SLEEP 2013 – APSS Annual Meeting, Baltimore

Postgraduate Courses

Saturday, June 1, 2013 – Sunday, June 2, 2013

In order to register for postgraduate courses, you must be registered for the SLEEP 2013 general session. The APSS does not offer registration to only attend postgraduate courses. Space is limited, and postgraduate courses sell out quickly. If a postgraduate course you select is full when your registration is received, you will not be charged the additional course fees. Attendees registered for SLEEP 2013 at the reduced training rate (i.e. Resident/Postdoctoral or Student/Predoctoral), may register for the postgraduate courses at the member rate regardless of membership status.

C01: Year-In-Review

Saturday, June 1, 2013
8:00am – 5:00pm

Member Fee: $150
Nonmember Fee: $200

During this annual course, faculty will highlight new perspectives and recent findings in translational science from the past year. The 2013 installment of this course will highlight advances in the areas of: sleep and physiological function, sleep and immunity, hypersomnia, sleep disordered breathing, sleep duration and quality of life, insomnia, sleep and metabolism and pediatric sleep medicine.

Chair: H. Craig Heller, PhD
Faculty: Carol Everson, PhD; Monika Haack, PhD; Daniel Kripke, MD; Carole Marcus, MBBCh; Lynn Marie Trotti, MD; Fred Turek, PhD; James Wyatt, PhD; and Henry Klar Yaggi, MD

Psychologist Level of Content: Intermediate

Target Audience: Physicians, researchers, psychologists, postdoctoral or predoctoral fellows and allied health care professionals

Learning Objectives:
  1. Discuss key concepts of recent basic and clinical sleep research and how these concepts apply to current practice;
  2. Apply up-to-date information and evidence-based knowledge to the clinical management of patients with a variety of sleep disorders;
  3. Improve clinical care and patient outcomes as a result of application of this knowledge.

C02: Trends in Sleep Medicine

Saturday, June 1, 2013
8:00am – 5:00pm

Member Fee: $150
Nonmember Fee: $200

This course will focus on the latest clinical trends relevant to the practice of sleep medicine in 2013. A few of the important topics covered in this course include accepting pediatric patients, CPAP data analysis in tracking patients with OSA, the rise of utilization management companies, perioperative sleep apnea assessment, coding and regulatory trends and perils and pitfalls of DME.

Chair: Douglas Kirsch, MD

Faculty: Amy Aronsky, DO; Charles Atwood, MD; Kelly Carden, MD, MBA; Lawrence Epstein, MD; Carol Rosen, MD; Richard Schwab, MD; Tracey Stierer, MD; and David White, MD

Psychologist Level of Content: Intermediate

Target Audience: Clinicians, including psychologists, and other health care providers involved with the clinical and business aspects of operating a sleep center

Objectives:

  1. Discuss the current trends of insurance regulations, coding and reimbursement;
  2. Discuss expansion of sleep center practice to include pediatric patients and provision of DME;
  3. Discuss trends in managing patients with sleep disorders including CPAP data analysis and perioperative sleep apnea assessment. 

C03: Sleep Disordered Breathing in Infants

Saturday, June 1, 2013
8:00am – 12:00pm

Member Fee: $85
Nonmember Fee: $150

Infant sleep-disordered breathing is quite common and differs markedly from that seen in older children. This course discusses the important developmental changes in the anatomy and physiology of the upper airway and lung mechanics during infancy, as well as changes in ventilatory control and arousal.

Chair: Eliot S. Katz, MD
Faculty: Stacey Ishman, MD; Carole Marcus, MBBCh; Indra Narang, MBBCh, MD; and Christian Poets, MD

Psychologist Level of Content: Intermediate

Target Audience: Pediatric and adult physicians that consult on infants or interpret infant polysomnograms who are seeking a comprehensive overview of the many unique sleep-disordered breathing patterns in infants that accompany specific disease states

Learning Objectives:

  1. Recognize the full spectrum of normal breathing patterns in infants;
  2. Identify the various patterns of sleep-disordered breathing observed in infants; and
  3. Discuss the natural history and treatment of infant sleep-disordered breathing patterns.

C04: Basic and Translational Circadian Science for the Clinician and Trainee

Saturday, June 1, 2013
8:00am – 12:00pm

Member Fee: $85
Nonmember Fee: $150

This course will provide a strong foundation to sleep clinicians, researchers and trainees on basic circadian science, the importance of circadian rhythmicity for physiology and behavior, interactions with sleep, and the future of circadian medicine. 

