The NYC-based multidisciplinary practice will also be a place for NYC Transit Authority employees to get obstructive sleep apnea testing and management.

A new practice in New York City aims to offer comprehensive care for cardiovascular patients with comorbid obstructive sleep apnea (OSA) and obesity. Empire Sleep Medicine is spearheaded by Lee Surkin, MD, FACC, FCCP, FASNC, whose background and training are unique. For many years, Surkin has been treating the convergence of OSA and cardiac issues at a practice in North Carolina. He now brings this expertise to NYC.

First trained and board-certified as a cardiologist, Surkin recognized the strong association between cardiovascular issues and OSA in his patients. This link has recently been reinforced in peer-reviewed research, including a recent review published in the Journal of American College of Cardiology, which states there is now strong evidence that “supports a causal association of sleep apnea with the incidence and morbidity of hypertension, coronary heart disease, arrhythmia, heart failure, and stroke.” The authors also note that severe OSA is associated with increased mortality, especially among individuals with cardiovascular disease.

Since Surkin noticed the prevalence of OSA was so high among patients with cardiovascular issues, he added sleep medicine training to his toolbox—in 2009, he became board certified in sleep medicine as well. “My objective was to be able to offer truly comprehensive management to both the cardiac patient and the sleep patient because there is tremendous convergence between the two,” he says.

Surkin now offers cardiovascular sleep medicine care at Empire, which had its soft launch in February 2018. (Surkin continues to practice in North Carolina by working with physician extenders in both locations, which allows him the flexibility to stay in North Carolina and travel to NYC when needed, and he plans to add telemedicine services in the future.) Working in concert with ISleep Management—which owns and operates sleep centers across the NYC area and provides him with locations, in-center testing capabilities, and practice management services—Surkin educates cardiologists on sleep and promotes screening and testing of their cardiac patients.

To market the practice, Surkin targets cardiology divisions in large healthcare institutions in and around NYC because of the obvious connection he has with them as a cardiologist and sleep medicine clinician. “I also market to dentists in the region, as well as primary care physicians,” he says. “We target potential referring physicians and share with them my unique expertise.”

Empire now has four locations in the NYC area—two in Manhattan, one in the Bronx, and one in Brooklyn. “The practice offers comprehensive sleep medicine testing, management, and follow-up,” says Surkin, who is also the founder of the American Academy of Cardiovascular Sleep Medicine and a Sleep Review editorial advisory board member. “And eventually we will incorporate obesity management and cardiac evaluation in those sleep patients who are appropriate for it.” Although he is targeting patients of a specific niche, Surkin doesn’t turn away patients based on the presence or lack of specific comorbidities.

Another aspect that Surkin says sets Empire apart from other practices is its involvement in helping screen for and treat OSA in employees of the NYC Transit Authority (NYCTA). SleepMed (formerly Watermark Medical) serves as a transit authority employee referral source for Surkin. “SleepMed was one of the entities that was awarded a contract to screen and test for OSA in employees of the NYCTA in response to a) the high prevalence on a national level of sleep apnea and b) the tragic accidents that have occurred involving employees related to undiagnosed sleep apnea,” says Surkin. “The transit authority has decided to embark on this system-wide screening and testing program to ensure the health and safety of their employees and the public at large. Empire is going to be one of the point practices to order appropriate testing, interpret the testing, and orchestrate the management of the NYCTA employees.”

This treatment paradigm, Surkin adds, will focus predominately on CPAP therapy for those with moderate to severe OSA, as well as incorporate oral appliance therapy as appropriate. “This will be orchestrated by the company DreamSleep, which has become the preferred provider of oral appliance therapy for the NYCTA,” he says. This designation was given by Aetna, the third-party management entity for the NYC transit authority, which is self-insured. Aetna chose DreamSleep because of the infrastructure it has and DreamSleep’s network of board certified sleep dentists, says Surkin.

When asked if Empire might one day expand to reach other parts of the country, Surkin says, “If I can make a difference, I’ll be there!”

Dillon Stickle is associate editor for Sleep Review.