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APSS - Sleep 2016
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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.
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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?
If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain in detail (e.g. session title, speaker name, situtation):
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.
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
Improve clinical care and outcomes as a result of application on this knowledge in the clinical setting
Describe current and future trends that will affect the practice of sleep medicine and review new models of care that may help practitioners adapt to these changes
Determine best approaches for patients with sleep disordered breathing in the preoperative and hospital settings
Identify treatment options for the management of central sleep apnea syndromes
Review current and emerging technologies that will be used to manage patients with sleep complaints and disorders in the ambulatory setting
Understand the evidence supporting the use of behavioral sleep medicine strategies for a range of sleep disorders commonly encountered in sleep medicine practice
Develop skills in behavioral sleep medicine therapies for a range of sleep problems
Recognize emerging opportunities for behavioral sleep medicine practice in the sleep medicine arena
List clinical presentation and diagnostic requirements for major sleep disorders in pediatrics
State the best up-to-date therapeutic protocols for pediatric sleep disorders
Explain the impact of sleep disorders in neuropsychiatric developmental disorders and be instructed on assessment tools and nighttime therapy to be offered
Identify early onset of RLS augmentation
Use new guidelines for initial RLS treatment and for use of alpha-2-delta agents vs. dopamine agonists
Use new guidelines for managing RLS augmentation including How to change or discontinue dopaminergic treatment
Summarize new options for opioid treatments of RLS
List new options for IV iron treatments of RLS
Explain the underlying neurobiology of sleep disturbances in the setting of dementia associated with amyloidopathies and alpha synucleinopathies
Review the mechanism by which sleep disturbances may contribute to cerebrovascular disease and seizures
List techniques that may be utilized when addressing sleep problems in patients with dementia, REM sleep behavior disorder, epilepsy, stroke, and gain familiarity with innovative management strategies
Describe new approaches to managing circadian rhythms disorders and hypersomnias
Identify best practices and areas of controversy in the treatment of the spectrum of sleep disordered breathing in both adults and children
Apply best practice recommendations for the management of patients with insomnia, parasomnias and restless legs syndrome
Explain the rationale, advantages and steps for bringing a positive airway pressure (PAP) management program into the sleep practice
Explain how to maximize adherence with PAP therapy and implement a compliance management system
Describe the different mechanisms of action of autotitrating PAP devices and recognize the role of these devices in a PAP management program
Identify the clinical features of the six major circadian rhythm sleep-wake disorders defined by the ICSD-3
Explain the interpretation of sleep diaries, wrist actigraphy, and measures of circadian phase derived from melatonin secretion
Summarize evidence from the 2015 American Academy of Sleep Medicine (AASM) Clinical Practice Guidelines that supports treatment strategies for circadian rhythm sleep-wake disorders
Discuss the treatment of circadian rhythm sleep-wake disorders in special populations
Identify the key components and goals of clinical trials in sleep medicine
Describe common challenges associated with clinical trials and determine strategies to manage these obstacles
Recognize and discuss the use of information technology (e.g., electronic health records) in clinical trials
Generate a comprehensive framework for the effective design and conduct of high quality clinical trials in sleep medicine
Understand the basic principles underlying actigraphy and be able to evaluate actigraphic devices
Implement actigraphy in their clinical sleep disorders clinical practice or research
List the strengths and weaknesses of actigraphy across a number of applications
Identify the strengths, weaknesses, and applications of various “fitness/sleep trackers” on the market and how to make use of these data in clinic
Analyze the relationship between sleep disorders and related medical specialties, including cardiology, pulmonary medicine, neurology and psychiatry
Explain how to focus Sleep Medicine specialists on the need to build bridges with related medical specialties to ensure a healthy clinical practice
Describe measurement tools to assess a variety of constructs in pediatric sleep
Discuss the pros and cons of several subjective and objective measures of sleep
List available treatment options and management plans for complicated sleep-related breathing disorders
Discuss diagnostic criteria, differential diagnosis, pathophysiology, evidenced based therapy, and future risk of degenerative disorders for parasomnias and other sleep-related movement disorders
Discuss how sleep disorders in athletes can be best identified, evaluated, and treated, and how this can affect athletic performance
Explain the underlying neuro-affective mechanisms of sleep loss, various forms of disordered sleep in psychiatric illnesses
Identify how low quality and quantity sleep can negatively impact mental health
Explain how high quality and quantity sleep can positively impact mental health
Describe how sleep factors may aid in prognosticating treatment response and psychiatric disease course and severity
Describe how sleep loss impacts learning and memory consolidation as well as interventions to prevent or reverse these effects
Review the profound molecular repercussions of both disrupted sleep and circadian misalignment which are likely to underlie their adverse health consequences
Discuss the construct of stress-reactivity as a risk factor for insomnia
Review the impact of stress and its different manifestations in the genesis of insomnia
Examine the relationships between stress and hyperarousal in insomnia
Name the latest advances in the application of genetic and genomic approaches to sleep and sleep disorders
Review the influence of light on the circadian clock
Discuss how and when you eat affects metabolic health
Describe multiple positive and negative emotional processes and how they are altered by sleep loss, and that these changes are related to sleep neurophysiology
Discuss how sleep disturbance-induced changes in behavioral and neural emotional processes are relevant for psychiatric disorders of emotional dysregulation.
