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APSS - Sleep 2013
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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?
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Having completed the activity, please rate your ability to meet each of the following objectives:
Discuss key concepts of recent basic and clinical sleep research and how these concepts apply to current practice
Apply up-to-date information and evidence-based knowledge to the clinical management of patients with a variety of sleep disorders
Explain how to improve clinical care and outcomes as a result of application on this knowledge in the clinical setting
Name the current trends of insurance regulations, coding and reimbursement
Discuss expansion of sleep center practice to include pediatric patients and provision of DME
Identify trends in managing patients with sleep disorders including CPAP data analysis and perioperative sleep apnea assessment
Identify the full spectrum of normal breathing patterns in infants
Name the various patterns of sleep-disordered breathing observed in infants
Discuss the natural history and treatment of infant sleep-disordered breathing patterns
Review basic concepts and components of the circadian system
Explain how light influences the circadian clock and mechanisms by which light influences sleep
Discuss mechanisms of cellular timekeeping and discuss how clocks are important for peripheral tissue and brain function
Explain the side effects and alternative options for therapy of refractory restless legs syndrome
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
Discuss diagnostic criteria, differential diagnosis, pathophysiology, and evidenced based therapy for parasomnias and narcolepsy with cataplexy
Review medical considerations for the use of PAP therapy with children and adolescents
Discuss the technical use of PAP with children and adolescents
Identify strategies for PAP desensitization as well to improve adherence to PAP therapy
Identify various ICSD-2-defined CRSDs in the clinical setting, with inclusion of the use of actigraphy and sleep logs
Discuss the treatment of select CRSDs, taking into account best available evidence
Review the various experimental protocols used in chronobiologic assessments, to in turn facilitate an understanding of the CRSD-related literature
Describe the specialized montages used to evaluate patients with neuromuscular disorders, those with parasomnias and patients with nocturnal seizures
Explain the OSA screening methodologies for perioperative patients
Review actigraphy, sleep logs and melatonin levels in the diagnosis of circadian rhythm sleep disorders
Describe the best evidence-based practices for evaluating and diagnosing various sleep disorders in clinical practice
Discuss the best evidence-based and cutting edge treatments for various sleep disorders in 2013
Identify major areas of uncertainty regarding best treatment practices in sleep medicine
Explain Recognize the indications and limitations of various PAP devices in the management of the spectrum of sleep disordered breathing
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
Identify the indications, limitations and technology underlying various actigraphy devices, as well as interpret downloaded data and troubleshoot common problems of several devices
Discuss concepts underlying the organization of sleeping and waking behavior, sleep-wake homeostasis, and circadian timing
State Appreciate the changes in normal sleep that emerge across the human life cycle
Identify the neuroanatomical and neurophysiological systems underlying sleep-wake regulation
Explain how to Recognize and manage sleep disordered breathing in children with neuromuscular and craniocervical junction disorders to optimize their quality of life and longevity
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
State Appreciate the complexity and value of treating sleep disorders in children with epilepsy and/or headache
Explain Realize how sleepiness from sleep disorders and from sleep loss and circadian misalignment interferes with safety and productivity in occupational settings
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
State Recognize how 24/7 operations affect health and may lead to shift work disorder, and what can be done to manage this
Outline the differential diagnosis of nocturnal events, including nocturnal epilepsies and parasomnias
Review the pathophysiology and usual presenting clinical and video-EEG-polysomnographic features of common sleep-related epilepsies and parasomnias in children and adults
Characterize cyclic alternating pattern (CAP) NREM sleep microarchitecture and its association with epilepsies
Explain how certain neurodevelopment disorders have distinctive and often unique insomnias related to their particular disorder as to be considered a phenotype
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
