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Volume 07 No. 04
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Sleep Medicine News and Updates

Sleep Medicine News and Updates

ABSTRACT


































The American Academy of Sleep Medicine board of directors appreciates the participation of all AASM members who gathered in Minneapolis, Minn., to attend SLEEP 2011, the 25th Anniversary Meeting of the Associated Professional Sleep Societies (APSS). Special thanks are extended to the numerous members who contributed to the premier scientific meeting in the sleep field by chairing or speaking at a session or course, presenting new science, leading a membership section or lending their expertise. On Monday, June 13, 2011, the AASM hosted its General Membership Meeting to discuss recent and upcoming initiatives, and to honor young investigators in the field. To see snapshots from the meeting, visit the AASM's Facebook page and browse the SLEEP 2011 photo album at http://www.facebook.com/sleepmedicine.

Mark your calendar for June 9-13, 2012, and make plans to join the APSS for SLEEP 2012 at the John B. Hynes Veterans Memorial Convention Center in Boston, Mass. Located in Boston's Back Bay, the convention center puts you at the doorstep of one of the nation's most historic and vibrant cities. Don't miss the SLEEP annual meeting's first return to Beantown since 1994. Go to www.sleepmeeting.org throughout the year for news and updates about the meeting.


Attendees who registered and paid for continuing medical education (CME) or continuing education (CE) credits at SLEEP 2011 now have a limited time to claim your credits. Attendees who registered for CME credits for physicians, AANP CE contact hours for nurse practitioners, or a letter of attendance must go to www.sleepmeeting.org/credits and complete an online evaluation form on or before Oct. 3, 2011, at 4 p.m. CDT. Contact Meeting Coordinator Frances Brideson at 630-737-9700 or fbrideson@aasmnet.org if you have any questions.


View and discuss nearly 250 of the top scientific abstracts presented as posters at SLEEP 2011, the 25th Anniversary Meeting of the Associated Professional Sleep Societies LLC (APSS), through the SLEEP 2011 Online Poster Viewing Website at http://www.sleepmeeting.org/PosterViewing.aspx. Each poster on this site is viewable in PDF format, and a comments area allows for interactive discussion of the science presented at the meeting. Access to the online posters is FREE for AASM and Sleep Research Society (SRS) members who attended SLEEP 2011. All other individuals may purchase access to view the posters for $25, providing unlimited access to the site until Nov. 30, 2011.


During her term as 2011-2012 AASM president, Dr. Nancy Collop will be writing regular blog posts to keep members up to date on the latest initiatives and activities of the AASM. Her blog, “HypnoGram,” will provide updates from meetings of the AASM board of directors as well as her personal insights regarding the state of the sleep field. Read HypnoGram when you log in as a member on the AASM website at www.aasmnet.org.


Beginning with the June issues of SLEEP and the Journal of Clinical Sleep Medicine, all papers, letters, and commentaries published in both journals now have a unique Digital Object Identifier (DOI) assigned to them. A DOI number is a permanent identifier that enables you to quickly locate digital content. The DOI System makes it easy for you to find a study online when you enter the DOI number in a search on the CrossRef website.


The AASM has published two hardcover picture books that will delight children with details about how animals sleep and teach them about the importance of getting a good night's sleep. I See the Animals Sleeping: A Bedtime Story and The Animals Sleep: A Bedtime Book of Biomes both utilize colorful illustrations and rhythmic text to entertain children as they prepare for bed. Additional resources in each book include a Note to Parents that will help to educate adults about the importance of sleep for their children. The bedtime stories are available through the AASM Online Store at http://www.aasmnet.org/store/ as well as on Amazon.com.


The AASM launched Sleep Education, a new website for K-12 teachers at www.sleepeducation.com. The website contains free lesson plans, activities, assessment tools and presentations that teachers can download to bring sleep into the classroom. Lessons are categorized by grade level and available in a printer-friendly format, and each lesson plan is complete with learning objectives, procedures, assessments and differentiation techniques. These resources will help generate interest in the study of sleep medicine and raise awareness of sleep disorders among students.


