Neurologist-influencer Anne Marie Morse, DO, FAASM, explains how to use sleep to reach patient-valued outcomes.
By Chaunie Brusie, RN, BSN
When people ask Anne Marie Morse, DO, FAASM, director of child neurology and pediatric sleep medicine at Geisinger Medical Center in Pennsylvania, co-host of the Sleeping Around podcast, CEO of DAMM Good Sleep, LLC, and mother of two young children, how she manages to accomplish all she does in a day, she responds simply: “I use sleep as a tool.”
Neurologist-sleep specialist Morse believes in sleep to power her life as a clinician and an advocate for sleep disorder awareness in both the lay and professional communities. For instance, Morse runs a popular TikTok channel (@dammgoodsleep, a play on her initials) where she educates on sleep disorders, especially narcolepsy, and works across disciplines as a clinician, speaking, collaborating, and writing on the importance of interdisciplinary diagnostics and care.
“I have my hands in so many different things because there’s cross-functionality,” Morse explains. “I generally approach everything I do in a very entrepreneurial mindset with the ultimate goal to completely disrupt healthcare and transform it into something that is more patient-directed, that will lead to more of the outcomes that patients value, to take advantage of the interconnectivity across all the areas that people in their healthcare journey touch, and to be able to start thinking beyond the bricks-and-mortar of where we exist.”
As a default, Morse thinks well beyond the bricks-and-mortar and is expanding the reach for sleep medicine across platforms—from one-on-one interactions with patients to globally through social media.
Parallels Between Multiple Sclerosis and Hypersomnias
Morse’s journey to becoming a neurologist specializing in narcolepsy started with her mother, who was diagnosed with multiple sclerosis (MS) when Morse was 5 years old. The young Morse was imprinted by her mother’s experience, in which she witnessed doctors dismissing symptoms. “There was misinformation. There was abandonment. There was reinforcement of hopelessness,” Morse remembers.
Even as disease-modifying agents became available, her mother’s initial dismissal by doctors led her to avoid seeking further help. As an adult, Morse was struck by the parallels between MS and narcolepsy: similar diagnostic numbers of about 1 in 2,000 people worldwide, peak onset age, and even the ages for secondary peaks.
“When I met this diagnosis [of narcolepsy], it was very much an academic and emotional response of, ‘Holy sh*t, this is exactly what my mom and my family went through,’” Morse recalls.
Seeing her mother’s magnetic resolution imaging scans and realizing that her mother missed out on medications that may have helped motivates Morse in the present to help patients with sleep disorders avoid similar experiences. Morse says, “This drives me to work to disrupt healthcare, putting the patient in the driver’s seat and figuring out what is important to them, understanding their individual needs and difficulties, and always looking to what we can do now.”
Morse sees narcolepsy following a similar path as MS, with more hope, treatments, and awareness of the disease process.
“Is it one size fits all? Absolutely not,” she says. “But I think we’re now seeing the same type of thing occurring with central disorders of hypersomnolence and advancing how we approach the diagnostic paradigm. How do we improve on that? How do we approach getting medication in hand as soon as we can?”
Sleep Has a ‘Huge, Huge Relevance to Everything’ in Medicine
Morse sees sleep disorders as a sorely lacking (if not completely overlooked) puzzle piece in nearly every neurological disease process.
“If you look internationally at how much sleep education is performed, there are some parts of the world where it’s zero hours,” Morse says. “In the United States, on average it’s about three to four hours in four years of medical school.”
Unfortunately, according to Morse, sleep training doesn’t increase in specialty training. “If you look at training programs in neurology and pediatric training programs, at least 25% don’t have any mandatory education or experience,” she adds. “In the 75% that do, many times it’s elective, and oftentimes it is a limited scope.”
For instance, she points out that sleep disorder training often boils down to a narrow view of sleep-disordered breathing with a brief introduction to obstructive sleep apnea (OSA) and CPAP. And while OSA and CPAP are a start, Morse believes more awareness of the role that sleep plays will benefit all care providers and patients. “There has to be this major transition of people understanding and appreciating that sleep and circadian science have such a huge, huge relevance to everything we’re doing in the rest of medicine,” she says.
