About

Indira Gurubhagavatula, M.D., MPH, is a Professor of Medicine specializing in Sleep Medicine at the Veteran's Administration Medical Center and the Hospital of the University of Pennsylvania in Philadelphia, PA. She serves as an Attending Physician in the Division of Sleep Medicine and is the Program Director for the Sleep Medicine Fellowship at the Hospital of the University of Pennsylvania. Her research focuses on screening for obstructive sleep apnea in high-risk populations, sleep, sleep disorders, and public health, as well as sleep disordered breathing and cardiovascular disease. Dr. Gurubhagavatula's clinical expertise encompasses sleep disorders medicine, pulmonary medicine, and critical care medicine. Her work includes investigating the biological mechanisms of sleep disorders and their impact on health, contributing to the understanding and management of sleep-related conditions.

Research topics

• Internal medicine
• Physical therapy
• Medicine
• Intensive care medicine

Selected publications

• 1184 Positive-Airway Pressure Adherence is Associated with Decreased Healthcare Expenditure: A Pilot Study in Law Enforcement Officers

  SLEEP · 2026-05-01

  articleSenior author

  Abstract Introduction Law enforcement officers (LEOs) are at risk for obstructive sleep apnea (OSA) due to high prevalence of risk factors including obesity, middle age and male gender. OSA leads to high healthcare costs for employed adults. For LEOs, OSA-related daytime sleepiness may also impact job performance in an occupation for which the consequences can be significant. The impact of diagnosis and treatment of OSA with positive airway therapy (PAP) in this population, and an assessment of whether this approach can lower healthcare costs is unknown. Methods This pilot study evaluated a telemedicine-driven program to screen and treat OSA in LEOs. High-risk participants identified by Multivariable Apnea Prediction Index (MVAP) ≥0.6 underwent home sleep testing, and those diagnosed with OSA started PAP with remote monitoring. Epworth sleepiness scale (ESS), quality-of-life (FOSQ) scores, and healthcare expenditures were collected at baseline and tracked after PAP initiation. We conducted descriptive statistics (proportions) for ESS, FOSQ, and used Kruskal-Wallis to assess significance of cost data. Results Out of 192 screened LEOs, 37 were eligible, and 30 enrolled in the study. A total of 29 participants underwent home sleep apnea testing, 23 of them were diagnosed with OSA and prescribed PAP. 22 participants started PAP therapy, and 13 of them maintained PAP compliance over the 24-month period. Mean ESS decreased from 7.8 to 5.0 in 6 months, and FOSQ increased from 3.4 to 3.7 over 18 months (p>0.05). PAP adherence varied, 10% were compliant, 33% moderately compliant, 13% did not use it, and the rest did not report data. Reductions in ESS correlated with the degree of PAP adherence, with greater use associated with a larger reduction in sleepiness. In contrast, increased health expenditures were observed among non-users and partial users (p=0.0433). Conclusion This pilot study demonstrates that consistent PAP use among LEOs with OSA tended to have reduced medical and medication costs within two years of treatment initiation, whereas partial or non-use led to increased healthcare costs. Full PAP adherence may drive meaningful economic benefit, and larger studies should explore additional OSA treatments as well. Support (if any) AASM Foundation Grant: 192-SR-18.

  PublisherDOI

• Feasibility and Form Factor Validation of Reflective Shoulder-Mounted Pulse Oximeter in Patients with Suspected Sleep Apnea

  Sensors · 2026-02-15

  articleOpen access

  The shoulder may be an effective central site for continuous oxygen saturation (SpO2) monitoring but studies of shoulder-mounted pulse oximetry technology are limited. We hypothesized that an alternative location would be similar in function and user acceptance to a standard FDA-cleared finger-based pulse oximeter. We conducted a quantitative and descriptive pilot study of two prototype biosensor designs in patients with clinical suspicion of hypoxic episodes at an outpatient sleep center. Participants wore two prototype biosensors-the primary a shoulder-mounted adhesive and the secondary a combination ring-bracelet-in addition to a control FDA-approved finger-based pulse oximeter. We assessed the comfort of the devices based on a survey. We monitored 27 patients during an overnight polysomnography study. Participants rated the shoulder-mounted device more highly than the control device on a Likert scale survey of comfort (4.6 out of 5 versus 3.1 out of 5). Open-ended questionnaires showed that the two major criticisms of the control and ring devices were devices falling off and disruption to sleep, while only one participant commented on the shoulder device specifically. We also investigated SpO2 agreement between the primary shoulder-mounted prototype and the control finger-based pulse oximeter. This study confirms that alternative configurations for SpO2 monitoring offer potential as well-tolerated devices with preliminary findings of acceptable agreement. Problems with traditional pulse oximetry, such as false readings of hypoxia due to device removal or noisy data, were encountered less frequently in shoulder-mounted pulse oximetry than in the commercial finger-based device. Future directions include studies of additional populations that are at risk of respiratory collapse and surveys to elicit specific feedback on the configurations, whether positive or negative.