Chair: Kenneth Wright, PhD
Faculty: Charles Czeisler, MD, PhD; Samer Hattar, PhD; H. Craig Heller, PhD; and Phyllis Zee, MD, PhD

Psychologist Level of Content: Intermediate

Target Audience:  Sleep clinicians, researchers and trainees who desire fundamental and translational knowledge of circadian science

Learning Objectives:

  1. Review basic concepts and components of the circadian system;
  2. Recognize how light influences the circadian clock and mechanisms by which light influences sleep;
  3. Discuss mechanisms of cellular timekeeping and discuss how clocks are important for peripheral tissue and brain function;
  4. Review the role of circadian timing for cognitive function and learning;
  5. Appreciate the fundamental integrative nature of circadian and sleep physiology, the importance of circadian entrainment and the influence of chronotype;
  6. Describe changes in circadian physiology across the life span and its impact on sleep;
  7. Identify tools used to measure circadian phase and its importance for assessment and treatment;
  8. Discuss circadian phenotyping; and
  9. Realize how circadian disruption is involved in disease processes and the future of circadian medicine.

C05: Difficult Cases That Keep You Up at Night: Case-Based Review of Challenging Clinical Scenarios for the Sleep Medicine Specialist

Saturday, June 1, 2013
8:00am – 12:00pm

Member Fee: $85
Nonmember Fee: $150

This course will review challenging clinical scenarios encountered by the practicing sleep specialist in a case-based format. The sleep clinician is challenged when initial and subsequent diagnostic and management plans are not effective or cause unexpected results. This course will provide guidance in example cases by describing the current literature, evidence, and when neither is available, expert opinion on accepted management. Faculty will describe atypical presentations of common sleep disorders, how to interpret indeterminate or borderline diagnostic data, complications of therapies including side effects and safety in special populations, and innovative methods for dealing with sleep disorders in specific patient populations. 

Chair: Raman Malhotra, MD
Faculty: Alon Y. Avidan, MD, MPH; Charlene Gamaldo, MD; and Christopher Lettieri, MD

Psychologist Level of Content: Advanced

Target Audience: Physicians, nurse practitioners, sleep technologists, psychologists and physician assistants

Learning Objectives:

  1. Recognize side effects and alternative options for therapy of refractory restless legs syndrome;
  2. Identify characteristics and factors associated with poor CPAP adherence and formulate ideas on how to combat them to increase usage of CPAP in sleep apnea patients; and
  3. Discuss diagnostic criteria, differential diagnosis, pathophysiology, and evidenced based therapy for parasomnias and narcolepsy with cataplexy.

C06: Pediatric Positive Airway Pressure (PAP) Therapy

Saturday, June 1, 2013
1:00pm – 5:00pm

Member Fee: $85
Nonmember Fee: $150

While adenotonsillectomy is the primary treatment for obstructive sleep apnea (OSA) in children, there remain a population of youth (e.g., children with craniofacial anomalies or obesity) who require the use of positive airway pressure therapy (PAP). PAP therapy has become more common in the practice of pediatric sleep medicine, however, as with adults, adherence to this treatment remains low. This course will provide clinicians more information about how to properly implement and utilize PAP therapy in their practice. Information will be presented on when and how to implement PAP therapy, including medical considerations, technical aspects, and behavioral interventions.

Chair: Lisa Meltzer, PhD
Faculty: Todd Antisdel, AAS; Susan Crane, PsyD; and Ann Halbower, MD

Psychologist Level of Content: Intermediate

Target Audience: Physicians, nurse practitioners, psychologists, respiratory therapists, and others engaged in pediatric sleep medicine practice

Learning Objectives:

  1. Review medical considerations for the use of PAP therapy with children and adolescents;
  2. Discuss the technical use of PAP with children and adolescents; and
  3. Identify strategies for PAP desensitization as well to improve adherence to PAP therapy.

C07: Diagnosis and Treatment of Circadian Rhythm Sleep/Wake Disorders

Saturday, June 1, 2013
1:00pm – 5:00pm

Member Fee: $85
Nonmember Fee: $150

Circadian rhythm sleep disorders (CRSDs) are often perplexing to manage due to the complexity of clinical presentations, a lack of well-defined practice guidelines, and a myriad of other factors. This course will provides attendees with realistic examples of select CRSDs in a clinical setting, and to promote proper identification (while understanding limitations) through the use of history, sleep logs, questionnaires, actigraphy, and salivary melatonin assessments.

