Thursday, June 12, 2008

SLEEP 2008 Concludes

The final oral presentations of the day brought SLEEP 2008 to a conclusion at the Baltimore Convention Center in Baltimore, Md.

The SLEEP 2009 23rd Annual Meeting of the Associated Professional Sleep Societies is scheduled for June 6 to 11, 2009, in Seattle, Wash.

Teens Benefit from Delayed School Start Time

A study (ID# 1118) from Israel that is being presented as an oral presentation this morning at SLEEP 2008 shows that teens may have improved attention and concentration when their school start time is delayed.

The study involved 47 eighth-grade students from two classes. A control group began school at the regular time (7:30 a.m.) each day for two weeks. The experimental group began the schoolday one hour later (8:30 a.m.) during week one and then at the usual time during week two.

During the first week, students in the experimental group woke up an average of 51 minutes later each morning than students in the control group. Bedtime remained the same.

The experimental group performed better than the control group on two cognitive tests that were performed on the fifth day of the first week. They had a better overall attention score on a computerized test and made fewer mistakes on a paper-and-pencil test.

According to the American Academy of Sleep Medicine, teens need a little more than nine hours of sleep each night to be alert the next day.

The SLEEP 2008 abstract book is available online at
http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

REM Sleep, Short Sleep Duration & Child Obesity

A study from the University of Pittsburgh (ID# 0195) that is being presented as an oral presentation this morning at SLEEP 2008 takes a deeper look at the relationship between short sleep duration and obesity. The study concludes that a core aspect of this association may be reduced amounts of rapid eye movement (REM) sleep.

The study involved 335 children and teens between the ages of seven and 17 years. Sleep was measured by polysomnography for three consecutive nights. Compared with normal-weight children, overweight children slept about 22 minutes less per night.

Overweight children also had shorter REM sleep periods, lower REM activity and density, and longer latency to the first REM period. After adjusting for other factors, one hour less of REM sleep increased the risk of being overweight by about three times, while one hour less of total sleep increased the odds of overweight by about two times.

According to the American Academy of Sleep Medicine, the complex process of sleep involves multiple stages that make up a sleep cycle. Most adults will go through four to six cycles in a full night of sleep. REM sleep tends to be the final stage of the sleep cycle in normal adult sleep.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Sleep and Suicide in Children and Teens

Two studies being presented as oral presentation this morning at SLEEP 2008 address the relationship between sleep and suicidal behavior in children.

A study (ID# 0194) of 450 boys and 348 girls examined how children may be affected when a parent has a history of chronic insomnia. The children in the study had an average age of 14.4 years.

Teens with a parental history of chronic insomnia were much more likely to report having suicidal thoughts than teens without a parental history of insomnia (16.7% vs. 5.3%); they also were more likely to have a suicide plan (9.5% vs. 1.5%) and to have attempted suicide (9.5% vs. 1.7%).

Another study (ID# 0180) involved 303 children and teens with bipolar disorder and unipolar disorder during depressive episodes. The children in the study had an average age of 12.8 years.

Results show that 83.8 percent of the children had sleep disturbances. The presence of sleep complaints showed a significant association with suicidal behavior. Children with bipolar disorder were more likely than children with unipolar disorder to report suicidal behaviors with sleep complaints, classified as suicidal thoughts (58% vs. 35.6%), desire to die (58% vs. 31.5%), suicide plans (55.5% vs. 22.3%), and suicide attempt (40.7% vs. 19.8%).

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Higher Blood Pressure in Children with Breathing Problems during Sleep

A study (ID# 0187) being presented as an oral presentation this morning at SLEEP 2008 shows that sleep disordered breathing of any level of severity is associated with increased levels of blood pressure in children.

The Australian study involved 88 children between the ages of seven and 13 years. Twenty of these children were non-snoring controls who were recruited from the community.

Mean arterial pressure (MAP) was lower in the control group both before falling asleep and during sleep. MAP was elevated during sleep in children with either primary snoring, mild obstructive sleep apnea (OSA), or moderate to severe OSA.

More information about obstructive sleep apnea in children is available from the American Academy of Sleep Medicine at http://www.sleepeducation.com/Disorder.aspx?id=71.

Wednesday, June 11, 2008

Day Three of SLEEP 2008 Comes to a Close

The scientific program for the third day of SLEEP 2008 concluded with the final symposia and oral presentations of the day.

Some American Academy of Sleep Medicine
section members are finishing up their section meetings.

The final day of the scientific program on Thursday will consist of symposia and oral presentations lasting from 8 a.m. to 12:15 p.m. The SLEEP 2008 exhibit hall closed this afternoon and will not be open on Thursday.

Insomnia Linked to Increased Risk of High Blood Pressure

“The medical impact of chronic insomnia has been underestimated,” said researcher Alexandros Vgontzas at the conclusion of his oral presentation this afternoon at SLEEP 2008.

In a study (ID# 685) of 1,741 men and women from Central Pennsylvania, Vgontzas and colleagues found that having
insomnia and a short sleep duration of less than or equal to five hours increased the risk of high blood pressure by five times. Having insomnia and sleeping for five to six hours made individuals three times more likely to have high blood pressure. Without a complaint of insomnia, short sleep duration of less than or equal to five hours increased the risk of high blood pressure by only 1.5 times.

Sleep time was recorded during one night in a sleep laboratory. “Insomnia” was defined as a complaint of insomnia for more than or equal to one year.

Vgontzas, of Hershey Medical Center in Hershey, Pa., indicated that these results show that insomnia with a short sleep duration may raise the risk of high blood pressure at a rate that is similar to
obstructive sleep apnea.