Discuss the new evidence-based standard for long-term care of RLS and the change in recommended initial treatment of RLS
Name advances and potential options for use of opioids and IV iron in long-term care of RLS
Discuss recent progress in research on effects of sleep and circadian rhythms on formtion and recall of memories
Describe the impact of changes across the life span on sleep and sleep-related processes
Describe the role of the locus coeruleus in regulating wakefulness
Discuss the interactions of the locus with orexinegic regulation of wakefulness
Review updates in basic cicadian physiology
State of the impact of circadian influences upon epilepsy
Review updated information on SIDS and the role of sleep disordered breathing on systemic function in children
Review the recent findings on the roles of mGluR/mGluR5 in sleep-wake regulation along a molecule-human-medicine continuum
Discuss the possible implications of genetic variation in genes regulating mGluR/mGluR5 for sleep/wake functions
Delineate possible therapeutic opportunities for interaction with mGluR/mGluR5 to improve sleep and wakefulness
Discuss changes in the understandings of insomnia as a condition over the past 50 years
Identify the prevalence and risk factors for developing insomnia
Reivew the views of the pathophysiology of insomnia and its implications for therapy
Discuss the role that the NIH has had in advancing sleep research
Review future opportunities for advancing sleep research
Discuss the prevalence, course, pathogenesis and prognosis of pregnancy-related RLS
Analyze the safety and efficacy of dopamine agonists and intravenous iron to treat RLS during pregnancy
Review new practice guidelines for RLS treatment during pregnancy
Discuss the National Institutes of Health’s (NIH) vision of high priority areas and goals for sleep and circadian science
State the opportunities for basic, clinical and high-impact translational research offered by NIH
Review funding opportunities for supporting training and interdisciplinary collaboration in the pursuit of sleep and circadian rhythms research
Evaluate mechanisms and interventions in insomnia
Discuss recent progress in human sleep deprivation research
Identify how different health care models have adopted out of center sleep testing (OCST) as means to accomplish institutional goals related to managing sleep apnea
Review practical strategies for understanding the patient base, payer mix, equipment choices and equipment distribution and return options
Formulate implementation strategies for OCST technologies and practices
Review the role of adenotonsillectomy in the management of pediatric sleep apnea, including its role in improving polysomnographic abnormalities, symptoms of sleep apnea, quality of life, cognition and behavior
Identify the rate of spontaneous improvement in sleep apnea in children with mild to moderate sleep apnea
Identify which clinical outcomes improve with adenotonsillectomy compared to watchful waiting with supportive care and which subgroups of children (defined by obesity, age, gender, sleep apnea severity) respond differently to surgical treatment
Discuss behavioral intervention and treatment for PAP-related anxiety
Review possible causes, diagnoses and treatment options for cases of abnormal pediatric sleep episodes
Analyze the relationship between enlarged tonsils, upper airway obstruction, mandibular position and their effects on breathing and cardiovascular events
Discuss the role of sleep for metabolism
Describe the role of sleep disturbances as risk factors for obesity and diabetes
Explain the importance of sleep and circadian function for glycemic control in patients with Type 2 diabetes
Discuss sleep development and sleep fragmentations as documented by actigraphy
Review different applications of actigraphy in developmental studies
Identify the advantages and limitations of actigraphy
Describe the impact of sleep on stroke, traumatic brain injury and neurodegeneration
Explain how hypersomnias affect various clinical outcomes and how novel interventions may modify these outcomes
Discuss some of the most recent molecular and genetic studies on sleep/wake and circadian mechanisms
Describe new methods of sleep detection and refinements in existing technologies
Discuss the circadian phase resetting and antidepressant effects of melatonin ag
Explain the role of timing and dose of melatonin agonists to achieve different clinical effects and the differences between melatonin agonists
Name the benefits of melatonin agonists where there has been a demonstrated clinical impact and the limitations where efficacy has not been demonstrated or is clinically-limited
Identify the two new CPT codes for pediatric polysomnography and explain when it is appropriate to use them
List the four sleep apnea measures accepted for the CMS Physician Quality Reporting System (PQRS) and describe how to participate in the PQRS program
Identify the differences between ICD-9 and ICD-10 coding and describe the steps for transitioning to ICD-10