Chair: R. Robert Auger, MD
Faculty: Helen Burgess, PhD; Katherine Sharkey, MD; and James Wyatt, PhD

Psychologist Level of Content: Introductory

Target Audience: Practitioners or trainees of clinical sleep medicine and anyone interested in the identification and treatments of circadian rhythm sleep/wake disorders (CRSDs)

Learning Objectives:

  1. Identify various ICSD-2-defined CRSDs in the clinical setting, with inclusion of the use of actigraphy and sleep logs;
  2. Discuss the treatment of select CRSDs, taking into account best available evidence; and
  3. Review the various experimental protocols used in chronobiologic assessments, to in turn facilitate an understanding of the CRSD-related literature.

C08: Beyond the Polysomnogram: Special Diagnostic Procedures in Select Patient Populations

Saturday, June 1, 2013
1:00pm – 5:00pm

Member Fee: $85
Nonmember Fee: $150

During this half-day course, the faculty will describe and demonstrate several specialized techniques and diagnostic modalities for select patient populations, including neuromuscular patients, patients with suspected parasomnias or circadian rhythm sleep disorders, and patients undergoing surgical procedures at high risk for complications due to occult OSA.

Co-chairs: Hrayr Attarian, MD; and Lisa Wolfe, MD, FAASM
Faculty: Peter Gay, MD; Tucker Woodson, MD; and Phyllis Zee, MD, PhD

Psychologist Level of Content: Intermediate

Target Audience: Sleep physicians, physician assistants, nurse practitioners and trainees

Learning Objectives:

  1. Describe the specialized montages used to evaluate patients with neuromuscular disorders, those with parasomnias and patients with nocturnal seizures;
  2. Explain the OSA screening methodologies for perioperative patients;
  3. Review actigraphy, sleep logs and melatonin levels in the diagnosis of circadian rhythm sleep disorders; and
  4. Demonstrate the upper airway structure phenotyping through sedated endoscopy.

C09: 2013 State of the Art for Clinical Practitioners

SOLD OUT
Sunday, June 2, 2013
8:00am – 5:00pm

Member Fee: $150
Nonmember Fee: $200

Ideal for individuals looking for a broad review of clinical sleep medicine in 2013, this course will provide attendees with tips for the practical application of treatments for several common sleep disorders based on clinical evidence. Topics covered will include: insomnia, pediatrics, circadian rhythms, parasomnias, hypersomnias, complex OSA, excessive daytime sleepiness in the workplace and out of center sleep testing devices.

Chair: Thomas Scammell, MD

Faculty: Ruth Benca, MD, PhD; Nancy Collop, MD; David Dinges, PhD; Peter Gay, MD; Madeleine Grigg-Damberger, MD; David Rye, MD, PhD; John Winkelman, MD, PhD; and Phyllis Zee, MD, PhD

Psychologist Level of Content: Intermediate

Target Audience: Physicians, researchers, psychologists and allied health care professionals

Objectives:

  1. Describe the best evidence-based practice for evaluating and diagnosing various sleep disorders in clinical practice;
  2. Discuss the best evidence-based and cutting edge treatments for various sleep disorders in 2013;
  3. Identify major areas of uncertainty regarding best treatment practices in sleep medicine.

C10: Gizmos and Gadgets: Technological Advances in Clinical Outpatient Sleep Medicine

SOLD OUT
Sunday, June 2, 2013
8:00am – 5:00pm

Member Fee: $150
Nonmember Fee: $200

This full-day course includes didactic lectures and several hands-on interactive workshop presentations. The following topics will be covered: PAP for obstructive sleep apnea; bilevel devices in the management of hypoventilation and central sleep apnea syndromes; portable sleep apnea testing; and actigraphy. Interactive workshops will provide the attendees with the necessary knowledge to evaluate, prescribe, adjust and troubleshoot the various technologies in a typical outpatient setting.