  PublisherOA PDFDOI

• Contributors

  Elsevier eBooks · 2025-11-29

  book-chapter
  PublisherDOI

• Artificial intelligence in sleep medicine: an updated American Academy of Sleep Medicine position statement

  Journal of Clinical Sleep Medicine · 2025-07-31 · 5 citations

  articleOpen access
  PublisherOA PDFDOI

• Identifying and treating obstructive sleep apnea in commercial vehicle operators: A summary of guidance for clinicians

  Elsevier eBooks · 2025-11-29

  book-chapter1st authorCorresponding
  PublisherDOI

• 0496 Cross-Sectional Evaluation of Sleep Health, Burnout and Professional Satisfaction in Academic Physicians

  SLEEP · 2025-05-01

  articleOpen access

  Abstract Introduction Burnout has reached crisis portions in health workers in recent years. Evidence suggests many medical professionals do not get adequate sleep, which may lower well-being and contribute to burnout. We investigated the relationships between sleep health and burnout among the Department of Medicine (DOM) physician faculty at a major academic medical institution. Methods We provided virtual 30-minute educational sessions during regular conference or meeting times to divisions within the DOM which covered impaired sleep and its related impact in personal and professional domains. Immediately following each presentation, attendees were invited to complete the Penn Sleep Health Survey via REDCap. Survey items included metrics regarding 1) sleep disturbance: Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Multivariable Apnea Prediction 2) burnout (Maslach Burnout Inventory (MBI), with subscales on emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA); and 3) demographics. We used Pearson correlation coefficients to determine the association between the presence of any sleep disorder and MBI, and each of its subscales (EE, DP, and PA). The thresholds for moderate burnout were: 18-29 (EE); 6-11 (DP), and 34-39 (PA). Results Of N=280 faculty attendees, 55.8% identified as female and 70.7% identified as White with a mean (SD) age of 45.5 (11.9) years. A total N=226 (80.7%) completed the surveys. Of these, N=125 (55.3%) flagged positive for at least one sleep disturbance. Among those with sleep disturbances, 76.8% had at least moderate burnout on EE or DP compared to 48.5% of those without sleep disturbance (chi sq(1)=19.4, P< 0.0001). Correlations (all p < 0.05) between the subscales of the MBI and ESS, ISI, and MVAP were as follows: 1) EE: 0.21, 0.43, 0.25; 2) DP: 0.22, 0.39, 0.21; 3) PA: -0.09, -0.18, -0.11. Conclusion Impaired sleep and sleep disturbance was common in academic medical physician faculty at a tertiary health center and associated with increased burnout and burnout subscales, including greater emotional exhaustion and depersonalization and less personal accomplishment. Future work should incorporate sleep health education and targeted interventions to improve sleep health into physician wellness programs and assess the impact of these approaches on burnout. Support (if any)

  PublisherOA PDFDOI

• Initial self-reported data on sleep and burnout in pulmonary, critical care and sleep medicine: an initiative from the Assembly on Sleep and Respiratory Neurobiology of the American Thoracic Society

  Respiratory Research · 2025-03-14 · 1 citations

  articleOpen access

  RATIONALE: Health worker burnout has reached crisis proportions, threatening workforce sustainability. Limited data exist on the burden of burnout in pulmonary, critical care and sleep medicine (PCCSM), a high-demand and strained specialty. OBJECTIVE: At the Assembly of Sleep and Respiratory Neurobiology of the American Thoracic Society, we aimed to gather exploratory data on burnout in this group. METHODS: During a dedicated series of five virtual town halls (THs), we polled the audience regarding self-reported burnout. Topics included the scope of the problem, role of sleep, impact on clinical and academic operations, contributors in vulnerable groups, and mitigation strategies. RESULTS: A high proportion experienced burnout (45%) and 58% considered premature retirement. Insufficient sleep (53%) was common, most often due to excessive workload (57%) curtailing sleep through early morning meetings and electronic medical record (EMR) documentation. 36% also reported having a sleep disorder. Sleepiness (69%) and fatigue (58%) impaired work performance and patient care, and 54% reported a fatigue-related, personal-safety incident. Contributors to burnout in vulnerable communities included bias/discrimination (81%), harassment (44%) and assault (12%). Respondents predominantly endorsed organizational mitigating strategies: promoting a culture of "recovery time" (96%) and healthy sleep (86%), and periodic evaluation and accountability of leadership (86%). CONCLUSIONS: In this convenience sample of participants in a TH series regarding burnout in PCCSM, self-reported burnout was common. Sleep disturbance is a prevalent, under-recognized, but potentially modifiable contributor. The high reported rates of discrimination and harassment suggest that vulnerable groups may be at particular risk. To reduce burnout, system-level interventions aimed at transforming organizational culture and promoting leadership accountability were strongly endorsed.

