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.