Quality of facilities.
Debate the pros and cons of screening commercial drivers for OSA.
Review the current US regulations and indicate proposed changes.
Review REM sleep circuitry.
Describe animal models of REM behavior disorder.
Discuss the role of GABA, glycine and glutamate in REM atonia.
Discuss the issues of sleepiness in commercial drivers in Australia and discuss the important issues of other non OSA sleep disorders in the risks of MVAs.
Cite the issues of lorries MVA related to sleepiness in the UK and the current drive for policy change involving the UK government including the debate on OSA screening.
Review the sleep-pain interaction and its significance for health.
Discuss potential mechanisms underlying the relationship between poor sleep (quantity/quality) and hyperalgesia.
Discuss pain mechanisms in fibromyalgia syndrome.
Discuss how homeostatic sleep drive differs from other biological drives such as hunger and thirst.
Review the sleep drive and its biological and behavioral markers.
Discuss how chronic sleep restriction alters the homeostatic sleep drive.
Name the consequences of sleep loss.
Identify whether or not the homeostatic sleep drive is the same between all species.
Review the subjective complaint of non-restorative sleep as a defining feature of insomnia.
Discuss whether there is adequate justification for paradoxical insomnia as a discrete diagnostic entity.
Discuss the circumstances that lead to medication or cognitive-behavioral therapy as the first-line treatment for insomnia.
Review the controversy over the types of healthcare providers that can and should be used to deliver psychological and behavioral treatments to sleep-disordered patients.
State the role of the gene PERIOD3 and its variations in the circadian and homeostatic regulation of sleep and cognition.
Explain why elucidating the role of PERIOD3 in sleep-wake regulation requires multidisciplinary approaches that encompass the entire range from genetic/molecular to sleep-physiology and brain imaging approaches.
Review new findings on how sleep influences basic emotional processes related to feelings and expressions of emotion.
Discuss new evidence that sleep facilitates processing of emotional memories and prevents generalization of fear.
Discuss interactions between sleep and emotion in psychiatric disorders, including bipolar disorder and insomnia.
Discuss alterations in sleep patterns (both nulliparous and multiparous), sleep disturbances/disorders including sleep disordered breathing, restless leg syndrome during pregnancy and associated physical and psychosocial factors.
Describe the impact of sleep disturbances/disorders on adverse maternal-fetal and perinatal outcomes.
Describe current management options for sleep disturbances/disorders in pregnancy, including medical and behavioral approaches.
Explain how to implement mindfulness based training for insomnia.
Cite progressive relaxation techniques for insomnia.
Discuss constructive worry treatment strategies for intrusive thinking.
Practice using Beck's five column method of disputing automatic thoughts.
Explain how to implement disputation of dysfunctional beliefs about sleep.
Describe the challenges posed by the placebo effect as noted in RLS trials and in clinical practice and means to minimize it.
Discuss the clinical value of objective testing for RLS in both children and adults.
State the role of different objective tests to assess RLS including polysomnography, suggested immobilization test, actigraphy and L-Dopa test.
Discuss usual presentations of common sleep-related epilepsies in children and adults.
Identify typical video-EEG polysomnographic features of nocturnal epilepsies.
Describe the impact of co-morbid sleep disorders in epilepsy.
Review current and evolving treatment options for sleep-related epileptic syndromes.
Review current research in sleep health disparities.
Clarify the presence or absence of sleep health disparities.
Discuss etiological differences in ethnic groups.
Describe the potential for sleep health disparities.
Review the primary evidenced-based recommendations of the Institute of Medicine’s (IOM) report on “Resident Duty Hours: Enhancing Sleep, Supervision and Safety.”.
Identify the key areas of the IOM report that relied on published literature from the sleep field for recommendations as well as what remains unresolved relative to those recommendations.
Contrast different perspectives on how sleep research relates to policy regarding work-rest schedules.
Discuss with NIH program officials community priorities for future research including approaches leading to a systematic and quantifiable assessment of how sleep disorders alter clinically significant health outcomes and how sleep disorder treatment affects these outcomes.
Communicate with NIH program officials regarding best practices and potential strategies to consider in planning an NIH grant application.
Inform NIH program officials about critical emerging gaps in the evidence base for clinical practice and stimulate discussion regarding potential directions for program development and research initiatives.
Discuss the role of the sleep research community in the goal of improving public health with emphasis on directing research hypotheses toward the priority mission areas of individual NIH funding offices.