With the launch of the AASM's new Sleep Education website for K-12 teachers, the AASM's public education website has moved to www.yoursleep.aasmnet.org. Your Sleep contains accurate, reliable and patient friendly information about sleep and sleep disorders from the AASM. The interactive discussion forum also gives people a place to ask questions, discuss sleep-related issues and share their own stories. Encourage your patients to visit Your Sleep today'


Order the full content of the AASM's Board Review for the Sleep Specialist course on a CD-ROM archive that includes MP3 audio files of the speaker presentations from the March 17–20, 2011, courses, as well as PDFs of all course PowerPoint presentations for review on your computer. The MP3 files included on this CD-ROM allow you to download files to your MP3 player, listen to presentations at your convenience through the use of audio bookmarking, and burn files to CD for use on-the-go.

The CD-ROM includes content from the AASM Board Review for the Sleep Specialist course as well as the two half-day companion courses: the AASM Intensive Scoring Review course and the SRS Basic Science of Sleep for the Sleep Specialist course. Over 25 hours of material' Order your copy today by going to the AASM Online Store at http://www.aasmnet.org/store/.


From 2007 through 2009, the AASM hosted several live, online webinar series covering topics related to the blueprint of the American Board of Medical Specialties (ABMS) sleep medicine certification exam. Several of these presentations have been remastered to improve audio quality and compatibility with the AASM Online Learning Modules, which allow members to stream multimedia presentations on demand from the AASM website. The presentations were led by experts in the field and are grouped into several series of related topics:

  • Board Review Study Sessions

  • Board Review for the Nonspecialist

  • Board Review Trouble Spots

  • Case-Based Board Review

The board review webinars are now available for purchase through the AASM Online Store at http://www.aasmnet.org/store/. Members may purchase the presentations for 3-day, 30-day or 1-year access.


Individuals interested in evaluating their sleep study scoring ability may now take advantage of a new resource available in the AASM Online Learning Center: 200-Epoch Scoring Reviews. These sets of 200 consecutive epochs from a clinical sleep recording (originally released through the AASM's online Inter-scorer Reliability Testing Program), allow the user to practice scoring sleep stage, arousals, limb movements and respiratory events. Each 200-Epoch Scoring Review will be available to users for six months and will offer the chance to earn up to 1.0 AMA PRA Category 1 Credit per record. This resource is ideal for physicians preparing to take the American Board of Medical Specialties (ABMS) sleep medicine certification exam, as the exam blueprint indicates that 20 percent of the exam will cover sleep study evaluation. For more information about this new resource, visit the AASM Online Learning Center.


Sleep Alertness and Fatigue Education in Residency (SAFER) has been revised by an AASM Task Force to ensure that it provides institutions with updated information to meet Accreditation Council for Graduate Medical Education (ACGME) standards for resident duty hours. Now available in a convenient self-study, multimedia format, the 25-minute, 2nd edition of SAFER is an essential tool for all teaching hospitals and institutions that wish to provide their staff with education about sleep deprivation in the health-care setting. SAFER is available in two formats: as an online learning module in the AASM Online Learning Center, allowing a single individual to view the presentation online, or as a site license for institutions that wish to have the presentation available for unlimited viewing by staff.


This fall, the AASM will host several educational courses at the AASM national office in Darien, Illinois (a suburb of Chicago). Registration is now open for these courses, and space is limited; with many courses expected to sell out as physicians prepare to take the November sleep medicine certification exam, be sure to register early to reserve your space and save on registration fees:

  • Interpreting Sleep Studies (Sept. 23–24 or Sept. 25–26)

  • Pharmacology and Sleep Medicine (Oct. 1–2)

  • A-STEP Introductory Course (Oct. 3-14)

  • Workshops in Sleep Medicine: Portable Monitoring (Oct. 15)

  • Workshops in Sleep Medicine: CPAP Adherence (Oct. 16)

  • Board Review Practice Exams (Oct. 29 or Oct. 30)

Get more information about these courses and register online at www.aasmnet.org/events.aspx.