The SLEEP 2008 abstract book is available online at
http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Symposium Examines Causes of Drowsy Driving

A symposium taking place this afternoon at SLEEP 2008 is examining the contributing factors related to drowsy driving. Co-chairs Dr. Naomi Rodgers and Dr. Kenneth Wright Jr., along with a faculty of experts, are presenting the latest information.

According to the
U. S. National Highway Traffic Safety Administration, drowsy driving is a cause of at least 100,000 auto crashes each year. These crashes injure an average of 40,000 people and result in more than 1,550 deaths; the NHTSA suggests that the actual numbers are much higher.

Drowsy-driving crashes tend to occur late at night, are likely to be serious, often involve a single vehicle leaving the roadway, and tend to involve a driver who is alone in the vehicle. In addition to veering off the road, drowsy drivers are likely to wander into another lane or steer into oncoming traffic.

Sleep loss is an obvious factor in drowsy driving. Studies show that sleep deprivation impairs drivers in a manner that is comparable to alcohol, causing lapses in attention and slowing critical reaction times.

Other factors such as late or irregular
work shifts, poor sleep habits and untreated sleep disorders such as obstructive sleep apnea and narcolepsy can combine to make anyone vulnerable to drowsy driving. Young men in their teens and 20s are more likely to be involved in a drowsy-driving crash.

According to the American Academy of Sleep Medicine, tips to avoid drowsy driving include getting a full night of sleep before a long drive and pulling off the road to take a nap if you begin to feel sleepy.

Lecturer Discusses Restless Legs Syndrome

This afternoon at SLEEP 2008, invited lecturer Dr. Christopher Earley is giving a presentation entitled, “Restless Legs Syndrome: From the Bed to the Bench and Back Again.” Earley will review the current understanding of RLS and discuss areas of potential for future research.

Earley is associate professor of neurology and associate director of the
Sleep Disorders Center at Johns Hopkins School of Medicine. For more than 15 years his research has focused on RLS.

In 2007
new studies added to the research that is cracking the complex genetic code behind RLS. According to the American Academy of Sleep Medicine, iron, dopamine and genetics appear to be the primary factors in the development of RLS.

RLS involves a strong, almost irresistible urge to move the legs that worsens at night and disturbs your ability to fall asleep or remain asleep. It occurs more often in women than in men.

Snack Attack: Short Sleep Promotes an Increase in Snacking

A study (ID# 0355) being presented as a poster presentation this afternoon at SLEEP 2008 shows that people who restrict their sleep are likely to increase the amount of snacks they eat. The authors conclude that this behavior may contribute to the increased risk of weight gain and obesity associated with short sleep hours.

The study involved 11 healthy volunteers with an average age of 39 years. Caloric intake was monitored for 14 days when sleep was restricted to 5.5 hours in bed each night, and for 14 days of 8.5 hours in bed each night.

Results show that meal intake remained similar in the two conditions, but subjects consumed more energy from snacks during the period of sleep restriction. The carbohydrate content of snacks also increased during restricted sleep.

Energy expenditure was comparable during the two sleep conditions, as were the levels of leptin and ghrelin, two hormones involved in appetite regulation.

According to the
American Academy of Sleep Medicine, most adults need about seven to eight hours of sleep each night.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Internet, Aerobic Exercise May Help People with Insomnia

Two studies being presented as poster presentations this morning at SLEEP 2008 offer hope to those who suffer from insomnia.

A study (ID# 0716) of 44 participants shows that a self-help program delivered via the Internet can significantly improve insomnia in adults. Individuals in the study group had an average age of 45 years, and 77 percent were women.

Participants reported having an average of five nights per week of sleep difficulties for about 10 years. The study involved a six-week, structured, interactive, self-guided, and tailored intervention that took traditional face-to-face
cognitive behavioral therapy and transformed it for delivery via the Internet.

Results show that sleep improved significantly over the six-week period. Sleep efficiency (i.e., the percentage of time in bed spent sleeping) improved from 66 percent to 88 percent. The average nightly total sleep time of the participants increased by 80 minutes.

Another study (ID# 0737) of 36 adults with chronic primary insomnia suggests that moderate aerobic exercise can help people with insomnia get some sleep.

The study involved 28 women and 8 men with an average age of 44 years. Results show that a 50-minute session of moderate aerobic exercise on a treadmill improved numerous measures of sleep quality. It decreased sleep onset latency (i.e., the amount of time it takes to fall asleep) by 54 percent and decreased wake time in bed by 36 percent after the exercise session.

The session of moderate aerobic exercise, which began at 6 p.m., also increased total sleep time by 21 percent and increased sleep efficiency by 18 percent.

Similar results were not achieved with either heavy aerobic exercise or moderate strength exercise. Heavy aerobic exercise involved three periods of 10 minutes of exercise on a treadmill alternating with 10 minutes of rest. Strength exercise lasted about 50 minutes and involved: shoulder press, chest press, vertical traction, leg press, leg curl, leg extension, abdominal crunch and lower back.

The SLEEP 2008 abstract book is available online at
http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Children Who Snore Have Higher Heart Rates

A study (ID# 0253) being presented as a poster presentation this morning at SLEEP 2008 shows that snoring has a significant impact on the cardiovascular functioning of children during sleep.

The study involved 40 children with an average age of 8 years. Children with severe
obstructive sleep apnea (OSA) had the highest average heart rate of 92 beats per minute (bpm). Children with primary snoring had an average heart rate of 82 bpm, which was higher than children with moderate OSA (76 bpm) and children with mild OSA (74 bpm). The heart rate of matched controls was 71 bpm.

The abstract authors conclude that these results challenge the notion that snoring is harmless.

According to the
American Academy of Sleep Medicine, the incidence of snoring in children is reported to be 10 percent to 12 percent.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Is Sleep the Secret to Successful Aging for Women?

