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SLEEP 2011 - 25th Annual Meeting of the APSS
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Agreement
By completing this form, you attest that you have participated in all selected activities in thier entirety.
Please rate the following:
The program was relevant to my work.
Content matched stated objectives.
Usefulness of handouts/AV.
Quality of facilities.
How well did the educational sessions give a balanced view of therapeutic options, including the use of generic names?
If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain:
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Having completed the activity, please rate your ability to meet each of the following overall conference objectives:

Summarize relevant information on the latest sleep research and clinical practices

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Identify present issues or challenges in diagnosis/treatment of sleep disorders, practice of sleep medicine or topics related to the field of sleep

Integrate strategies and tools for the enhancement/advancement of sleep medicine

Having completed the activity, please rate your ability to meet each of the following objectives:
Discuss state-of-the-art knowledge of recent advances in diagnosis and treatment for various clinical topics
Explain how to improve clinical care and outcomes as a result of application of this knowledge in the clinical setting
Discuss key concepts of recent basic and clinical sleep research and how these concepts apply to current practice
Review several concepts underlying the organization of sleeping and waking: behavior (e.g., lifestyle, culture), sleep-wake homeostasis, circadian timing
Explain demographic factors influencing sleep and sleep disorders and the changes in normal sleep that emerge across the human life cycle
Identify the neuroanatomical and neurophysiological systems underlying sleep-wake regulation and the evidence for the genetic basis of some sleep phenotypes and sleep disorders
Review common sleep disorders comorbid in neurology
Discuss unique sleep disorders that often result from underlying neurologic conditions, and are directly attributable to the disorder itself, or from treatment of the underlying condition
Review recent data in the following unique topics: neuroimaging of sleep, brain- based biomarkers of sleep stability, role of neuroimmunology in narcolepsy and the pathophysiology of sleep apnea in stroke
Discuss the current advances in nasal CPAP, oral appliances and other behavioral therapies for OSA
Identify the numerous upper airway surgical procedures and staging protocols for the treatment of OSA
Explain the role of sleep physicians, including otolaryngologists, and dentists, including oral and maxillofacial surgeons, in a comprehensive multidisciplinary team approach to OSA
Review intermediate to advanced level skills in engaging in pediatric behavioral sleep medicine practice with infants through adolescents
Explain the importance of the use of actigraphy in assessing sleep/wake patterns and guiding interventions in a pediatric population
Discuss interventions for improving CPAP adherence in children and adolescents
Review the important aspects of sleep medicine in operation of moving vehicles, with a focus on those employed in a transportation industry
Discuss methods of tracking and improving PAP adherence in our patient population
Examine the implementation of a pre-operative screening program for obstructive sleep apnea in a hospital-based setting
Describe the best practices for evaluating and diagnosing the most common sleep disorders in clinical practice
Discuss the best evidence-based and cutting edge evaluations and treatments for various sleep disorders in 2011
Identify major areas of uncertainty regarding best treatment practices in sleep medicine
Review various assessment methods such as the clinical interview, sleep diary, actigraphy and selected questionnaires in conducting assessments and developing case conceptualizations with patients with sleep disorders
Discuss behavioral sleep medicine therapies for a range of sleep problems including primary and comorbid insomnia, circadian rhythm sleep disorders, CPAP-nonadherence, sleep-disruptive nightmares, NREM parsomnias and the age-related sleep difficulties of community dwelling and institutionalized older adults
Assess the empirical evidence supporting each of the techniques discussed
Discuss how optimal treatment of nocturnal asthma, allergic rhinitis, atopic dermatitis, pain, traumatic brain injury and gastroesophageal reflux can improve sleep and breathing in children and adolescents
Review the long-term cardiovascular and metabolic consequences of obstructive sleep apnea, obesity and short sleep duration on children and adolescents
Identify which syndromes predispose children and adolescents to sudden death in sleep
Identify the static and dynamic features of the nasal airway that affect obstructive sleep apnea patients and their treatment with CPAP and oral appliances
Assess the oral and pharyngeal anatomy relevant to the diagnosis, medical and surgical treatment of obstructive sleep apnea
Discuss methods of anatomical assessment and advanced surgical treatment of obstructive sleep apnea in children
Outline the differential diagnosis of nocturnal events, including nocturnal epilepsies, parasomnias, and other physiological and psychological paroxysmal events
Review the pathophysiology of sleep-related seizures and epilepsies and usual presenting clinical features of common sleep-related epilepsies in children and adults