Morse points to examples in different disease states, such as if someone has breast cancer and a circadian rhythm disorder, they are more likely to have a more invasive and aggressive cancer.1 Or, as a 2023 systematic review and meta-analysis of immune checkpoint indicators demonstrated, administration timing can lead to improved outcomes.2 “When you’re talking about sleep and circadian science, we need to be able to lead with those types of conversations to say we’re talking about your disease first, and this is why sleep matters,” she says.
In 2014, the Centers for Disease Control and Prevention declared sleep deprivation in the United States a public health epidemic. “When you’re looking at more than two-thirds of people are not getting the right duration of sleep, that is just the tip of the iceberg,” Morse says.
Morse Works Toward Change
Just as Morse views sleep as “not one sphere” but multi-faceted, she sees an interdisciplinary approach integral to treating disease processes and sleep disorders concurrently. While she hopes physicians and care providers in every specialty will be awakened to the need for more conversations about sleep in care management, she also hopes more disciplines will know they can turn to sleep specialists.
“It’s not asking people in different disciplines to become sleep specialists,” she says. “There’s so much more to know in every discipline. But…. providers can ask, ‘What time do you go to bed? How long does it take you to fall asleep?’ And you start identifying that, hey, protracted periods of waking up, of falling asleep, increased number of wakings, a large period awake, high degree of irregularity, those are all just saying, OK, this is when I reach for my partner in sleep medicine who can help me better manage the primary condition.’”
Morse isn’t just hoping for an interdisciplinary approach to sleep disorders within all disciplines—she’s also actively working toward it. She does this via public speaking, her work as a textbook and lay author (she’s currently finishing a book on communication and healthcare with Forbes), and her podcast and social media advocacy.
“I call her one of one for a reason,” says her Sleeping Around podcast co-host Matthew Allard. “Anne inspires anyone she meets. Her knowledge and compassion are what set her apart. She’s a true subject matter expert in all things sleep.”
In fact, Morse has been so influential that she won the 2024 Patient Advocacy Award from Wake Up Narcolepsy, to be presented at the nonprofit’s first Shadows to Light Gala in New York City.
Monica Gow, co-founder and executive director of Wake Up Narcolepsy, says that Morse supports the narcolepsy community in “many ways,” and Morse’s work helps both “increase the understanding of the medical disorder and potentially lead people in the right direction if they think they are suffering with an undiagnosed case of narcolepsy.”
Along with her efforts to expand the sleep medicine community, Morse is also ushering in new technology within her clinical practice. For instance, her clinic is evaluating bringing Natus diagnostic equipment into its sleep labs. To her, part of Natus’ appeal is that the company is one of the few diagnostic companies with the full spectrum of polysomnography, as well as EEG.
“As a neurologist, I’m biased in that being able to tap into that and have that cross-functionality, number one, makes sense from a fiscal business delivery,” Morse notes. “But secondarily, the part that’s even more exciting is that it starts to create this opportunity to think about what we can do with machine learning and artificial intelligence (AI). I think it’s important to remind people that it’s not that AI is going to replace what you do; it’s going to improve on it. If there is the ability to auto-detect a certain characterization or biomarker, can we actually improve diagnosing and characterizing traits better that will optimize the patient?”
She adds, “I get excited about companies like this because they have the foresight, as well as the investment in their innovations and their research and development arm, to really start thinking about these things. If there is a physiologic finding, a neurophysiologic finding, that would help us better diagnose and manage—or consider—it is a piece that is very exciting to be able to utilize, especially in a large healthcare system like ours.”
Morse is hopeful about a future that, like her multifaceted platforms, integrates everything from technology to primary care to even social media as pathways to expand the scope of sleep medicine. She says, “It’s coming into its full capacity of what I had envisioned, which is utilizing sleep as a tool and a springboard to ask, ‘How do we live our best days?’”
References
1. Blakeman V, Williams JL, Meng QJ, Streuli CH. Circadian clocks and breast cancer. Breast Cancer Res. 2016 Sep 2;18(1):89.
2. Perdyan A, Sobocki BK, Balihodzic A, et al. The effectiveness of cancer immune checkpoint inhibitor retreatment and rechallenge-A systematic review. Cancers (Basel). 2023 Jul 4;15(13):3490.
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