A study (ID# 0305) being presented as a poster presentation this morning at SLEEP 2008 reinforces the importance of normal sleep for the healthy aging of women.

The study involved 2,226 women who were 60 years of age or older. Nearly 21 percent of the women were determined to be “successful agers.” Measures of successful aging included independent living, active engagement with life, life satisfaction and well-being, freedom from disability and the absence of physical disease.

Women who reported less sleep disturbance on an
insomnia rating scale were more likely to be successful agers. Successful aging was best predicted by less daytime napping and fewer complaints of sleep maintenance insomnia (i.e., when awakenings occur during the night).

An increased severity of sleep disturbance predicted lower self-ratings of “successful aging” and a greater difference between perceived and actual age.

According to the
American Academy of Sleep Medicine, women tend to describe sleep problems using different terms than men. Women may be less likely to say that they feel sleepy during the day. Instead women often describe feeling tired, unrested or fatigued. They also may report an overall lack of energy or vitality.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Workshop Looks Back at Historic 2007 Certification Exam

A workshop taking place this morning at SLEEP 2008 is taking a look back at the historic certification examination in sleep medicine that was administered by member boards of the American Board of Medical Specialties in November 2007.

Although certification for
sleep specialists has been available for more than 25 years, this was the first time that the exam was administered under the umbrella of the ABMS. The exam was offered by the American Board of Internal Medicine, the American Board of Psychiatry and Neurology, the American Board of Pediatrics, the American Board of Family Medicine and the American Board of Otolaryngology. The exam will continue to be offered every two years.

The workshop chair is
Dr. Stuart Quan, who will review both the development of the exam content and the results from the 2007 exam.

The
American Academy of Sleep Medicine administered a certification examination in sleep medicine from 1978 to 1990, giving specialists in sleep medicine an opportunity to prove their expertise in the diagnosis and treatment of patients with sleep disorders.

The AASM then voted to create the independent American Board of Sleep Medicine, and the ABSM assumed responsibility for the exam from 1991 to 2006.

Child Sleep Patterns around the World

A study (ID# 0185) being presented as an oral presentation this morning at SLEEP 2008 compares the sleep patterns of young children from 12 different countries. Results are based on questionnaires completed by the parents of 21,273 infants and toddlers from zero to 36 months of age.

The study indicates that young children in predominately Caucasian countries have earlier bedtimes and obtain more overall sleep than young children in predominately Asian countries. No differences were found in night wakings or napping behaviors.

Children in New Zealand went to bed the earliest with an average bedtime of 7:16 p.m. Children in Hong Kong went to bed the latest with an average bedtime of 10:10 p.m. U.S. children had an average bedtime of 8:52 p.m.

Japanese children had the lowest total sleep time (i.e., nightly sleep plus daytime naps) of 11.6 hours of sleep per day. Children in New Zealand had the highest total sleep time of 13.3 hours of sleep. U.S. children averaged 12.9 hours of total sleep time per day.

Seventy-six percent of Chinese parents perceived that their child has a small or severe sleep problem. Only 11 percent of parents in Taiwan responded similarly.

According to the
American Academy of Sleep Medicine, newborns up to three months of age need about 16 to 20 hours of total sleep time per day, while infants between three and 12 months old need 14 to 15 hours of total sleep time. Toddlers between the ages of one and four years need about 12 to 14 hours of total sleep time.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Tuesday, June 10, 2008

Second Day of SLEEP 2008 Comes to a Close

The scientific program for the second day of SLEEP 2008 concluded with the final symposia and oral presentations of the day.

Some American Academy of Sleep Medicine
section members are finishing up their section meetings.

Day three of the scientific program will begin at 8 a.m. on Wednesday with symposia and brief oral presentations. Wednesday also is the final day for the SLEEP 2008 exhibit hall.

Neck Size a Predictor of OSA in Children

A study being presented as an oral presentation this afternoon at SLEEP 2008 describes the link between neck size and obstructive sleep apnea in children.

The study examined the records of 242 children between two and 18 years of age. The actual neck size of each patient was adjusted for age to obtain the child’s percent deviation from predicted neck size (DPN).

DPN showed a high correlation with apnea-hypopnea index (AHI), a measure of the severity of
obstructive sleep apnea (OSA). DPN showed a higher association with AHI than did body mass index (BMI) or tonsil size.

These results show that DPN may provide a more anatomically specific risk factor for OSA in children than obesity measures such as BMI.

According to the
American Academy of Sleep Medicine, OSA occurs in about two percent of young children. It can develop in children at any age, but it is most common in preschoolers. OSA often occurs between the ages of 3 and 6 years when the tonsils and adenoids are large compared to the throat.

SRS Welcomes New Leaders, Recognizes Award Recipients

Dr. Michael Vitiello, a researcher with 20 years of experience studying the neuroscience of sleep and aging, was installed as president of the Sleep Research Society during the SRS General Membership Meeting this afternoon at SLEEP 2008.

Vitiello, professor of psychiatry and behavioral sciences at the University of Washington in Seattle, was introduced by outgoing president
Dr. Eric Nofzinger after he described some of the significant achievements made by the SRS in the past year. Nofzinger then gave Vitiello a gavel to symbolize the transfer of leadership.

Vitiello elicited laughter with his characteristic sense of humor, but became serious when describing the challenges sleep scientists face in securing
funding for their research. He said that in the next year the SRS will continue to advocate for the funding of, and infrastructure development for, sleep research and training.

He added that the SRS will continue to make an impact on the professional development of its members by enhancing career entry, career development, and professional education at all levels in sleep science and sleep medicine.

Earlier in the meeting the entire SRS board of directors for 2008 – 2009 was introduced. Joining Vitiello as officers are past president Nofzinger;
Dr. Clifford Saper, who rotates from director-at-large to president-elect; and Dr. Ronald Szymusiak, a newly elected member of the board of directors who will serve as secretary-treasurer.