In July, Oregon Governor John Kitzhaber signed into law Senate Bill 723 (SB 723), which directs the Oregon Health Licensing Agency (OHLA) to license sleep technologists beginning Jan. 1, 2012. The bill requires that an applicant for licensure complete educational and training requirements approved by a newly constructed Respiratory Therapist and Polysomnographic Technologist Licensing Board (“Board”) before obtaining a sleep technologist license. The Oregon Sleep Society (OSS), AASM, and American Association of Sleep Technologists (AAST) worked together closely on this bill, which received large bipartisan support. The AASM congratulates the OSS and all of our members in Oregon who contributed to this successful effort.


The new American Board of Sleep Medicine (ABSM) Sleep Technologist Registry Examination will be offered for the first time Nov. 11, 2011. All practicing sleep technologists who have passed the Board of Registered Polysomnographic Technologists (BRPT) examination prior to Dec. 31, 2011 - and are a Registered Polysomnographic Technologist (RPSGT) in good standing - are eligible to apply for equivalency status and receive the Registered Sleep Technologist (RST) certification by the ABSM. RPSGTs must submit an application for the Registered Sleep Technologist certificate to the ABSM before March 31, 2012. Get complete details on the ABSM website at www.absm.org/techcertification.aspx.


Each year the American Sleep Medicine Foundation (ASMF) provides research scientists with significant funding opportunities for sleep-related investigations, while also supporting the education and training of sleep scientists and sleep medicine specialists. The AASM congratulates the recipients of the 2011 ASMF grants:

  • Physician Scientist Training Award

    • Amy Amara, MD, PhD - University of Alabama at Birmingham

    • Jonathan Lipton, MD, PhD - Children's Hospital Boston

    • Roneil Malkani, MD - Northwestern University

  • ABSM Junior Faculty Award

    • Neomi Shah, MD, MPH - Montefiore Medical Center

  • Strategic Research Award

    • Marina Hinojosa-Kurtzberg, PhD - Biomedical Research & Education Foundation of Southern Arizona

    • Jan Polak, MD, PhD - Johns Hopkins University


This year the American Sleep Medicine Foundation (ASMF) introduced the Humanitarian Projects Awards, a new grant program to support projects that address sleep problems or sleep education needs in disadvantaged groups. The AASM congratulates the following organizations that are the recipients of the 2011 ASMF Humanitarian Projects Awards:

  • Case Western Reserve University: Improving the Sleep of Children Victimized by Violence

  • It's Your Life Foundation: NIGHTS (Nurturing and Inspiring Good Habits in Teen Sleep)

  • Sleeping Children Around the World: 2011/12 Bed Kit Distribution

  • Sweet Dreamzzz, Inc.: Early Childhood Sleep Program


The AASM congratulates the recipients of the 2011 Section Investigator Awards, which honor the most outstanding abstract from a young investigator within the membership of each section:

  • Childhood Sleep Disorders and Development: Alyssa Anne Cairns, PhD, RPSGT

  • Insomnia: Ting-hsu Chen, MD

  • Movement Disorders: Lynn Marie Trotti, MD

  • Narcolepsy: Miranda Lim, MD, PhD

  • Sleep Deprivation: Hengyi Rao, PhD

  • Sleep Related Breathing Disorders: Danny Eckert, PhD

The Circadian Rhythms and Parasomnias sections did not issue an award this year. The award recipients had an opportunity to present their abstract during their membership section meeting at SLEEP 2011 in Minneapolis, Minn.


The AASM congratulates the University of Washington Medicine Sleep Program, which was recently recognized as the sixth AASM Comprehensive Academic Sleep Program of Distinction. This program recognizes academic sleep programs that have demonstrated excellence though compliance with rigorous standards in the areas of clinical service, educational mission and research accomplishments. Learn more about the program on the AASM website.