Explain the discovery of the third photoreceptor of the eye
Describe how this relates to sleep and circadian rhythms
Discuss how eye disease and sleep disruption and circadian rhythms are related
Review and synthesize the evidence suggesting that OSA patients have an increased cardiovascular risk that is independent of their co-morbidity
Explain how (a) activation of Angiotensin II Type 1a Receptors (AT1Ra) (b) generation of oxidative stress and (c) initiation of the inflammatory cascade are involved in the mechanism of the increased cardiovascular risk observed in OSA
Describe how compliant and effective PAP therapy can affect the mechanisms listed above and how to maximize the physiological benefit of PAP
Identify the potential for supplemental and adjunctive therapies in tandem with PAP to reduce cardiovascular risk in OSA
Summarize the evidence for new behavioral and pharmacological treatments of insomnia
Review the latest research and development on strategies to manage patients and hypersomnia
Discuss association between sleep duration and quality of life in children
Interpret a body of information from an expert in the field of microbiology about the gut microbiome and it’s role in health and wellbeing
Summarize the pathway linking stress (and by extension, insufficient sleep) with disruption to the gut microbiome
Identify the real-world implications of managing a stable gut microbiome for individuals in social and occupational settings where insufficient sleep is common
Identify multiple future research avenues to further enhance the novel sleep-gut-health avenue of inquiry
Discuss associations between sleep and cognition, emotion, and behavior
Describe the importance of health services research in sleep medicine
Identify areas in health services and implementation science that are important
Compare the controversies in this area
Identify the most common trajectories of insomnia and moderators of its long-term course
Summarize long-term consequences of chronic insomnia
Describe the best treatment algorithms for managing insomnia
Discuss clinical and translational research on sleep and chronic neurological/neurodegenerative disease
Review gender differences in sleep and sleep health
Explain the diverse effects of sleep upon disease
Summarize interactions between sleep, circadian rhythms and metabolic physiology in animal models and humans
Identify the most pressing healthcare system challenges that threaten sleep medicine
Describe several initiatives that the AASM could take, to improve the value a sleep physician can offer, increase the numbers of trainees who choose this career path, and grow access to high-quality, patient-centered care for people with sleep disorders
Debate about several competing visions for where sleep medicine is headed, where it should be headed, and how the AASM can help steer this evolution toward a goal that will best serve both your practice and your patients
Describe the latest advancements in manipulation of the timing of the circadian clock
Review the clinical application of novel mechanisms of treating circadian-based sleep disorders
Discuss the diagnostic and treatment challenges presented by comorbid sleep apnea, mood disorders, and circadian rhythm disorders in the patient with hypersomnolence
Compare emerging treatment strategies for hypersomnolence
Discuss indications and realistic goals for sleep apnea surgery
Discuss the wide array of surgical treatments available in the treatment of sleep apnea
Demonstrate understanding of evidence in support of the roles of surgery for sleep apnea
Describe the basic mechanisms of translational control affected by the circadian clock, sleep and sleep deprivation
Describe how altered cellular metabolic pathways due to sleep deprivation may contribute to human disease
Identify how stress impacts sleep and translational control
Review the relationships between circadian factors, sleep and athletic performance
Develop research projects to explore sleep intervention as potential performance enhancing tool
Implement various sleep and performance consulting strategies for Professional, Olympic, and Collegiate teams
Identify the relative efficacy and important role CBTI has in insomnia management
Review CBTI's impact on comorbid syndromes
Discuss remaining challenges and opportunities for improving our CBTI approaches
Review the relationship between circadian disturbances, cancer risk and survival
Discuss the effect of circadian rhythm on the expression of the human genome
Review the potential opportunity for pharmacological and non-pharmacological circadian intervention in patients with cancer
Summarize the novel and improved treatments for OSA and CSA
List the value of video and electro-clinical correlation in the evaluation of abnormal sleep-related behaviors and motor activity
Compare the key features which best differentiate sleep-related seizures, NREM parasomnias, REM Behavior Disorder, arousals and other physiological events