Identify typical clinical and video-EEG polysomnographic features of nocturnal epilepsies and parasomnias which mimic them
Review early indicators for identification of major dopamine treatment failures: development of impulsive behavior, augmentation, loss of efficacy
Explain biological mechanisms and predictors of standard dopamine treatment failure
Describe when to consider and how to use major alternative treatment options including long acting dopaminergics, opioids, gabapentin, pregabalin, and IV iron
Review the concept of network state oscillation and how they can be studied in vitro and in vivo
Describe the local use-dependent hypothesis for sleep regulation
Demonstrate how to incorporate the newest paradigm for sleep regulation into clinical problems
Compare and contrast neuropsychological outcomes of snoring and obstructive sleep apnea
Discuss the cognitive, behavioral and socio-emotional implications of snoring and obstructive sleep apnea
Appraise the neuropsychological outcomes of assessments in snoring and obstructive sleep apnea subjects
Review the consequences of insufficient and poor-quality sleep at several levels of analysis linked together by evidence of altered metabolism
Discuss how the effects of inadequate or poor-quality sleep on fundamental processes may increase susceptibility to disease, exacerbate symptoms of disease, or delay recuperation
Discuss areas of controversy and gaps in the current knowledge in this field
Detect genetic influences on sleep in flies and humans
Describe changes in the homeostatic regulation of sleep across the lifespan
Explain brain mechanisms that underlay these developmental changes in sleep homeostasis
Review how the understanding of these mechanisms may impact the treatment or diagnosis of sleep disorders
Explain how and when to use light boxes and melatonin pills to reset (phase shift) human circadian rhythms to correct the circadian misalignment in circadian rhythm sleep disorders
Describe how to use melatonin pills to entrain free-running blind people
Assess the advantages and disadvantages and the appropriate use, of various doses and preparations of melatonin
Compare the similarities and differences between animal and human sleep
Explain sleep homeostasis as a basic regulatory principle in sleep
Describe a conceptual framework for what constitutes a sleepiness biomarker
Discuss the usefulness of current tools for measuring sleepiness
Discuss potentially novel approaches to identifying sleepiness biomarkers
Describe the surgical options in the treatment of OSA
Discuss the perioperative management of the otolaryngological procedures, including surveillance for adverse outcome and postoperative disposition for these patients
Explain the difference between adult and pediatric patients in the diagnosis and treatment of OSA
Summarize the data that has been presented in previous studies and the gaps in the literature that exist
Examine options and new strategies including use of more objective data (such as actigraphy) and study design in future studies to show a causal relationship between insufficient sleep and childhood obesity
Assess the relationship between insufficient sleep and childhood obesity
Explain the ascending pathways and physiological mechanisms involved in cortical activation
Describe how ascending pathways can be turned off to induce sleep or general anesthesia
Review how damage to ascending pathways can lead to comatose states and what therapeutic possibilities exist to ameliorate this damage
Identify demonstrate helpful intervention strategies for managing patients with comorbid depression or nocturnal panic attacks
Demonstrate how to implement Imagery Rehearsal Therapy for Chronic nightmares
Demonstrate the implementation of graded exposure therapy for CPAP-related anxiety and claustrophobic reactions
Discuss the value of PSG and other measurements for the neurophysiological phenomena underlying periodic leg movements (PLMS)
Describe the consequences and associated physiological changes of PLMS in restless legs syndrome and other sleep disorders with PLMS
Assess if PLMS have a role in refining also the diagnostic process of RLS, PLMD and other conditions
Review the studies that led to the discovery of hypocretins
Explain optogenetics and dissection of neuronal circuits
Describe the multiple roles of arousal nuclei in sleep, memory and brain reward
Review new developments in childhood OSAS
Review new aspects of pathophysiology of childhood OSAS
Discuss current research on treatment, especially CPAP therapy
Appraise gender differences in sleep duration and sleep pattern
List the effects of trauma and the military service on sleep and sleep physiology
Critique new measures of respiration in obstructive sleep apnea
Identify pathophysiological factors in restless legs syndrome
Evaluate the complex relationship between learning, memory and sleep
Inventory the effects of sleep restriction on energy regulation and immune reactivity
Discuss sleep EEG changes that accompany adolescent development
Review how cortical changes in the developing brain are reflected in the sleep EEG
Explain the use of the sleep EEG as an index of cortical structure
Describe the anatomy and physiology of circadian rhythms in humans
Discuss approaches to evaluation of the circadian system in neurodegenerative disorders
Discuss the role of circadian rhythms in Alzheimer's and Parkinson's disease
Assess methods for disseminating cognitive behavioral therapy for insomnia