Dr. Mark Opp, Dr. Thomas Kilduff, Dr. Sharon Keenan and Dr. James Walsh were recognized for completing their terms on the board of directors, and
Dr. Janet Mullington, Dr. Thomas Scammell, and Dr. Terri Weaver were introduced as newly elected directors at large. Dr. Eliza Van Reen will replace Dr. Tracy Rupp as the trainee member-at-large.

The meeting also included the recognition of several SRS award recipients. Thomas Penzel, PhD, received the Bill Gruen Award for the highest-rated abstract in the instrumentation category.


Three members received the SRS Young Investigator Award: Antoine Adamantidis, PhD; Esra Tasali, MD; and Vladyslav Vyazovskiy, PhD. Honorable mention went to David M. Raizen, MD, PhD.

Benefits of Receiving Care at AASM-Accredited Sleep Centers

Two studies being presented as poster presentations today at SLEEP 2008 describe benefits of receiving medical care from American Academy of Sleep Medicine-accredited sleep centers and from board certified sleep specialists.

One ongoing study (ID# 1069) of 243 patients at four participating sleep centers found that patients cared for by AASM-accredited centers and board-certified physicians received better education than patients cared for by non-accredited centers and non-certified physicians.

One-hundred percent of study subjects at AASM-accredited centers reported receiving adequate education about
obstructive sleep apnea (OSA). At non-accredited sites, 83.5 percent of study subjects reported receiving adequate education about OSA.

AASM
Standards for Accreditation require that accredited sleep centers have on staff at least one board-certified sleep specialist. Initial results of this study were published in the Journal of Clinical Sleep Medicine in 2006.

Another study (ID# 1073) of 55 patients shows that access to specialized services with close follow up in an AASM-accredited sleep center can make a significant difference in treatment success. Each of the patients had a high risk of failure to comply with continuous positive airway pressure therapy (CPAP) for OSA. Sixty-one percent of the patients became compliant and were followed up for six months.

Is Circadian Advantage a Home Run for MLB Teams?

A study funded by Major League Baseball (ID# 0165) that is being presented as a poster presentation this morning at SLEEP 2008 examined the effect of circadian timing on the outcome of MLB games.

The analysis of 24,133 games from 1997 to 2006 found that in 79 percent of the games, both teams were “at home” in the current time zone. In the remaining 5,046 games, the team with the circadian advantage won about 52 percent of the games.

The study found that the magnitude of circadian advantage influenced success. The winning percentage for teams with a three-hour circadian advantage increased to 60.3 percent. The direction in which teams traveled did not appear to influence the outcome of games.

This study is a follow-up to a 2005 study that analyzed the results of MLB games from 2004. That study found that teams performed better traveling eastward than they did traveling westward. The initial research abstract was presented
in 2005.

According to the
American Academy of Sleep Medicine, jet lag is a circadian rhythm sleep disorder that occurs when a long trip across time zones quickly puts you in a place where you need to sleep and wake at a time that is different than what your internal body clock expects. Symptoms can include disturbed sleep, decreased alertness and impaired functioning.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Do You Sleep Like You Eat?

Two studies from Brazil that are being presented as poster presentation this morning at SLEEP 2008 address the relationship between your sleep and the food you eat. Both studies involved 52 healthy subjects between the ages of 20 and 45 years.

One study (ID# 0084) found that both total energy intake and late-night snack energy intake are significantly correlated with awakenings during sleep. Both measures of energy intake also were correlated with apnea-hypopnea index, a measurement of the severity of obstructive sleep apnea.

Another study (ID# 0085) found that total fat intake is related to a number of sleep measures, including percentage of REM sleep, arousal index and apnea-hypopnea index. The study also found that fat intake at dinner is associated with sleep measures such as sleep efficiency and REM percentage. The results show that total fat intake and dinner fat intake seem to have a negative influence on the sleep pattern of healthy adults.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Experts Take a Look at Home Sleep Testing

In a clinical workshop taking place this morning at SLEEP 2008, leaders of the American Academy of Sleep Medicine are providing a detailed analysis of home sleep testing for the detection of obstructive sleep apnea.

The workshop will compare
AASM guidelines with a recent decision from the Centers for Medicare & Medicaid Services and will discuss the impact that the CMS decision will have on sleep-medicine providers. There also will be a discussion of current local coverage determination (LCD) policies.

In the December 15, 2007, issue of the
Journal of Clinical Sleep Medicine, the AASM published “Clinical Guidelines for the Use of Unattended Portable Monitors in the Diagnosis of Obstructive Sleep Apnea in Adult Patients.”

The guidelines recommend unattended portable monitoring (PM) as a valid option for detecting OSA in adults who have a high pretest probability of moderate to severe OSA, and who have no comorbid medical conditions or
sleep disorders that may degrade the accuracy of PM.

The guidelines also recommend that PM testing be administered by
AASM-accredited sleep centers and labs and reviewed by a board-certified sleep specialist.

In March 2008 CMS released its “Decision Memo for Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA) (CAG-00093R2).” The decision allows coverage of home sleep testing for the detection of OSA in Medicare beneficiaries.

Sleep Loss, Alzheimer’s and Sleep Apnea

A study (ID# 0291) being presented as an oral presentation this morning at SLEEP 2008 evaluated 52 older adults who have both Alzheimer’s disease (AD) and obstructive sleep apnea (OSA).

When the study subjects were treated with continuous positive airway pressure (
CPAP) therapy, the resulting increase in total sleep time was significantly associated with improvements in neurocognitive testing.

No other variables, including changes in oxygenation, were significant. This implies that the cognitive impairment associated with OSA in AD patients may result from short sleep time.