Discuss the lessons learned from investigators conducting national and international studies on patients with obstructive sleep apnea
Identify the steps, issues and challenges associated with planning, developing and implementing a large-scale clinical research studies
Describe considerations in conducting international investigations including similarities and differences in executing research in the United States versus other countries
Identify novel methods for evaluation of driver drowsiness and their potential application to road safety
Name the impact of sleep deficiency on performance during real driving, the perception of drowsiness by sleep-deprived drivers and the effectiveness of interventions to reduce the hazards of drowsy driving
Review what is known about postnatal development of sleep-regulatory processes in different species, with an emphasis on sensitive periods in the maturation of sleep behavior
Discuss brain mechanisms that underlie developmental changes in sleep-regulatory homeostatic and circadian processes and the utilization of such knowledge in the treatment of sleep related disorders
Evaluate functional relationships between sleep and brain maturation
Review the characteristics of pediatric and adult narcolepsy and its relationship to H1N1 vaccination or infection
Analyze the association between the H1N1 vaccination and narcolepsy with cataplexy in children and adults based on epidemiological studies conducted in several countries
Discuss the outcome and therapeutics of post-H1N1 narcoleptic patients
Explain the role of atypical mammalian photoreceptors in controlling sleep and alertness
Identify how irregular light schedule influences mood and learning
Discuss the retinal circuits that influence all of the above mentioned functions
Discuss controversial coding for sleep medicine including PAP Nap, when to use modifiers and which codes to use for out of center sleep testing
Apply behavioral and pharmacological treatments to these patients
Identify potential behavioral and medical causes of poor sleep in infants, children and adolescents with autism spectrum disorders
Review empirically-based treatments for sleep difficulties
Describe the relationship of obstructive sleep apnea with other disease states
Analyze physiological and environmental stressor effects on sleep
Review the mechanisms by which poor sleep increases pain
Analyze the clinical impact of sleep loss on pain and comorbid conditions
Identify biomarkers of chronic pain and responses to therapy
Discuss the novel drugs presently under preclinical and clinical development for insomnia
Review novel physiological mechanisms and receptors that might represent novel targets for insomnia beyond the GABAergic system
Review the recent history of the growth of sleep medicine as a field
Discuss current challenges to the field of sleep medicine
Consider the future of sleep medicine and how the field needs to position itself to continue to be successful
Describe the overall structure of ICSD-3 and its utilization
Identify major changes in diagnostic nosology from ICSD-2 and the rationale for these changes
Develop greater skill and accuracy in the diagnosis of sleep disorders
Correlate brain maturation with changes in sleep and discuss common sleep disorders
Assess the effects of treatment of OSA molecularly and clinically
Identify the prevalence of various chronic pain syndromes and their interactions with sleep disturbances and insomnia
Identify the potential mechanisms underlying the interrelationship between sleep quality and perceived pain
Review the recent evidence for effective treatment of insomnia and co-morbid pain in fibromyalgia and osteoarthritis
Review the autonomic, endocrine, cardiac, vascular and inflammatory mechanisms underlying the impact of sleep, sleep disorders and the molecular circadian clock on the vulnerability for myocardial infarction, ventricular arrhythmia and sudden cardiac death
Discuss the morning peak in serious adverse cardiovascular events in humans that may be attributable to the interaction of triggering behaviors, such as sleep apnea, arousal from sleep and internal circadian factors
Analyze the relevance of sleep, sleep disorders and the circadian clock for cardiovascular diagnosis and therapy
Discuss local aspects of sleep on multiple levels from multi-unit recordings to high-density EEG
Explain how basic knowledge of sleep regulatory mechanisms can be translated in to clinical populations
Analyze the effects of sleep deprivation on neuronal firing patterns and cognition
Discuss how acute brain ischemia could correlate with sudden onset of hypersomnolence
Analyze the importance of the suprachiasmatic nucleus (SCN) in regulating circadian rhythms and how sudden damage to the SCN resulting from a head wound or injury can lead to onset of Irregular Sleep Wake Rhythm Disorder (ISWRD)