Explain how to adapt cognitive behavioral therapy for insomnia for diverse populations with multiple mental and health comorbidities and within different settings
Describe the challenge of competency rating to determine success of training
Explain how the latest basic and clinical research related to understanding respiratory motor plasticity can be used to treat sleep related breathing disorders
Discuss the neurochemical, genetic and molecular factors that underlie respiratory motor plasticity in animals models of sleep related breathing disorders
Summarize clinical data on newly identified mechanisms by which respiratory motor plasticity is triggered during sleep in humans
Review the principles and models underlying homeostatic sleep regulation
Describe the concept of sleep-active neurons and the evidence for their existence in the cerebral cortex
Explain the various classifications of GABAergic interneurons in the cerebral cortex and their relationship to the sleep-active population
Identify relationships between sleep, learning and memory
Contrast surgical, oral appliance and novel therapies of obstructive sleep apnea
Examine methods for modifying circadian rhythms and the relationship between eating and sleep
Analyze the emerging relationship between cardiovascular disease and restless legs syndrome
Summarize sleep changes in patients with neurodevelopmental disorders
Review the mechanisms linking sleep apnea to cardiac electrical instability
Describe the role of OSA in bradyarrhythmias, atrial fibrillation and ventricular arrhythmias
Assess the potential contribution of sleep apnea to nocturnal sudden cardiac death
Analyze the relationships between sleep, learning and memory
Describe effects of sodium oxybate on sleep and characteristics of hypocretin receptors
Explain how to integrate aspects of the two process model of sleep
Identify interactions between psychiatric illness and sleep
Cite gender differences in sleep related breathing disorders
Review recent data that provide insights into the neurobiological link between sleep/circadian biology and mental health
Discuss emerging data on the developmental neural mechanisms underlying the interface between early regulation/dysregulation of sleep and circadian systems and the healthy (and unhealthy) regulation of affect and behavior in children and adolescents
Identify promising directions for future research to advance our understanding of the relationships between sleep/circadian regulation and affect regulation
Review the legal process and of principles of criminal and civil
Explain how sleep complicates the issue of “state of mind” in legal proceedings, and how courts and legislatures have attempted to address this issue
Describe how sleep science can inform and contribute to the development of this area of law and public policy
Describe the evolution and limitations of current insomnia nosologies
Discuss the DSM-V approach to insomnia classification
Review empirical approaches for improving our diagnostic classification systems
Describe emerging evidence linking dream experience to memory processes in the sleeping brain
Evaluate this data in the context of current theories of sleep-dependent memory consolidation
Discuss the potential of subjective reports for elucidating the mechanisms of memory consolidation
Assess the pros and cons of oral appliance therapy in obstructive sleep apnea
Describe clinical features and test that may be useful in selecting patients for oral appliance therapy
Review new approaches and trends in the field particularly as it relates to assessment and selection
Assess the major clinical distinctions between parasomnia and seizures
Describe what additional testing can help in the evaluation and when it is needed, including use of extended EEG and standardized instruments
Describe implications for treatment and counseling
Review the different ways in which fMRI can be used to characterize alterated brain function in sleep deprived persons
Review the contributions fMRI has made to understanding the mechanisms underlying cognitive performance deterration in sleep deprived persons
Describe how fMRI can be used to assess inter-individual differeneces in cognitive decline following sleep deprivation
Describe how the endogenous circadian system optimally regulates human physiology and behaviors
Assess the clear patterns of severity across the day and night for several diseases, including the timing of adverse cardiovascular events, asthma exacerbations and epileptic seizures
Describe the role of the endogenous circadian system in these day/night patterns of disease severity
Identify treatment concerns in hypersomnia patients
Analyze novel measurement methods in sleep research
Assess sleep in development, aging and after neonatal intermittent hypoxia
Validate biological dimensions of insomnia
Formulate relationships between sleep and mood disorders, substance abuse and suicidal ideation
Distinguish factors contributing to PAP compliance
Compare the similarities and differences between proton (1H) and phosphorous (31P) spectroscopy, including the different metabolites identified by the two methods
Explain how information about the relative levels of these metabolites inform our understanding of sleep disturbances and sleep deprivation
Describe the implications of these differences with respect to treatment options for individuals with sleep disturbances
Summarize recent studies of recuperation following shift work that are informing new federal regulations in transportation in the U.S.