The
American Academy of Sleep Medicine reports that the steepest prevalence increase for OSA is in the transition from middle-aged to older-aged adults. According to the National Institute on Aging, up to 4.5 million Americans suffer from AD, which usually begins after the age of 60.

The SLEEP 2008 abstract book is available online at
http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

U.S. Veterans Battle Insomnia after Returning from Iraq

A study (ID# 0697) being presented as an oral presentation this morning at SLEEP 2008 shows that insomnia is a significant problem for combat-exposed U.S. soldiers returning from Iraq.

The study examined the sleep of 14
Operation Iraqi Freedom veterans who have post-deployment adjustment disorders. They were compared with 14 people who have primary insomnia and 14 good sleepers.

The veterans reported much worse sleep quality and sleep efficiency, increased time to fall asleep and wake time after falling asleep, and more nocturnal awakenings than good sleepers. Sleep measures of the veterans were similar to those of the people with primary insomnia.

The veterans also had more severe disruptive nocturnal behaviors than both good sleepers and people with primary insomnia.

A study (ID# 0736) that was presented yesterday as a poster presentation shows that U.S. veterans of the war in Iraq who struggle with insomnia may prefer treatment that combines medications with non-pharmacological approaches such as relaxation therapy. Veterans also preferred receiving therapy through MP3 files and the Internet.

Another study (ID# 0556) presented yesterday as a poster presentation reports that black veterans are significantly less likely than white or Asian veterans to adhere to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Day Two of SLEEP 2008 Begins with a Focus on Heart Health

The second day of SLEEP 2008 begins with three symposia, one of which focuses on the impact that sleep-disordered breathing has on heart health. The symposium is entitled, “Sleep Disordered Breathing as a Cardiovascular Risk Factor: An Epidemiological Perspective from the Sleep Heart Health Study.”

The ongoing
Sleep Heart Health Study, which is sponsored by the National Heart, Lung, and Blood Institute, has contributed significantly to the scientific data showing that sleep-disordered breathing may increase the risk for high blood pressure and cardiovascular diseases such as coronary artery disease and stroke.

According to the NHBI,
the study has been renewed several times since it began in 1994, allowing for the collection of more data and follow up. The estimated study completion date is August 2008.

The chair of the symposium is
Dr. Stuart Quan of the University of Arizona, one of the principal investigators working on the multi-site study. Dr. Quan is a past president of the American Academy of Sleep Medicine and the editor of the Journal of Clinical Sleep Medicine.

He will be joined by four other experts who will make presentations about the relationship between sleep-disordered breathing and cardiovascular disease, stroke, cardiac arrhythmia and mortality.

Monday, June 9, 2008

First Day of SLEEP 2008 Comes to a Close

The scientific program for the first day of SLEEP 2008 concluded with the final symposia and oral presentations of the day.

Some American Academy of Sleep Medicine
section members are currently in section meetings, and a workshop on Genetics and Sleep also is underway.

Day two of the scientific program will begin at 8 a.m. on Tuesday with symposia and brief oral presentations.

Oral Presentations Describe Research Linking Sleep to ADHD, Suicidal Symptoms

Research abstracts being presented as oral presentations this afternoon at SLEEP 2008 link sleep problems to attention-deficit/hyperactivity disorder (ADHD) and suicidal symptoms.

In
a study of 882 ninth-grade students (ID# 0321), teens reported sleeping an average of 7.6 hours per school night. According to the American Academy of Sleep Medicine, teens need a little more than nine hours of sleep each night.

Getting less sleep on
school nights increased students’ risk of having emotional disturbances and ADHD. Every additional hour of sleep on school nights decreased the risk of emotional disturbance by 25 percent and decreased the risk of ADHD by 34 percent.

In
another study of 322 undergraduates at a large university (ID# 0958), sleep quality and insomnia severity were significantly associated with an increased risk of depression. Severe insomnia also was a significant predictor of an increased severity of suicidal thoughts. After controlling for depression, sleep quality and insomnia severity jointly predicted an increased severity of suicidal thoughts.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

AASM Installs New Leaders, Honors Young Investigators


Dr. Mary-Susan Esther was installed as president of the American Academy of Sleep Medicine during the AASM General Membership Meeting this afternoon at SLEEP 2008.

Esther, medical director of
The Sleep Center at SouthPark in Charlotte, N.C., was introduced by outgoing president Dr. Alex Chediak after he discussed the initiatives advanced by the AASM in the past year. Chediak then gave her a gavel to symbolize the transfer of leadership.

Esther thanked the members, saying that practicing sleep medicine for more than 20 years has prepared her well for this opportunity. She assured the members that during her term the AASM would continue to be the leading voice representing the interests of
sleep specialists and promoting the field of sleep medicine.

Esther emphasized that the AASM would be steadfast in its commitment to setting evidence-based
standards for the field, and that it would work even harder to promote the recognition of board-certified sleep specialists and AASM-accredited sleep centers as the leading providers of quality medical care for people with disorders of sleep and alertness.

Earlier in the meeting the entire AASM board of directors for 2008-2009 was introduced. Joining Esther as officers are past president Chediak;
Dr. Clete Kushida, who rotates from secretary-treasurer to president-elect; and Dr. Nancy Collop, who assumes the role of secretary-treasurer.

Dr. Rich Berry and Dr. Art Spielman were recognized for completing their terms on the board of directors, and
Dr. Safwan Badr and Dr. Sam Fleishman were introduced as newly elected directors at large.

The meeting also included the recognition of Dr. Ehab Dayyat of the University of Louisville, who received the AASM 2008 Young Investigator Award. Honorable mention went to Dr. Fawad Mian, Daniel Kay, Dr. Nabil Al Lawati and Dr. Tracy Rupp.

Blame the Cell Phone, Early School Start Times for Teen Sleep Loss?