  PublisherOA PDFDOI

• A Novel Shoulder-Mounted Pulse Oximeter in Patients with Suspected Sleep Apnea: Design and Patient Perceptions

  Preprints.org · 2025-12-19

  preprintOpen access

  The shoulder may be an effective central site for continuous oxygen saturation (SpO2) monitoring but studies of shoulder-mounted pulse oximetry technology are limited. We hypothesized that a shoulder-based biosensor device would be similar in function and user acceptance to a standard FDA-cleared finger-based pulse oximeter. We conducted a quantitative and descriptive pilot study of two prototype biosensor designs in patients with clinical suspicion of hypoxic episodes at an outpatient sleep center. Participants wore two prototype biosensors–the first a shoulder-mounted adhesive and the second a combination ring-bracelet–in addition to a control FDA-approved finger-based pulse oximeter. We assessed SpO2 agreement among the devices as well as the comfort of the devices based on a survey. We monitored 27 patients during an overnight polysomnography study. The prototype shoulder pulse oximeter SpO2 readings agreed with the control values of the commercial finger-based pulse oximeter with a 0.72% mean absolute error. Participants rated the shoulder-mounted device more highly than the control device on a Likert-scale survey of comfort (4.6 out of 5 versus 3.1 out of 5). Open-ended questionnaires showed that the two major criticisms of the control and ring devices were devices falling off and disruption to sleep while only one participant commented on the shoulder device, specifically. This study confirms that alternative configurations for SpO2 monitoring offer potential as accurate and well-tolerated devices. Problems with traditional pulse oximetry, such as false readings of hypoxia due to device removal or noisy data, were encountered less frequently in shoulder-mounted pulse oximetry than in the commercial finger-based device. Future directions include studies of additional populations that are at risk of respiratory collapse and surveys to elicit specific feedback on the configurations, whether positive or negative.

  PublisherOA PDFDOI

• Clinical significance of sleepiness: an American Academy of Sleep Medicine position statement

  Journal of Clinical Sleep Medicine · 2025-04-14 · 5 citations

  article
  PublisherDOI

• 0566 Reducing Burnout in Faculty Physicians with Sleep Coaching

  SLEEP · 2025-05-01

  articleOpen access

  Abstract Introduction Health workers are experiencing record rates of occupational burnout. A significant proportion of faculty physicians have impaired sleep that may affect wellbeing and contribute to burnout. Fortunately, there are simple, behavioral strategies that improve sleep, but their impact on burnout is unknown. We identified faculty physicians with mild sleep impairment and assessed the impact of a brief sleep coaching intervention on self-reported burnout using validated scales. Methods We delivered 30-minute educational presentations to Department of Medicine (DOM) faculty at an academic medical center. Using Research Electronic Data Capture (REDCap) we asked attendees to complete a Sleep Health Survey which included the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), shiftwork, and the Maslach Burnout Inventory (MBI). Respondents were offered a single session of sleep coaching with a psychologist if they met one or more of the following criteria: ISI between 7-13 or yes to current shiftwork. We conducted post-intervention surveys one month after their appointment and compared pre-post changes in the ISI, ESS, and MBI using paired-samples t-tests. Results A total of N=226 faculty completed the REDCap survey and 79 (35%) met criteria for sleep coaching. N=63 had ISI between 7-13, N=9 said yes to shiftwork, and N=7 had both ISI between 7-13 and shiftwork. N=24 participants completed both a single session of sleep coaching and the post-intervention survey at 1 month. These faculty were 62.5% female and 75% White with an average age of 45.8 (8.9) years. There were significant improvements on the ISI (9.6 (1.8) to 5.3 (3.6); p < 0.01), and on the MBI Emotional Exhaustion (20.2 (9.7) to 15.3 (9.1); p < 0.01), Depersonalization (11.8 (8) to 9.3 (6.8); p = 0.03), and Personal Achievement (39.2 (5.8) to 41.5 (5.5); p = 0.02) subscales. Conclusion These exploratory data show how a simple targeted intervention can have significant benefits in terms of improving sleep and reducing burnout among faculty physicians. Larger scale studies are needed to examine scalability and effectiveness of delivering sleep coaching to address occupational burnout in physicians. Support (if any) University of Pennsylvania Department of Medicine, Clifton Family Foundation Grant

  PublisherOA PDFDOI

Recent grants

• NIH Grant R01OH009149

  NIH · $945k · 2013

• NIH Grant K23RR016068

  NIH · $647k · 2006

• NIH Grant M01RR000040

  NIH · $7.2M · 2007

Frequent coauthors

• Greg Maislin

  143 shared

• Allan I Pack

  California University of Pennsylvania

  134 shared

• Julio A. Chirinos

  University of Pennsylvania

  112 shared

• Samuel T. Kuna

  Philadelphia VA Medical Center

  111 shared

• Raymond R. Townsend

  111 shared

• Preston Broderick

  Hospital of the University of Pennsylvania

  109 shared

• Thomas A. Wadden

  109 shared

• Hassam Saif

  Reading Hospital

  108 shared