Explain how the diagnostic accuracy of recordings in patients with sleep-related behaviors and motor activity is enhanced by through examiner interviews, high quality video and tailored electrographic-polysomnographic monitoring
Identify the utility of mobile recording methods in the evaluation and treatment of patients with sleep-related seizures and parasomnias including commercially available light- or motion-activated video-surveillance devices
Review the basal forebrain micro-circuitry and cell-types involved in control of cortical activation
Describe the wake-promoting role of VTA dopaminergic neurons controlling goal-directed behavior
Discuss environmental noise’s effects on sleep in adults and children and what health consequences can be expected, both immediate and long-term
Describe how noise exposure affects patients' sleep in the hospital and what can be done to minimize this problem
Review guidelines and legislation that are in place to protect people from unacceptable levels of nocturnal noise exposure and will learn about areas in need of further improvement
Review the economic benefits of OSA treatment for employers
List the economic benefit of OSA treatment for payors
Identify the economic benefits of OSA treatment for patients
Describe the impacts of circadian rhythm misalignment on health, safety and performance outcomes
Review the diverse industry, government and academic stakeholders required for research to make a significant impact, and potential funding models to support collaborative research
Discuss the Alertness CRC and its primary outputs
Describe the cause-effect relationship between poor sleep and major health and safety outcomes in adolescence and will understand the potential impact of early identification and treatment of sleep problems
Identify stakeholder preferences for the format and outcomes of a sleep-focused intervention program for adolescents, and potential facilitators and barriers to intervention program adherence
Describe the latest circadian rhythm studies that have examined the phase-dependent responses to bright light in adolescents to shift rhythms, and incorporate these findings into clinical treatment
List strategies for tailoring standard behavioral sleep treatment to suit the developmental and affective profiles of anxious adolescents
Discuss new findings in the field of OSA diagnosis and epidemiology
Review neurophysiological and neurochemical mechanisms leading to hyperarousal in RLS
Describe the contribution of brain imaging studies to the understanding of hyperarousal circuitry
Discuss the future treatment implications of hyperarousal in RLS
Define "sleep telemedicine" and related telemedical terminology
Identify key financial, technological, privacy and security considerations for sleep telemedicine programs
Develop a sleep telemedicine implementation plan for your practice setting
Illustrate tools and processes the AASM has to assist in the process including guidelines and tools
Explain the physiological brain and body responses to sleep loss
Review the physiological brain and body responses to sleep loss
Discuss current understanding of prevalence, risk factors, consequences, management and outcomes for SDB in youth
Describe the major findings from the CHAT study that inform clinical practice and questions that remain unanswered
Identify quality improvement opportunities for care of SDB in youth that will impact the future practice of sleep medicine
Explain the brain pathways that control sleep and wake
State the neural mechanisms that give rise to sleepiness and cataplexy in narcolepsy
Tell how these neural pathways provide a framework for understanding current and future narcolepsy therapies
Discuss the importance of circadian rhythms in disease processes and how to assess circadian rhythms
Describe new findings in the epidemiology and diagnosis of insomnia
Explain the delivery of sleep medicine treatments
Describe associations between sleep and performance, social functioning, and the gut across the lifespan
Review the necessary role of physician-scientists
Describe the data showing the decline in the number of individuals entering the biomedical research workforce as physician-scientists
Compare the strategies being adopted to address this issue
Review an ideal Sleep Health IT framework - components include the electronic health record (HER)
Discuss Sleep monitoring technologies and how to utilize that data
Describe PRO initiatives at the individual and population based levels
Review the principle of electrical stimulation of the upper airway for the treatment of OSA
Discuss the theory and impact of transcutaneous electrical stimulation as a treatment for restless legs syndrome
Review the longitudinal outcomes associated with upper airway electrical stimulation