A research abstract being presented as a poster presentation today at SLEEP 2008 provides an interesting explanation for why some teens may not be sleeping well: They spend too much time on the cell phone.

The study of 21 teens (ID# 0249) shows that those who have more than 15 calls and/or 15 text messages a day are more likely to sleep poorly than teens who make less than five calls and/or send five text messages a day.

Excessive cell-phone users are more prone to disrupted sleep, restlessness, stress and fatigue. They also have more trouble waking up in the morning and are more tired before mid-day.

One member of the study group had more than 200 text messages per day. Only one of the 21 participants turned the cell phone off at night.

Another
abstract presentation (ID# 0226) addresses a common cause of teen sleep loss: early school start times.

Following a 40-minute delay in the school start time from 7:35 a.m. to 8:15 a.m., students’ total sleep time on school nights increased by 33 minutes per night from 7 hours and 2 minutes to 7 hours and 35 minutes. Students went to bed about eight minutes later at night, but they slept in 41 minutes later in the morning, waking up at 6:53 a.m. instead of 6:12 a.m.

More students reported having “no problem” with
sleepiness after the schedule change.

The
American Academy of Sleep Medicine recommends that teens get a little more than nine hours of sleep each night to feel alert and well rested during the day.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Sleep Problems Linked to Depression and Anxiety

Research abstracts being presented as poster presentations this morning at SLEEP 2008 show a link between sleep problems and emotional disturbances.

A study (ID# 0204) compared 122 children who have major depression with 200 healthy peers. Eighty-two percent of depressed children reported a sleep problem, compared to only five percent of controls.

A study of children in grades 2 – 5 (ID# 0269) found that children at risk for sleep-disordered breathing are more likely than their peers to have anxiety (19.7 percent vs. 7.3 percent).

A study of 14 mothers of twins (ID# 0374) shows that more than 70 percent had severe postpartum sleep restriction of less than six hours of sleep in 24 hours. About half of the women also reported mild to severe depression symptoms.

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Research Abstracts Examine the Effect of Sleep on School Performance

Research abstracts being presented as poster presentations this morning at SLEEP 2008 are describing the link between sleep and school performance.

One study (ID# 0199) found that different sleep variables affect the school performance of students in junior high, high school and college. In junior high, the complaint of restless legs/aching legs is more common in students with a lower grade-point average (GPA). Daytime sleepiness is more likely to affect the performance of high school students. Insomnia has the most negative effect on the GPA of college students.

A related study of adult college students (ID# 0709) found that insomnia complaints are significantly associated with lower GPAs. Students with lower GPAs were more likely to have trouble falling asleep, report waking at night and have trouble going back to sleep.

A study of 824 undergraduate students (ID# 0728) found that students who are “morning types” (preferring to wake up early) are more likely to have better grades than students who are “evening types” (preferring to stay up late).

The SLEEP 2008 abstract book is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Experts Take a Closer Look at REM Sleep Behavior Disorder

In a clinical workshop taking place this morning at SLEEP 2008, co-chairs Dr. Carlos Schenck and Dr. Marco Zucconi, along with a faculty of experts, are presenting, “The Diagnosis of REM Sleep Behavior Disorder in the Sleep Lab: Clinical, Video and Polysomnographic Criteria.”

REM sleep behavior disorder (RBD) is a parasomnia that occurs when you act out vivid dreams as you sleep. These dreams are often filled with action and may even be violent, putting both the dreamer and bedpartner at risk of injury.

Schenck is credited with identifying RBD along with Dr. Mark Mahowald, his colleague at the University of Minnesota and the
Minnesota Regional Sleep Disorders Center at Hennepin County Medical Center in Minneapolis. They published their findings in the article, “Chronic behavioral disorders of human REM sleep: a new category of parasomnia,” which appeared in the journal Sleep in 1986.

In 2002 Schenck and Mahowald published the article, “
REM sleep behavior disorder: clinical, developmental, and neuroscience perspectives 16 years after its formal identification in SLEEP.”

A clinical workshop is a forum for clinicians to review and discuss clinical challenges in sleep medicine, or to present and discuss controversial clinical topics and difficult clinical situations. Over the next three days there will be seven clinical workshops at SLEEP 2008.

Intriguing Keynote Address, Awards Open SLEEP 2008

The SLEEP 2008 plenary session was a successful beginning to the 22nd Annual Meeting of the Associated Professional Sleep Societies LLC. The session featured an intriguing keynote address from Dr. J. Allan Hobson on “Sleep, Dreaming and Consciousness – A New Paradigm.” Hobson is a professor of psychiatry at Harvard Medical School in Boston, Mass.

After Program Committee Chair
Dr. Michael Vitiello opened the plenary session, Sleep Research Society President Dr. Eric Nofzinger came forward to present the 2008 SRS Awards. Dr. Charles Czeisler of Harvard Medical School received the Distinguished Scientist Award for his studies of circadian timing and the sleep-wake cycle.

The Outstanding Scientific Achievement Award went to three men who played a critical role in the discovery of the suprachiasmatic nucleus as circadian pacemaker:
Dr. Robert Moore of the University of Pittsburgh, Dr. Irving Zucker of the University of California-Berkley, and Dr. Friedrich Stephan of Florida State University.

Nofzinger then presented the Mary A. Carskadon Outstanding Educator Award to
Dr. Richard Bootzin of the University of Arizona, a pioneer of the behavioral treatment of insomnia.

American Academy of Sleep Medicine President Dr. Alex Chediak followed with a presentation of the 2008 AASM Awards. The Nathaniel Kleitman Distinguished Service Award went to Dr. Conrad Iber of the University of Minnesota for his many contributions to the AASM.