Chair: Neil Freedman, MD
Faculty: Sean Caples, DO; Ann Cartwright, PA-C; Loretta Colvin, APRN; Peter Gay, MD; Cathy Goldstein, MD; Shahrokh Javaheri, MD, FAASM; Douglas Kirsch, MD; and Lisa Wolfe, MD, FAASM

Psychologist Level of Content: Intermediate

Target Audience: Patient care providers at all levels including physicians, physician assistants, respiratory therapists, sleep technologists, and nurses

Learning Objectives:

  1. Recognize the indications and limitations of various PAP devices in the management of the spectrum of sleep disordered breathing;
  2. Discuss the indications and limitations and be able to troubleshoot common problems of several different portable monitoring systems that are commonly used in an outpatient setting to diagnose obstructive sleep apnea; and
  3. Identify the indications, limitations and technology underlying various actigraphy devices, as well as interpret downloaded data and troubleshoot common problems of several devices.

C11: The Basics of Sleep

Sunday, June 2, 2013
8:00am – 5:00pm

Member Fee: $150
Nonmember Fee: $200

This course will provide scientists and clinicians who are new to the field with an enhanced introduction to the concepts that form the basis for understanding sleep and its disorders. This introduction to a number of multi-disciplinary topics will inform basic and applied sleep and circadian rhythm research, as well as clinical sleep medicine practice. The course will cover several topic areas based on Basics of Sleep Guide (BSG) chapters as they form the basis of the field’s fundamental principles.

Chair: Stephanie Crowley, PhD
Faculty: Christian Baumann, MD; Mary Carskadon, PhD; Chiara Cirelli, MD, PhD; David Dinges, PhD; Janet Mullington, PhD; Frank Scheer, PhD; Ronald Szymusiak, PhD; and Jonathan Wisor, PhD

Psychologist Level of Content: Introductory

Target Audience: Sleep clinicians and scientists seeking an enhanced background in the fundamental principles and findings that form the core knowledge of the sleep field

Learning Objectives:

  1. Discuss concepts underlying the organization of sleeping and waking behavior, sleep-wake homeostasis, and circadian timing;
  2. Appreciate the changes in normal sleep that emerge across the human life cycle;
  3. Identify the neuroanatomical and neurophysiological systems underlying sleep-wake regulation;
  4. Analyze the genetic basis of sleep phenotypes and sleep disorders, and the genetics of sleep in animals;
  5. Realize the interplay of sleep-wake and endocrine systems and how sleep loss can alter these associations;
  6. Recognize the role of sleep in thermoregulation, immune function, and autonomic regulation of multiple organ systems;
  7. Appreciate the effects sleep loss produces on the brain and behavior; and
  8. Review the major categories and types of sleep-wake disorders in adult populations, and the pharmacological therapies used to treat these disorders.

C12: PedSleep 2013: Pediatric NeuroSleep Primer

SOLD OUT
Sunday, June 2, 2013
8:00am – 12:00pm

Member Fee: $85
Nonmember Fee: $150

Sleep problems in children with a variety of neurological and neurodevelopmental disorders are often much more common, frequent, severe and persistent compared to the general pediatric population. In many children with particular developmental disorders, sleep problems are so highly prevalent as to be considered a behavioral phenotype. In this four-hour course, faculty will review the four most common pediatric referrals to sleep specialists and centers: children with epilepsy, headache, central hypersomnias, neurodevelopmental and craniocervical junction and neuromuscular disorders. 

Co-chairs: Madeleine Grigg-Damberger, MD; and Sanjeev Kothare, MD, FAASM
Faculty: Timothy Hoban, MD; and Shelly Weiss, MD

Psychologist Level of Content: Intermediate

Target Audience: Sleep specialists, fellows, technologists, researchers, trainees, and industry interested in pediatric sleep medicine

Learning Objectives:

  1. Recognize and manage sleep disordered breathing in children with neuromuscular and craniocervical junction disorders to optimize their quality of life and longevity;
  2. Identify common, uncommon, and rare causes of hypersomnia in children and the roles of infection, H1N1 encephalitis and vaccination in childhood-onset narcolepsy-cataplexy and other hypersomnias;
  3. Appreciate the complexity and value of treating sleep disorders in children with epilepsy and/or headache; and
  4. Realize how certain neurodevelopment disorders have distinctive and often unique insomnias related to their particular disorder as to be considered a phenotype.

C13: Sleep Medicine in Occupational Settings

SOLD OUT
Sunday, June 2, 2013
8:00am – 12:00pm

Member Fee: $85
Nonmember Fee: $150

Many sleep disorders and other medical conditions cause sleepiness, which interferes with individuals’ ability to perform well in their professional job. Sleepiness also occurs in occupational settings due to extended work hours and/or circadian misalignment caused by night work, shift work or travel across time zones. In some, shift work even results in pathology, e.g., shift work disorder. In many 24/7 operations, “fatigue” (the term used for sleepiness in most occupational settings) is a significant threat to safety, productivity and well-being. Increasingly, management, labor organizations, and government agencies are recognizing this issue and seeking innovative solutions, ranging from fatigue risk management systems to company-wide screening and treatment programs. This half-day postgraduate course features faculty presenters actively involved in researching, managing and treating occupational fatigue from sleep disorders and other causes.

