnea in heart failure patients. This method is also more comfortable for the patient, because the machine adapts to the patient instead of making the patient adapt to the machine," said Chandra.

 

In 2009, Chandra began using actigraphy, a diagnostic method in which the patient wears a small non-invasive device on the wrist–perhaps for several days–rather than spending the night in a diagnostic facility. "For some sleep disorders, actigraphy can provide diagnostic information that we can't get any other way," said Chandra. "In many cases, we can make a better diagnosis with this technology."

 

Increasing the community's understanding of sleep disorders and healthy sleep is a priority for Chandra. He is regularly interviewed for print and broadcast media on sleep disorders. Every year he collaborates with the National Sleep Foundation to secure local coverage of the Foundation's annual poll about Americans' sleep habits. In 2008, he helped one of his sleep apnea patients organize Chattanooga's first support group for people with apnea and other sleep disorders. AWAKE (which stands for Alert, Well, And Keeping Energetic) is open to any sleep disorder patient, to people who may have been prescribed CPAP but have difficulty with it, and to anyone wants to know more about sleep apnea and meet others who have had good success with the treatment.

 

For the last four years, Chandra has returned to India every year to serve as faculty for the National Sleep Medicine Course. As India's economy has boomed in recent years, a potentially life-threatening side effect has become apparent: an increase in sleep disorders.

 

"Recent research has shown that Asian Indians have a high prevalence of sleep apnea, even with no obesity," according to Chandra. "In addition, the growing prevalence of shift work that synchronizes Indian workers with international schedules has led to a huge increase in shift work sleep disorder."

 

The course moves to another city every year to disseminate knowledge of sleep medicine as widely as possible. The response has been very enthusiastic among Indian physicians. "Attendance has grown from 50 participants in the first year to about 200 in the most recent course," said Chandra. "Among the most rewarding things for me is seeing physicians who attended the course setting up their own sleep centers across India. Doctors are taking this knowledge base and putting it into practice."

 

Several years back, Chandra made it his goal to make Chattanooga the best slept city in the nation. "I continue to work on this every day, be it speaking to physician groups, to residents in training, or to community organizations. Sleep disorders are among the most underdiagnosed. A lot of work needs to be done to improve the sleep health of our community. We have miles to go before we sleep," he added with a smile.