Identify the relationship between cardiovascular issues and sleep disordered breathing, particularly in cases where severe SDB, when treated, can also regulate cardiovascular problems
Explain the relationship between sleep and fatigue in cancer patients
Identify possible treatments of sleep and fatigue in cancer patients
Describe the impact of sleep, fatigue and circadian rhythm disruption on cognitive function in cancer patients
Review the general relationship between sleep and memory consolidation in humans
Identify sleep- and wake-promoting neurons in the fly brain
Describe experimental methods used to demonstrate an enhancement of memory by sleep
Analyze interaction between high-stakes occupations and sleep
Review how REM sleep behavior disorder affects and is affected by various interventions across the diagnosis and evaluation spectrum of the disorder
Discuss the most recent studies on the pharmacology and biochemistry of sleep
Discuss how sleep research may potentially affect public policy
Identify strategies to create successful multidisciplinary alternatives to CPAP programs in private and academic settings
Review methods to maximize the efficacy of an established multidisciplinary alternatives to CPAP program
Discuss appropriate metrics to determine success of a multidisciplinary alternatives to CPAP program
Review the pathophysiology of RLS
Identify changes in the diagnostic criteria and their applications in clinical practice and research
Describe the impact of pathophysiology and improved diagnostic criteria on the strategies for long-term management of RLS
Discuss how to access and use the online AASM scoring manual and understand the organization of rules and notes
State the goals and mandate of the Scoring Manual Committee
Review how to submit questions to the Scoring Manual Committee and review of answers to selected questions submitted over the past year
Discuss the pathophysiological mechanisms of circadian sleep disorders
Describe segmented sleep in humans from an historical perspective
Review polyphasic vs. monophasic sleep-wake patterns in different mammalian species
Discuss the plausibility of segmented sleep from a mathematical modeling perspective
Review how changes in brain development are reflected in sleep
Analyze sleep changes across adolescence
Identify changes in sleep physiology and brain structure in adolescents with psychiatric disorders
Review the clinical outcome data supporting the critical respiratory threshold for treatment of sleep disordered breathing in children
Discuss the natural history and risk factors of sleep disordered breathing in children
Contrast the current conceptual model of treatment of sleep disordered breathing in children with a multifactorial, evidence-based model
Identify the major changes to the respiratory scoring rules
Apply the concept of segmented sleep to discuss the nature and treatment of sleep disorders such as insomnia
Identify adaptations of evidence-based behavioral treatments for sleep disturbances for patients with specific co-morbid conditions
Apply the principles of evidence-based treatments to patients with select co-morbid conditions
Review these adaptations when working with individual patients whose co-morbidities present a challenge to traditional behavioral treatment approaches
Discuss the consensus and divergence of viewpoints regarding strategies to accelerate the translation of advances in sleep and circadian science into clinical practice
Review research advances pointing to new ways sleep medicine may protect health and prevent disease
Identify gaps, opportunities and priorities for research that will advance clinical medicine and public health
Discuss the effects of aging on sleep, including diagnosis and treatment of sleep disorders in older adults
Explain how sleep disordered breathing is related to health and metabolism
Review the prevalence, severity and characteristics of different sleep-wake disturbances after traumatic brain injury
Discuss the neuropathological basis of posttraumatic arousal disturbances, namely regarding the injury to arousal-promoting brain areas located in the upper brainstem and the hypothalamus
Analyze recent advances in rodent models of traumatic brain injury and the contribution of translational research to the field of posttraumatic sleep-wake disturbances
Assess the impact of anesthetic agents on control of breathing
Distinguish natural sleep from the CNS manifestations of anesthetic-induced reduction in alertness
Review the available data to construct viable patient safety plans for those with OSA undergoing anesthetic for surgical procedures
Discuss the subjective experience of children and adolescents and their families living with narcolepsy
List the common challenges pediatric patients with narcolepsy face in a variety of domains including family life, educational, social, mental and physical health and safety
Develop strategies to improve quality of life in pediatric patients with narcolepsy