Fellow status in the AASM is a unique honor that recognizes special competency in sleep medicine and significant contributions to the field. The AASM is pleased to welcome the following new Fellow Members:

  • Anita Bhola, MD

  • Ikshvanku A. Barot, MD

  • Chaudhry M. Ghumman, MD

  • Lance S. Patton, MD

  • Katherine M. Sharkey, MD, PhD

  • Pathmanathan Subakeesan, MD

  • Anwar Wassel, MD

If you are interested in becoming a Fellow member of the AASM, please review the requirements on the AASM website at http://www.aasmnet.org/Articles.aspx?id=292.

All required documentation should be submitted to aasmmembership@aasmnet.org.


The AASM submitted comments to the Department of Transportation's Federal Motor Carrier Safety Administration, addressing recently released studies relating to hours of service for drivers of commercial vehicles. The AASM noted that these new studies provide additional evidence to support the well-established scientific connection between hours of work and fatigue. The AASM noted, however, that the studies overlooked the clear evidence on the critical connection between circadian rhythm and sleep deprivation. The AASM called for drivers to also be educated on the contribution of circadian rhythms to sleepiness and available countermeasures.


The AASM submitted comments to the National Advisory Committee on Occupational Safety and Health (NACOSH) on the importance of effective sleep as a vital element in achieving the goal of developing and maintaining safe workplaces. The AASM urged NACOSH and its Subgroup on Injury and Illness Prevention Programs to take a serious look at the undisputed implications between fatigue and workplace safety. The AASM offered to work with the Occupational Safety and Health Administration (OSHA) and the Department of Labor in addressing sleepiness in workplace safety standards and implementing fatigue mitigation programs.


The AASM sent a memo to members to provide guidance regarding how to respond to the Comparative Billing Reports (CBRs), which were distributed by the Centers for Medicare & Medicaid Services (CMS) in May and June. On July 15, the AASM sent a letter to CMS and the CBR Producer outlining several concerns about how the CBR analysis was performed. As an additional resource, the AASM developed a template letter to assist members in drafting a response to the CBR Producer. Members interested in responding to the CBR are encouraged to send a personally modified version of the form letter or their own individually crafted letter to the CBR Producer. Complete details are available on the AASM website at www.aasmnet.org.


In July the Centers for Medicare & Medicaid Services (CMS) published the proposed rule for the proposed changes to policy and payment for the Physician Fee Schedule for 2012. If implemented, changes outlined in the proposed rule will significantly affect sleep physicians. One of the more significant proposed changes is the acceptance of a new measures set for sleep apnea in the Physician Quality Reporting System (PQRS) program. If approved in the final rule, the addition of these new quality measures will allow sleep physicians to participate in the PQRS program and potentially earn an incentive of 0.5 percent of allowable charges for successful participation.

A lingering concern from the 2011 final rule is the issue of the conversion factor, which helps determine payment for all physician services. The proposed rule estimates that, with the current formula CMS is legally mandated to use, the conversion factor will be $23.9635. This would be a cut of almost 30 percent. In the display copy of the proposed rule, CMS explains that it is working with Congress on a solution to the legally required reductions in the conversion factor.

Final decisions on the proposed policy and payment changes are scheduled to be published in November 2011 in the final rule.


The AASM sent a letter to CMS requesting that sleep specialists be exempt from the penalties associated with the 2012 Medicare Electronic Prescribing (eRx) Program. On June 1, CMS published a proposed rule outlining modifications to the program, which would give providers added opportunities to request exemption from the eRx Program. The AASM's letter outlines the potential difficulties that sleep specialists will run into when prescribing hypnotics and stimulants in states that do not allow these medications to be prescribed electronically. The letter also highlights that many durable medical equipment (DME) suppliers are not equipped to accept electronic prescriptions, thereby making it difficult for a sleep specialist to meet the minimum number of successful e-prescriptions necessary to avoid penalties.


The AASM submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule to establish standards for the operation of Accountable Care Organizations (ACOs), which create incentives for health-care providers to work together to treat an individual Medicare patient across care settings – including doctor's offices, hospitals, and long-term care facilities. The AASM strongly urged CMS to amend the proposal to include sleep-focused quality reporting measures, which would be consistent with proposed measures on prevention, care of chronic illness, and treatment of high prevalence conditions. The AASM submitted several sleep-related quality measures for CMS to consider incorporating in the ACO Quality Performance Standards.