Discuss the array of sleep complaints and sleep disorders reported by patients with post-traumatic stress disorder (PTSD) and other stress-related disorders.
Identify psychophysiological and neurobiological correlates of sleep disturbances in PTSD.
Describe effective pharmacological and behavioral treatments for sleep disturbances in PTSD.
Review the chemical, neuroanatomical and physiological bases of sleep-wake state regulation.
Discuss chemically specific cell groups, which are intermingled with each other in the brain, that have reciprocal profiles of discharge and can respectively stimulate sleep or waking.
Evaluate evidence that activity-dependent changes in excitability of the specific cell groups can underlie the alternation of homeostatic regulation of sleep and waking.
Examine evidence for what standard polysomnography can provide, and cannot provide, in clinical practice.
Discuss the limitations of polysomnography.
Compare novel approaches that may improve the predictive value and clinical utility of sleep studies.
Explain data relevant to the pathophysiology of REM Behavior Disorder and Restless Legs Syndrome.
Evaluate subjective and objective methods for assessing sleepiness and fatigue.
Review new findings in the neurochemical control of sleep.
Review Ishimori’s first description of a sleep promoting substance in cerebrospinal fluid.
Summarize the progress made and related to the progress to sleep pathology.
Summarize findings on the significance of non-circadian effects of light on sleep, alertness and cognition.
Discuss the neural pathways underlying the non-circadian effects of light (from retinal photoreceptor to the brain).
Review methodologies on various approaches to fragment sleep in rodents.
Compare relative strengths and weaknesses of different approaches.
Develop criteria for what would constitute an ideal system.
Inventory endocrine and weight consequences of obstructive sleep apnea.
Differentiate between good sleepers and insomniacs using physiological measures and review consequences of insomnia.
Discuss pathophysiology and consequences of obstructive sleep apnea in children.
Review the evidence for variation in behavioral and neurophysiological alterations induced by sleep deprivation.
Describe how variation in neurotransmitter/neuromodulator-related genes may modulate aspects of cognitive performance decline during sleep deprivation and their pharmacological improvement.
Discuss how functional brain imaging can be used to evaluate the consequences of sleep deprivation on memory consolidation and cognition, as well as the effects of pharmacologic intervention.
Discuss the role of nitric oxide in brain with specific presentations on the emerging role of NO in the regulation of sleep-wake behavior and sleep disorders.
Summarize the most recent discoveries on the specific brain regions and cellular subtypes involved in the induction of nitric oxide in response to sleep deprivation and their role in sleep homeostasis.
Explain how and where sleep apnea and intermittent hypoxia alter nitric oxide synthase activities and signaling, how these perturbances lead to neural dysfunction and neuronal loss and how these changes might be prevented.
State the basis for the two therapeutic effects identified for melatonin: acute sleep promotion and circadian phase shifting.
Discuss the importance of using low-dose melatonin for causing circadian phase shifts and high-dose melatonin for acute sleep promotion.
Analyze the phase response curve for low-dose melatonin and how if administered in the morning it causes phase advances and in the afternoon/evening it causes phase delays.
Describe the methodological issues facing CAM researchers including the FDA and NIDA stage model, use of control groups, use of placebo controls and alternatives to placebo controls and research to identify mechanisms of action.
Discuss a systematic approach taken to developing and testing the use of mindfulness meditation for the treatment of psychophysiological insomnia.
Review findings on the efficacy of acupuncture on sleep in depressed pregnant women.
Identify the effects of yoga in chronic insomnia and its association with hyperarousals.
Explain the nature and severity of sleep disturbances in veterans with PTSD and other post-deployment psychological difficulties.
Describe available pharmacological and cognitive-behavioral treatments for sleep disturbances in PTSD.
Discuss how sleep disturbances may interfere with allostasis in those with PTSD.
Review the evidence and possible public health implications of the link between RLS/PLMS and renal failure.
Assess frequent psychiatric co-morbidities of RLS/PLMS such as anxiety, depression and ADHD and implications for treatment.
Explain how to determine appropriate initialization and data analysis parameters for wrist actigraphy.
Identify the appropriate clinical populations in which to utilize actigraphic estimation of sleep, wakefulness and activity.
Utilize actigraphic monitoring of sleep, wakefulness and activity levels in research protocols.
Summarize the controversy regarding the clinical importance of sleep apnea burden in geriatric patients.
Discuss the conflicting issues of treating sleep apnea in geriatric patients.