For the next presentation, Dr. Chediak deferred to
Dr. William Dement, namesake of the William C. Dement Academic Achievement Award. Dement presented the award to his friend and colleague Dr. Terry Young of the University of Wisconsin-Madison for her work on the landmark Wisconsin Sleep Cohort Study.

Chediak then returned to present the Mark O. Hatfield Public Policy Award to
Dr. Neil Kavey of Columbia University, longtime president of the New York State Society of Sleep Medicine.

Following the awards ceremonies was a presentation by
Dr. James Kiley, Director of the Division of Lung Diseases in the National Heart, Lung, and Blood Institute within the National Institutes of Health. He spoke about the NHLBI strategic plan.

Hobson concluded the plenary session with his keynote address.

SLEEP 2008 Program to Begin with the Plenary Session

Final preparations are being made for the start of the SLEEP 2008 scientific program, which begins at 8 a.m. with the plenary session. The registration desk opened at 6:30 a.m., so a large crowd has already gathered and is assembling in the Baltimore Convention Center ballrooms where the plenary session will take place.

Representatives from more than 150
exhibiting companies and organizations are putting the finishing touches on their booths and displays, which were loaded into the exhibit hall and set up over the weekend. The SLEEP 2008 exhibit hall will open immediately after the plenary session.

Abstract authors who are scheduled for today’s first session of poster presentations are setting up their displays in the viewing room.


Following the plenary session there will be a full schedule of clinical workshops, discussion groups, abstract presentations, meet–the-professor sessions, invited lectures and symposia.

Sunday, June 8, 2008

Foundations, Grant Recipients are Discovering the Secrets of Sleep

On the eve of SLEEP 2008, the Sixth Annual Discovering the Secrets of Sleep Fundraising Dinner takes place tonight at 7 p.m. at the Hyatt Regency Baltimore in Baltimore, Md.

Proceeds from the dinner are shared by the Sleep Research Society Foundation and the American Sleep Medicine Foundation. Every dollar raised at the dinner goes directly toward grants that are a part of the sleep research initiatives of the two foundations. During the dinner the recipients of the 2008 grants from each foundation will be recognized.

The Sleep Research Society Foundation is awarding the 2008 J. Christian Gillin, MD, Research Grant to:

  • Nancy Johnston, DVM – Southern Illinois University School of Medicine
  • Anna Kalinchuk, PhD – Harvard Medical School
  • Mirjam Munch, PhD – Harvard University
  • Yuka Sasaki, PhD – Harvard Medical School

The Sleep Research Society Foundation also is awarding the 2008 Sleep Fellowship Grant to:

  • Natalia Tulina, PhD – University of Pennsylvania

The American Sleep Medicine Foundation is awarding the 2008 AASM Physician Scientist Training Award to:

  • Josna Adusumilli, MD – Brigham and Women’s Hospital – Takeda Pharmaceuticals Grant for Sleep Medicine Post-Fellowship Research Year
  • Ina Djonlagic, MD – Brigham and Women’s Hospital
  • Mikhail B. Litinski, MD – Brigham and Women’s Hospital
  • Dennis Hwang, MD – NYU School of Medicine

The SLEEP 2008 scientific program begins with the plenary session at 8 a.m. on Monday.

Saturday, June 7, 2008

Research Will Take Center Stage at SLEEP 2008

Beginning on Monday, June 9, more than 1,150 research abstracts will be presented during the scientific program at SLEEP 2008, showcasing the latest findings in sleep research from around the world.

More than 900 abstracts will be on display as poster presentations from 10:15 a.m. to 12:15 p.m., Monday, June 9, to Wednesday, June 11. Each poster will be displayed for one day only. Abstract authors will be available at their posters to discuss their findings with meeting attendees.

Nearly 250 abstracts will be presented as brief oral presentations during scheduled, one-hour sessions from Monday, June 9, to Thursday, June 12. Sessions involve a common theme and consist of four abstract presentations. Each oral presentation is 10 minutes long and is followed by five minutes of questions from the audience.

Five “late-breaking abstracts” were selected for presentation during a special session from 12:15 p.m. to 1:30 p.m. on Wednesday, June 11. These oral presentations involve high-quality, emerging data found between December 2007 and April 2008.

The abstracts being presented at SLEEP 2008 were recently published in a special supplement of the journal
Sleep.

The abstract supplement is available online at http://www.journalsleep.org/PDF/AbstractBook2008.pdf.

Friday, June 6, 2008

Invited Lecturers Headline SLEEP 2008 Scientific Program

At SLEEP 2008 from Monday, June 9, to Wednesday, June 11, seven experts in sleep science and sleep medicine will present their recent research findings as invited lecturers. Each presentation will take place from 1:30 p.m. to 2:30 p.m. on the day scheduled:

Monday, June 9

“Managing Sleep Apnea – Are We There Yet?” by Ronald R. Grunstein, MD, PhD

“Hypothalamic Regulation of Sleep Onset and Sleep Maintenance” by Ronald S. Szymusiak, PhD

Tuesday, June 10

“Sleep and Circadian Rhythms in Humans: Tales of Translation from the Lab to Practice” by Charles A. Czeisler, PhD, MD

“Treating Insomnia with CBT: Should We Step Up to Stepped Care?” by Colin A. Espie, PhD

“Pediatric Sleep Apnea: A Systemic Inflammatory Disease” by David Gozal, MD

Wednesday, June 11

“Restless Legs Syndrome: From the Bed to the Bench and Back Again” by Christopher J. Earley, MD, PhD

“Not Tonight Honey! - The Effect of Sleepiness on Daily (or Nightly!) Functioning” by Terri E. Weaver, PhD, RN

Note: No invited lectures are scheduled for
Thursday, June 12.