Describe how fatigue translates to accident risk and how this can be quantified in operational settings
Discuss new techniques for drowsy driver detection
Explain how to diagnose excessive daytime sleepiness (EDS) and cataplexy in children
Identify the role of clinical investigation in the management of narcoleptic children
Describe the therapeutic challenges and outcome in pediatric narcolepsy
Explain how the mechanisms underlying insomnia may be pursued using techniques that have proven useful in cognitive neuroscience and psychiatry to define phenotypes and ultimately underlying genotypes and polymorphisms that determine one’s risk
Describe how the internet may be used for both phenotype assessment and treatment support
Describe the progress in psychological treatment of late-life insomnia
Describe current trends in the psychological treatment of hypnotic-dependent insomnia
Explain the advances in psychological treatment of comorbid insomnia
Appraise relationships between OSA and neurocognition
Describe prevalence and correlations between sleep time and sleepiness, insulin resistance and habits as well as a syndrome of asymptomatic short sleepers
Assess age related changes in sleep
Cite responses to sleep deprivation
Review consequences of sleep restriction and sleep patterns in a model of sleep fragmentation
Summariaze current research regarding  interactions between sleep/arousal regulation and affect regulation in adolescence
Describe the clinical relevance of understanding the interrelationships between sleep and affect regulation in youth
Describe the policy implications (and need for additional research) in these areas
Critique age-related changes in the relationship between sleep, learning and memory
Document consequences of shift work, incidence of OSA in commercial drivers, and utilization of health care in patients with sleep complaints
Judge phenotypes of resilience following sleep deprivation or restriction
Assess methods for assessing circadian phase and consequences of circadian rhythm disorders
Distinguish characteristics and consequences of insomnia
Assess the current status of sleep medicine
Appraise tools available for sleep medicine diagnosis
Critique the patient centered medical home model and its relevance to sleep medicine
Explain the assumptions, stated or unstated, in publications describing actigraphy collection analysis and interpretation
Identify the strengths and limitations in the use of actigraphy to assess sleep
Describe the key research questions surrounding the longitudinal validity of actigraphic assessments of sleep
Review sleep research opportunities that are identified in the Sleep Research Plan
Identify the purpose of the Sleep Research Plan, and how it may be used by stakeholders including individual NIH Institutes and Centers
Discuss opportunities to advance sleep research as a field, and what sleep research offers to the NIH mission
Explain why proper modification of circadain rhythms is equally efficacious to antidepressants in treating mood disorders
Explain the significance of the timing of melatonin secretion
Describe techniques for monitoring circadian rhythms in patients
Describe the indications and goals of surgery for treatment of obstructive sleep apnea
Discuss the anatomical basis of surgery and review the menu of site-directed surgical approaches
Discuss the evidence for surgical treatment of OSA, based on recent reviews and beyond
Describe common sleep disturbances and their pathogenesis in post-traumatic stress disorder
Discuss a pharmacologic approach to treating sleep disorders in patients with PTSD
Discuss non-pharmocologic approaches to treating sleep disorders in patient with PTSD
Review the basic properties and underlying neural, cellular, molecular and genetic mechanisms for the entrainment, generation and expression of physiological and behavioral circadian rhythms
Discuss how the circadian clock system regulates timing in multiple organ systems at the molecular, cellular and tissue levels and integrates these processes to organize the temporal and behavioral program of the organism
Explain the current understanding of the importance of internal circadian organization for health and disease
Interpret longitudinal studies of chronic insomnia
Analyze interrelationships between sleep and emotionality
Assess neural regulation of sleep
Discuss fMRI studies of the effects of sleep deprivation

Appraise relationships between sleep and medical disorders

Critique current approaches to the management of insomnia
Document issues in the sleep of children and adolescents
Appraise the effects of light on the circadian system
Describe how neural correlates of cognition during wakefulness are modulated by specific sleep states, acute sleep loss and insomnia
Demonstrate how brain imaging methodologies are powerful tools to study the impact of genotype or intervention on cognitive functions modulated by sleep