The Institute of Medicine of the National Academies (IOM) released a new consensus report, “Early Childhood Obesity Prevention Policies.” The IOM reviewed factors related to overweight and obesity from birth to age 5, recommending actions that health-care professionals, caregivers and policymakers can take to prevent obesity in young children. In addition to recommending an increase in physical activity and the promotion of healthy eating, the IOM also made two recommendations related to sleep:

  • “Child care regulatory agencies should require child care providers to adopt practices that promote age-appropriate sleep durations.”

  • “Health and education professionals should be trained in how to counsel parents about their children's age-appropriate sleep durations.”

The IOM also provided four sleep-related potential actions including, “seeking consultation yearly from an expert on healthy sleep durations and practices.”


The white paper, “Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety,” was published in the open-access, online journal Nature and Science of Sleep. The paper was the product of a conference that took place at Harvard Medical School in June 2010. The co-authors, including sleep scientists Dr. Charles Czeisler and Dr. Christopher Landrigan, compare the recommendations made by the Institute of Medicine in a report on resident duty hours with the new standards that were implemented by the Accreditation Council for Graduate Medical Education (ACGME) beginning July 1, 2011. They conclude that the ACGME standards “stop considerably short” of the IOM recommendations, and they offer guidance to help policymakers, hospital administrators, and residency program directors implement safer work hours for resident physicians.


The National Heart, Lung, and Blood Institute (NHLBI) released an executive summary of the 2011 NHLBI Bariatric Surgery Workshop that was held in January. Experts in bariatric surgery, cardiovascular disease, sleep disordered breathing, clinical trials, guideline development, and insurance coverage identified patients at high risk for cardiovascular disease as a priority population for clinical trials in bariatric surgery, while also identifying patients with sleep disordered breathing as an important sub-population to include. The workshop group also determined that shorter length trials should focus on recognized surrogate or intermediate markers such as changes in sleep disordered breathing as measured by the apnea-hypopnea index.


At the June 15, 2011, meeting of the National Heart, Lung, and Blood Advisory Council (NHLBAC), NHLBI staff presented 15 new initiatives that had been reviewed in May by the Board of External Experts (BEE). One of the proposed initiatives was a Mentored Scientific and Career Enhancement Award in Sleep and Circadian Health and Biology (K18), which would improve the capacity of established investigators to develop trans-disciplinary research programs that integrate the latest concepts in sleep and circadian biology.

The Council was mostly supportive of the initiatives presented, but made a number of specific recommendations for consideration prior to their release. NHLBI Acting Director Dr. Susan Shurin will consider the recommendations of the BEE and the NHLBAC, as well as other budgetary and programmatic issues, in determining which of the proposed initiatives to implement.


The National Institutes of Health (NIH) issued a funding opportunity announcement (PAR-11-242) to encourage research project grant (R01) applications to improve the design, implementation and effectiveness of preventive interventions for sudden infant death syndrome (SIDS) and unintentional injury infant deaths associated with the sleep environment. The application due dates are Sept. 13, 2011, 2012 and 2013.

The National Heart, Lung, and Blood Institute (NHLBI) issued two program announcements and two requests for applications related to Virtual Reality Technologies for Research and Education in Obesity and Diabetes: a research project grant (PA-11-211), an exploratory and developmental research grant award (PA-11-212), a small business innovation research grant (RFA-HL-12-020) and a small business technology transfer grant (RFA-HL-12-024). The announcements note that VR technology presents new opportunities to apply recent advances in sleep research in relation to obesity and diabetes risk by objectively evaluating individual sleep and alertness status, delivering personalized guidance on healthy sleep behaviors, implementing physician-recommended treatments, and assessing treatment outcomes in terms of changes in sleepiness, psycho-motor vigilance, and ocular markers of sympathetic tone.

Get complete details about these grant opportunities on the NIH website at www.grants.nih.gov.