Analyze the reciprocal role between sleep disturbances and depression
Review the genetic factors that have effects on sleep function
Discuss the mechanisms by which the circadian system through its effects on the autonomic nervous system affect glucose, metabolism and sleep
Analyze the mechanisms by which insufficient sleep is associated with metabolic risk
Review the effects of insufficient sleep on the transcriptome of various tissues in humans and animals
Appreciate the variability of sleep from night to night in patients with insomnia
Evaluate the predictability of insomnia sleep and its relation to overall sleep quality
Discuss the relationship of this variability to daytime functioning and the implications for the treatment of insomnia
Review the concept of tailoring PAP therapy to OSA co-morbidities due to these co-morbidities impact on general and especially CVD outcome
Recognize the importance of understanding OSA and its co-morbidities as a multifaceted disease in need of a multidisciplinary therapeutic plan to achieve the best patient outcome
Identify the key operational factors that cause fatigue
Analyze how companies can assess and manage those fatigue factors
Discuss outstanding areas for future research
Discuss the developmental changes in the complexities of sleep in women
Analyze novel approaches to insomnia evaluation
Discuss sleep neurobiology across species
Describe the relationship between sleep and various medical disorders including cardiovascular disease, COPD and HIV
Discuss new technologies in the diagnosis and treatment of sleep disorders
Identify the clinical characteristics and features of common and complex nocturnal events that may be encountered in clinical practice, including parasomnias, nocturnal seizures, psychiatric phenomena and movement disorders
Describe the various diagnostic and therapeutic strategies for evaluating and managing these events
Identify key features of various nocturnal behaviors based on patient behavior
Review the implementation timeline for the Affordable Care Act (ACA)
Examine the impact of the ACA on patient management, including influx of patients, state exchanges and CO-OP Health Insurance Plans and accountable care organizations
Discuss the operational impact the ACA will have on independently-owned sleep centers, including the tax provisions
Evaluate risk factors for insomnia
Identify new methods of evaluation and management of sleep disordered breathing
List neural, endocrine and immune mechanisms mediating effects of sleep loss
Assess the long-term impact of the ACA on the sleep medicine profession
Discuss neurobiological regulation of sleep, alertness and circadian rhythms
Describe the role of sleep and circadian rhythmicity in Alzheimer's disease
Review how circadian dysregulation and impaired sleep-wake cycle impact Parkinson's disease
Identify sleep and circadian rhythms disturbances in Huntington's disease
Objective 1: Summarize relevant information on the latest sleep research and clinical practices
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Objective 2: Identify present issues or challenges in diagnosis/treatment of sleep disorders, practice of sleep medicine or topics related to the field of sleep
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Objective 3: Integrate strategies and tools for the enhancement/advancement of sleep medicine
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Objective 4: Recognize and have a basic understanding of common sleep disorders
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional activities?
Was the educational content scientifically sound?
If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
Was the mode of education effective to learning?
If you answered "No" to any of the above questions, please explain.
Did you perceive any product/service/company/commercial bias in any educational session you attended or materials you received?
If you answered "Yes" to the above question, please detail the situation below (e.g. session title, speaker name):
Were you solicited by sales personnel in an educational room (other areas do not matter) while you attended this educational activity?
If you answered "Yes" to the above question, please explain in detail (e.g. who, when, where):
How much did you learn as a result of this education program?
What specifically did you learn during this activity that you intend to integrate into your practice?

What questions have arisen in your practice for which you need answers/strategies that you can implement?

What patient/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?
What problems are your patients/clients communicating to you that need attention or follow up?

Are you interested in basic, intermediate or advanced level trainings?

What barriers might you have that would interfere with implementation of new information learned from this training?

How can this training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?

Additional comments:

Mr question