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Faculty Spotlight: Ann Augustine, MD

Monday, October 28, 2019

After residency, Ann Augustine, MD, completed a fellowship in multiple sclerosis, until she decided that sleep medicine was a better fit. Now she’s one of our newest faculty members, where she treats patients at the Durham Veteran’s Affairs Medical Center and our new Crooked Creed clinic in South Durham. For this week’s “Spotlight” interview, Augustine talks to us about why she enjoys being a sleep medicine doctor. She also discusses how the veteran population she treats in Durham compares to the veterans she saw as a trainee and how their sleep needs compare to those of the general population.

What are your current responsibilities within the Neurology Department? What does a typical day for you look like?
Presently, most of my time is at the Durham VA, though I do spend a day at the South Durham clinic location. Most days I am seeing patients in clinic either by myself or supervising APPs or one of the fellows.  I also read sleep studies. The non-clinical aspect of this role is to help improve access to the sleep clinic for veterans at the VA.

How and when did you first get interested in neurology, and in sleep medicine in particular?
After residency, I did a fellowship in Multiple Sclerosis but it did not feel like the right fit.  Although I did not know much about sleep medicine, there was an opening in the fellowship, and I took the opportunity.  It was a good decision because I really enjoy being a sleep medicine doctor. I like that it is a relatively “new” field and we are still trying to understand things about sleep.  I like that it is multidisciplinary and that you can see a wide variety of patients –young/old/male/ female—because everyone sleeps. 

What do you enjoy most about your work? What is the hardest part of your job?
I like that for most patients you can actually “fix” an issue and it can improve their quality of life. So far the biggest challenge is getting used to the different environment at the VA. Things run a bit differently, but overall we have a good group of people who want to do their best for patients.

What types of patients or conditions do you most often see in the Durham VA? How do the sleep needs of veterans compare to those of the rest of our population?
Interestingly, the population I see here is not what I remember from being a trainee – typically older (think retired) and male.  I was a little surprised to see that many patients are younger (in their 30s), and there are quite of few women. But this could have a lot to do with where the country was 8 years ago vs. now.

In some ways their sleep issues are not that different from the rest of the population –you see mostly sleep apnea, quite a bit of insomnia, some RLS, occasional narcolepsy and REM behavior disorder.

I think what is different is that there is a higher burden of mental health issues, but fortunately there seems to be a good network of mental health services. Many patients I have seen carry a diagnosis of PTSD.  In fact, recently, there was a new sleep disorder proposed called “trauma associated sleep disorder” which may be a different entity from REM behavior disorder. The research on this is still new, and limited, but the idea is interesting.

What’s the biggest or most exciting change you see coming in how we understand sleep disorders in the next decade?
That’s a tough one—I think we are going to have more understanding of how sleep impacts other areas of our health.  The relationship between cardiac health and sleep is pretty well established, but I think that strong associations between sleep health and other disease states will be made.
I also hope there will be a better understanding of narcolepsy/ fatigue/sleepiness and better ways of treating it.

What other passions or hobbies do you have outside of the Department?
I enjoy trying new recipes, and catching up with friends. I am hoping to travel more—that’s something I don’t do enough of (and I wished I did). I also like seeing my nieces and nephews—that’s always fun.


Augustine enjoys a visit to San Sebastian, Spain.