Evaluate the relationship between sleep and the cellular fuel adenosine triphosphate (ATP)
Describe how brain ATP use varies in accordance with sleep state
Discuss how sleep regulatory circuits detect and react to changes in ATP
Identify opportunities to improve and standardize sleep clinical data management within and across sleep laboratories and sleep cohorts
Identify how informatics tools can promote clinical and comparative effectiveness and genetic research
Identify the opportunities to distinguish between different data sharing models and identify models most appropriate for sleep researchers
Review how sleep affects control of ventilation and the upper airway
Explain the interplay of sleep-wake and endocrine systems and how sleep loss can alter these associations
Describe the role of sleep in thermoregulation, immune function, and autonomic regulation of multiple organ systems
Review how the circadian timing system is controlled and how it interacts with other systems to regulate the timing of sleep-wake and related physiological processes
Describe the effects that sleep loss produces on the body, brain, and behavior
Review the major categories and types of sleep-wake disorders, and the pharmacological therapies used to treat these disorders
Assess the interaction between traumatic brain injury, both mild and severe, and sleep
Characterize sleep abnormalities in children with sickle cell disease
Compare the good, bad and ugly effects of drugs on sleep and wakefulness in children
Explain how optimal treatment of pain, itch, inflammation, and/or arthritis can improve sleep quality, disease severity and quality of life in children
Identify anatomical structures for modern, targeted surgical treatment in adults
Describe an anatomical assessment for oral appliance therapy of obstructive sleep apnea
Explain the physical examination of the sleep apnea airway using basic and advanced tools such as peak flow meters and fiberoptic endoscopes
Review strategies of EEG recording and viewing during clinical polysomnography practice that increase the yield of identifying interictal epileptiform discharges and seizures
Characterize the pathophysiology of cyclic alternating pattern (CAP) NREM sleep microarchitecture and its associations with nocturnal epilepsies and parasomnias
Review the impact of circadian influences and co-morbid sleep disorders in epilepsy
Review the impact on seizure frequency by early recognition and treatment of co-morbid obstructive sleep apnea and other primary sleep disorders
Describe current and evolving treatment options for sleep related epileptic syndromes, including the range of approved and investigational antiepileptic drugs, neurostimulation with the vagus nerve stimulator and other devices, and epilepsy surgery
Describe new electrophysiological signals and measurements used to characterize sleep and regulate sleep including local field potentials and evoked response potentials
Formulate best practice guidelines to assess, interpret and treat the neuropsychological outcomes
Identify the implications of snoring and obstructive sleep apnea on cognitive, behavioral and socio-emotional performance from infant to adult
Discuss the current evidence and management of surgical outpatients with OSA, with an emphasis of choice of venue, anesthetic technique, and monitoring
Identify measures of adverse outcome in patients with OSA undergoing inpatient surgical procedures
Review postoperative monitoring and treatment options
Contrast differences in outcome between outpatient and inpatient procedures
Discuss factors that potentially contribute to these differences
Identify the role of a sleep domain ontology in facilitating sleep analyses for clinical and research purposes
Review the effects of changes in ATP levels on sleep circuits by astrocytes and G protein-coupled purinergic receptors
Discuss how this new understanding may lead to novel treatment strategies for pathologies underlying multiple disease states, such as obesity
Review how the timing of body temperature minimum with respect to the timing of sleep determines when bright light and/or melatonin should be administered
Discuss the evidence relating to the amount of bright light or melatonin necessary for efficacious treatment
Explain how the Sleep Research Plan was developed
Contrast outcome measures and review the role of patient registries in sleep medicine
Evaluate the future of sleep medicine
Discuss the role of emergent therapies in narcoleptic children
Evaluate  new tools for optimized shift work scheduling in which fatigue risk is minimized without jeopardizing operational integrity
Analyze the therapeutic implications of alterations in disease severity across the day and night (medical chronobiology)
Explain the neural correlates of altered risky decision-making and reward valuation in sleep deprived persons
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Additional comments:

Mr question