Review the bidirectional relationship between sleep and a number of conditions including headache syndromes, cancer, traumatic brain injury and ICU stay
Explain the interactions of common pain medication on sleep and sleep disorders
Discuss the data on management strategies for sleep disorders in these pain inducing conditions
Explain how specific electrophysiological events support the enhancement of memory formation
Describe discrepancies and similarities across human and animal studies in the field
Identify open questions for future research
Identify how physiological factors such as homeostatic time constants and intrinsic circadian period modify the timing of sleep and the timing of self-selected light exposure
Compare the relative importance of environmental vs. physiological factors in the delayed timing of sleep across adolescence
Explain the rationale and measures for evaluating PROs developed by the American Academy of Sleep Medicine for OSA
Explain the process of implementing an electronic PROs system and its integration with electronic medical record
Explain the data on cutting edge science pertaining to PROs from studies of adults with OSA being treated with PAP or surgery, partners of OSA patients, and children with insomnia
Explain new findings in the pathophysiology of insomnia
Identify mechanisms of sleep and circadian disruption in psychiatric conditions
Apply best practices on recognizing which patients are most likely to present with sleep disordered breathing in the hospital setting
Explain the prevalence of adverse events related to sleep disordered breathing in the hospitalized patient
State new findings on how sleep deprivation impacts the brain, behavior and health
Review the mechanisms through which the circadian system and sleep regulate neuroinflammation
Discuss the effects of circadian and sleep disruption on neuroinflammatory disorders
Identify environmental factors that contribute to circadian and sleep disruption
Apply knowledge gained about circadian rhythms to improve experimental design and therapeutic intervention
Discuss new methods of analyzing polysomnography that are alternatives or advancements to traditional sleep staging and power-spectral analysis
Identify the strengths and weaknesses of traditional and new methods of analysis
Examine new data that has been obtained as a result of these new methods
Describe new methods of analysis and identify potential applications for these approaches
Explain the need to identify and treat pediatric sleep apnea
Describe the impact of stress and trauma on sleep
Identify differences in the clinical phenotypes of overlap syndrome and obesity hypoventilation syndrome
Identify benefits and limitations of type 3 devices vs. laboratory based PSG studies in hypercapnic sleep disorders
Differentiate the NIV treatment approach between overlap syndrome and obesity hypoventilation syndrome
Apply long term treatment goals and outcomes with NIV/PAP therapy in overlap syndrome and obesity hypoventilation syndrome
Describe new techniques for measuring circadian rhythms in humans
Define evidence-based treatment strategies for circadian rhythm sleep-wake disorders
Demonstrate applications for circadian biology in precision medicine extending beyond the realm of sleep/circadian disorders
Review the sleep of hunter-gatherers, living in the environment in which humans evolved
Compare and contract the sleep or hunter-gatherers with “modern” sleep and the relevance of understanding the evolution of sleep for treating sleep pathologies
Discuss the impact of female sleep disorders on women’s’ physical and mental health
Discuss the interaction of circadian rhythms and disease
Explain the complex interactions between sleep and cardiovascular and CNS disease
Review the delivery of sleep medicine treatments in OSA
Determine the role of sleep processes in sleep and aging
Discuss the sleep environment and sleep
Identify critical factors affecting sleep inertia and arousal
Review existing studies on sleep duration in pediatric populations
Discuss new recommendations provided by the consensus panel
Review the latest human research on RLS and other movement disorders of sleep
Review the interactions of OSA on other body systems and disease states
Describe how quantitative sleep parameters are useful for diagnosing insomnia phenotypes
Discuss how insomnia phenotypes react differently to treatments
Characterize some new aspects of sleep neurobiology
Describe chronotype and sleep timing in different racial/ethnic groups
Review the integration of chronotype and sleep timing and the association with measures of health
Describe the heritability of chronotype and the association between chronotype and genetic racial ancestry.
Describe how chronotype and sleep timing may play a role in racial/ethnic health disparities
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?

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