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Mayo Proceedings: Pharmacotherapy Failure in Chronic Insomnia Patients

Barry Krakow, MD, Victor Ulibarri, RPGST, and Natalia McIver, RPGST from the Sleep & Human Health Institute, and the Maimonides Sleep Arts and Sciences, Ltd, in Albuquerque, NM, and the Los Alamos Medical Center, in Los Alamos, NM, preview their article appearing online ahead of print and in the December 2014 issue of Mayo Clinic Proceedings, to provide clinicians with a new theory on the co-morbidity of insomnia and sleep apnea among insomnia patients failing drug therapy, including new assessment tools to diagnose sleep apnea when medications fail. Available at:

Second Opinions and the Rise of REPAP: Part V

The impetus to develop the REPAP protocol derives from the recognition CPAP failure often emerges because continuous pressurized air provokes expiratory pressure intolerance (EPI) when settings are raised to titrate out RERAs. In accordance with AASM standards, a... read more

Second Opinions and the Rise of REPAP: Part IV

As we revisit the REPAP protocol, you will find a short summary of topics in the recently posted third installment that covers the two earlier REPAP posts I and II. REPAP III covered the interesting academic system through which the manuscript traversed in its various... read more

Where should the insomnia patient begin?

The popular trade magazine Sleep Review: The Journal for Sleep Specialists recentlypublished a story on the symposium last year in Bologna, Italy at the European Sleep Research Society meeting where Christian Guilleminault, Erla Björnsdóttir, Leon Lack and I each... read more

Second Opinions and the Rise of REPAP: Part III

As the REPAP paper has just been published, now is a good time to finish up our earlier series on this innovative protocol. Briefly to summarize key points from the earlier works: 1) second opinion research is rare to non-existent in the sleep literature; 2) the use... read more

Barry Krakow, M.D.

Barry Krakow, MD is a board certified internist and sleep disorders specialist, who has spent 25 years in medicine in the fields of internal medicine, emergency medicine, addiction medicine, and sleep medicine.

Books by Dr. Krakow

Turning Nightmares Into Dreams Sound Sleep Sound Mind