Summarize the literature pro and con regarding the importance of sleep apnea and the roles of treatment in geriatric patients.
Determine if there are recurring themes pertaining to recruitment and training of the various disciplines that serve as the pipelines for sleep medicine physicians.
Discuss challenges involved in the scholarship requirements for training within an ACGME fellowship program with a heavy clinical requirement and reflect on the implications for trainees.
Describe how to develop a culture of camaraderie among program directors, department chairs, clinical program leaders, national leadership, etc. who all have a vested interest in the growth and development of sleep medicine educational training programs.
Discuss current models of BSM implementation and services typically provided by behavioral sleep specialists.
Identify opportunities and challenges to implementing different BSM practice approaches.
Review challenges to applying efficacious research models to broader clinical populations.
Apply different approaches to practical and business aspects of building a BSM service, including marketing, referral and business development.
Review the concept of clinical equipoise with respect to CPAP randomization.
Discuss the ethical issues related to control groups for OSA trials.
Identify circumstances under which randomization to a control group may or may not be ethical.
Explain recent advances in understanding the complexities of the mammalian circadian system.
Discuss how mammalian circadian organization may influence sleep structure.
Discuss one method for deriving novel treatments that involves a multi-systems and mechanisms-focused framework.
Illustrate this approach as applied to chronic insomnia.
Illustrate this approach as applied to sleep disturbance in bipolar disorder.
Explore the neurobiology of sleep and wake.
Discuss how orexin/hypocretin neuropeptides promote wake.
Discuss how mouse models of narcolepsy shed light on narcolepsy in people.
Compare therapeutic alternatives in Restless Legs Syndrome and review a study of RLS in pregnancy.
Describe sleep and its effect on mortality and behavior in the elderly.
Explore neurophysiological mechanisms controlling sleep.
Discuss recent progress in understanding the association between the depth of sleep, arousal threshold and termination of sleep disordered breathing events in children with obstructive sleep apnea (OSA).
Identify potential mechanisms, clinical characteristics and possible implications of arousals.
List the consequences of basal forebrain lesions for cortical activation.
Identify the properties of different basal forebrain cell types.
Describe the roles basal forebrain neurons play in cortical activation and behavior.
Discuss the three unique interactions between sleep and legal implications.
Discuss electromyographic investigations of the upper airway in obstructive sleep apnea and mechanisms for airway collapse.
Compare and contrast behavioral and pharmacological treatments of insomnia.
Describe behavioral effects of sleep deprivation.
Describe the intimate relationship between sleep, sleep disorders and high blood pressure.
Discuss the relationship between sleep apnea, periodic limb movements, insomnia and poor sleep quality with high blood pressure.
Discuss how to manage patients with high blood pressure through identification of sleep disorders that raise blood pressure.
Explain the variability of sleep duration and quality between various species.
Describe the variation between humans in sleep duration and quality, and response to sleep deprivation.
Discuss these phenomena in the context of possible functions of sleep.
Explain the multitude of contexts and scenarios covered by the term “decision making”.
Discuss the behavioral effects of sleep deprivation and sleep restriction on various aspects of decision making.
Review the neural effects of sleep deprivation on various aspects of decision making as measured with functional magnetic resonance imaging (FMRI).
Review causes and consequences of obstructive sleep apnea as elucidated by epidemiological studies.
Evaluate sleep disturbance in patients with psychiatric disorders.
Evaluate sleep disturbance in patients with medical disorders and chronic pain syndromes.
Describe the complex relationship between epilepsy and sleep.
Discuss the clinical semiology, interictal / ictal EEG patterns of the epilepsy syndromes in children which occur predominantly out of sleep.
Differentiate nocturnal seizures in children from other causes of sleep-related arousals.
Assess the polysomnographic abnormalities seen in children with epilepsy.
Describe the impact of OSA on neurocognitive functions and the interplay between mood disturbances and OSA.
Discuss the relationship between Cerebrovascular disease and OSA.
Review the different brain areas affected by OSA.
Explore the cause and possible consequences of the condition of insomnia.
Explain how the brain deals with insomnia.
Discuss whether the brain compensates for insomnia, resulting in mostly unaffected behavioral performance, yet with subjective complaints of difficulties with daytime function.
Discuss whether intact performance is the result of a combination of baseline hyperarousal and attenuated brain activation resulting from disturbed sleep.
Detect the relationship between sleep variables and cognition.
Examine treatments for circadian rhythm sleep disorders and methods for altering normal circadian rhythms.
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