Chair: Hans Van Dongen, PhD
Faculty: Christopher Drake, PhD; Stefanos Kales, MD; and Charles Samuels, MD
Psychologist Level of Content: Intermediate

Target Audience:  Clinicians, translational researchers and occupational professionals who encounter sleepiness from sleep disorders and from sleep loss and circadian misalignment in their patients, research subjects or work setting, or wish to learn about how sleep disorders and sleepiness impact on workers in occupational settings

Learning Objectives:

  1. Realize how sleepiness from sleep disorders and from sleep loss and circadian misalignment interferes with safety and productivity in occupational settings;
  2. Identify solutions for sleep disorders and other causes of sleepiness in occupational settings, and review what innovative strategies to “fatigue risk management” have been developed and implemented; and
  3. Recognize how 24/7 operations affect health and may lead to shift work disorder, and what can be done to manage this.

C14: Sleep and Epilepsy

SOLD OUT
Sunday, June 2, 2013
1:00pm – 5:00pm

Member Fee: $85
Nonmember Fee: $150

Epilepsy is a common public health issue, impacting 1% of the population, or about 30 million individuals worldwide. 25% of patients with epilepsy experience pure sleep epilepsy. Nocturnal epilepsies may present with unusual clinical manifestations, leading to diagnostic confusion, and the treatment of epilepsy has become increasingly complex with many newer antiepileptic drugs and surgical approaches for refractory epilepsies. In this course, faculty will discuss recent research that has clarified the role of intrinsic cortical and circadian factors, and that of co-morbid sleep disorders on seizures.

Co-chairs: Milena Pavlova, MD; and Erik St. Louis, MD
Faculty: Michael Silber, MBChB; and Bradley Vaughn, MD

Psychologist Level of Content: Intermediate

Target Audience: Sleep physicians, technologists, nurses, neurologists, pulmonologists, psychiatrists and trainees

Learning Objectives:

  1. Outline the differential diagnosis of nocturnal events, including nocturnal epilepsies and parasomnias;
  2. Review the pathophysiology and usual presenting clinical and video-EEG-polysomnographic features of common sleep-related epilepsies and parasomnias in children and adults;
  3. Characterize cyclic alternating pattern (CAP) NREM sleep microarchitecture and its association with epilepsies;
  4. Realize of the impact of circadian influences upon epilepsy;
  5. Recognize the impact on seizure frequency by early recognition and treatment of co-morbid obstructive sleep apnea and other sleep disorders; and
  6. Describe current treatment options for sleep-related epileptic syndromes.

C15: Advances in Measurement of PLM and Long-Term Treatment of RLS

SOLD OUT
Sunday, June 2, 2013
1:00pm – 5:00pm

Member Fee: $85
Nonmember Fee: $150

A convergence of new evaluation approaches and new treatments has produced a major change in the approach to both periodic limb movements (PLM) and the restless legs syndrome (RLS). The recently developed changes in the diagnosis of RLS and the evidence-based guidelines for long-term treatment of RLS significantly alter evaluation and treatment approaches to RLS. This course will explain both when and how to do these evaluations in the sleep lab and with ambulatory monitoring.

Chair: Richard Allen, PhD
Faculty: Christopher Earley, MBBCh, PhD; Raffaele Ferri, MD; and Diego Garcia-Borreguero, MD

Psychologist Level of Content: Intermediate

Target Audience: Sleep clinicians and sleep researchers interested in the issues involved in restless legs syndrome, brain iron, periodic limb movements in sleep, and movement disorders in sleep; and sleep technicians responsible for reducing physiological recordings of leg movements in sleep

Learning Objectives:

  1. Review the advanced methods for evaluating both the restless legs syndrome (RLS) using repeated suggested immobilization tests and also the periodic limb movements in sleep using periodicity as well as frequency characteristics of the events; 
  2. Discuss the new evidence-based standard for long-term care of RLS and the change in recommended initial treatment of RLS; and
  3. Appreciate advances and potential options for use of opioids and IV iron in long-term care of RLS.