Thursday, June 5, 2008

Historic Breakthroughs Set Stage for Today’s Sleep Research

More than 1,150 scientific abstracts will be presented at SLEEP 2008, displaying the latest findings in sleep research. This research follows the historic discoveries made in previous years by sleep scientists. These are some of the milestones in the history of sleep research, courtesy of the American Sleep Medicine Foundation:

1875 – Caton records the brain electrical activity of animals in England.
1880 – Gelineau describes a group of patients in France with a problem he names “
narcolepsy.”
1929 - Berger discovers and reports the “electroencephalogram (EEG) of man” in Germany.
1937 – Loomis documents the EEG patterns of what is now called non-rapid eye movement (NREM) sleep.
1945 – Ekbom describes
restless legs syndrome in Sweden.
1953 – Kleitman and Aserinsky at the University of Chicago describe the rapid eye movement (REM) stage of sleep and propose a correlation with dreaming.
1957 – Dement and Kleitman describe the repeating stages of the human sleep cycle.
1966 – Gastaut and colleagues in France, and Jung and Kuhlo in Germany discover
obstructive sleep apnea (OSA).
1972 – Studies pinpoint the suprachiasmatic nuclei (SCN) as the site of the biologic clock.
1981 – Sullivan and colleagues use continuous positive airway pressure (
CPAP) to treat OSA.
1986 - Schenck, Mahowald and colleagues publish the first formal description of
REM sleep behavior disorder (RBD).
1989 – Rechtschaffen and colleagues find that total
sleep deprivation results in the death of all rats within two to three weeks.
1999 – Studies show that hypocretin mutations cause narcolepsy in mice and dogs.

2000 – Mignot and colleagues at Stanford discover that human narcolepsy also is associated with hypocretin deficiency.

Wednesday, June 4, 2008

Recognition of Sleep Medicine as a Medical Subspecialty

The field of sleep medicine has grown significantly since 700 people attended the first SLEEP annual meeting in June 1986 in Columbus, Ohio. Today sleep medicine is recognized as an independent medical subspecialty. Here are some milestones in the development of the field of sleep medicine:

1964 - The first sleep disorders center opens as a
narcolepsy clinic at Stanford.
1975 – Blue Shield of California begins reimbursing patients for sleep services.
1975 – The Association of Sleep Disorders Centers is formed (later to become the
American Academy of Sleep Medicine)
1977 – American Academy of Sleep Medicine (AASM) grants
accreditation to a sleep center for the first time.
1978 – AASM begins
board certification for sleep specialists.
1989 – AASM begins to accredit
fellowship training programs in sleep medicine.
1995 –
American Medical Association (AMA) recognizes sleep medicine as a self-designated practice specialty.
1997 – AMA grants the AASM a seat in its
House of Delegates.
1997 –
Accreditation Council for Continuing Medical Education (ACCME) accredits the AASM as a sponsor of continuing medical education for physicians.
2003 –
Accreditation Council for Graduate Medical Education (ACGME) formally recognizes sleep medicine as an independent subspecialty.
2004 – ACGME approves program requirement for residency education in sleep medicine training.
2006 – Number of
sleep centers and laboratories accredited by the AASM surpasses 1,000.
2007 – The board examination in sleep medicine is administered for the first time by member boards of the
American Board of Medical Specialties.

Source: Shepard JW, Buysse DJ, Chesson AL, et al.
History of the development of sleep medicine in the United States. J Clin Sleep Med 2005;1:61-82.

Tuesday, June 3, 2008

Exhibit Hall to be a Highlight of SLEEP 2008

In addition to its scientific program of research presentations and educational sessions, SLEEP 2008 features an exhibit hall with booth displays from more than 150 pharmaceutical companies, medical equipment manufacturers, publishers, software distributors and educational providers.

Exhibitors at SLEEP 2008 will showcase products such as sleep medications, diagnostic equipment used for sleep studies, and therapeutic devices such as continuous positive airway pressure (CPAP) units and masks.

Of particular interest this year will be unattended portable monitoring systems that can be used for
home sleep testing. A recent decision by the Centers for Medicare & Medicaid Services approved the use of home sleep testing for the diagnosis of obstructive sleep apnea in Medicare beneficiaries.

Many of the products on display are used in the diagnosis and treatment of people with
sleep disorders. It is estimated that 50 million to 70 million people in the U.S. suffer from a chronic sleep disorder, and the majority of them have not been diagnosed or treated. There are 81 sleep disorders classified in the International Classification of Sleep Disorders, 2nd Edition (American Academy of Sleep Medicine, 2005).

The SLEEP 2008 exhibit hall will be open to registered attendees from 10 a.m. to 4 p.m. on Monday, June 9, and Tuesday, June 10; and from 10 a.m. to 2 p.m. on Wednesday, June 11.

Monday, June 2, 2008

Welcome to the SLEEP 2008 Blog

Welcome to the official blog of the SLEEP 2008 22nd Annual Meeting of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

More than 5,000
sleep specialists, sleep scientists, sleep technologists, allied health professionals and students are expected to attend SLEEP 2008 at the Baltimore Convention Center in downtown Baltimore, Md. Some attendees will arrive early for postgraduate courses on Saturday, June 7, and Sunday, June 8. Then the scientific program begins with the plenary session at 8 a.m. on Monday, June 9.

During the plenary session
Dr. J. Allan Hobson will give the keynote address on “Sleep, Dreaming and Consciousness – A New Paradigm.” Hobson is a professor of psychiatry at Harvard Medical School in Boston, Mass.

The SLEEP Meeting blog will be updated daily with pre-meeting announcements up until Monday, June 9. Then live updates will be posted multiple times a day until the meeting ends at 12:15 p.m. on
Thursday, June 12.

If you’re unable to attend SLEEP 2008, then this blog will keep you up to date with breaking news and highlights from Baltimore.