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Sleep Fellowship Curriculum

Clinical Activities

Out-patient clinics

Up to four sleep medicine clinics (1/2 day) per week, under the supervision of a board- certified sleep medicine physician.
In addition, subspecialty clinic rotations will be arranged at our Sleep Centre in the following areas:

  1. Neurology- Dr. W. Murphy
  2. Psychology - Dr. T. Moroz
  3. Psychiatry- Dr. C. Chang
  4. CPAP clinic – with Registered Respiratory Therapists
  5. Pediatrics- Dr. Val Kirk
  6. Dental- Dr. Leslie Dort
  7. Neuromuscular / ALS: Dr. K Rimmer, Dr. Andrea Lowen

Inpatient sleep medicine consultations

Within the Calgary Zone, consultations will be directed to the sleep medicine fellow who, under the supervision of attending physicians at the Sleep Centre, will direct further investigation and management.  

Polysomnography (PSG)/ MSLT Interpretation

The sleep medicine fellow will interpret all PSG’s generated by his/ her own out-patient sleep clinics. Additional PSG interpretations (up to 200 studies) will be done in order to achieve competence. A minimum of 25 MSLT’s will be interpreted.

Interpretation of level 3 ambulatory sleep studies (Snoresat)

The sleep medicine fellow will interpret all SnoreSats generated by his/ her own sleep clinic. Additional SnoreSat interpretations will be done in order to reach the number required to achieve competence. 

Actigraphy

The sleep medicine fellow will interpret 20 actigraphs.

Polysomnography set-up 

The sleep medicine fellow will participate in the set up and monitoring of overnight PSG in order to acquire the necessary skills to perform the test and interpret the results. This includes but is not limited to:

  • PSG set-up 
  • Troubleshooting all physiologic recordings, including TcCO2, during PSG 
  • Application of nasal and oro-nasal masks during PSG 
  • Titration of oxygen, CPAP, BiPAP S and ST, and other modes of ventilation 
  • Set up and performance of tests of daytime function, including MSLT and MWT

Research & Rounds

Presentation

  1. Journal club will be organized and led by the sleep medicine fellow. These rounds are held once per month during the academic year.
  2. Sleep and Respiration rounds are held twice per month during the academic year. The sleep medicine fellow will present at these rounds twice per year.

Attendance

Attendance is required at the following rounds:

  1. Sleep and Respiration rounds: noon-1pm, 1st and 3rd Wednesday of the month
  2. Journal club: 8:00-9:00am, 3rd Wednesday of the month
  3. Polysomnography rounds: noon-1pm, 4th Wednesday of the month
  4. Sleep Board: 8:00-9:00am, 2nd and 4th 4th Wednesday of the month

Teaching

The sleep medicine fellow is expected to contribute to teaching at all levels including medical students, internal medicine residents, and pulmonary fellows (academic half day and during rotation through the Sleep Centre).

Research

The sleep medicine fellow is expected to initiate and complete a research project during the sleep medicine fellowship. The project should be presented at local academic rounds and an international meeting and should be submitted for publication to a high level academic journal.

The Sleep Centre has an active research program with original research performed by sleep medicine physicians alone or in collaboration with other clinical researchers and/or basic scientists at the University of Calgary. The sleep medicine fellow is encouraged to approach any of the principle investigators identified below to discuss participation in these or other projects that are of interest. Current research projects that are underway in the Sleep Centre include the following:

Sleep Apnea:-Basic Mechanisms

  • Control of breathing in health and disease (pathogenesis of obstructive sleep apnea)
    • Investigators: Dr Andrea Loewen, Dr Magdy Younes, Dr Patrick Hanly
    • Funded by CIHR

Sleep Apnea:-Complications

  • Regulation of cerebral blood flow in a human model of intermittent hypoxia
    • Investigators: Andrew Beaudin (PhD student), Dr Patrick Hanly, Dr Todd Anderson, Dr Marc Poulin
    • Funded by Heart and Stroke Foundation and CIHR
  • White matter disease in TIA and minor stroke patients with obstructive sleep apnea
    • Investigators: Shiel Patel (Masters student, Dept of Neuroscience, University of Calgary) Dr Shelagh Coutts, Dr Patrick Hanly
    • Funded by Hotchkiss Brain Institute and AHFMR
  • Assessment of sleep and respiration in patients with chronic renal failure
    • Investigators : David Nicholl (Masters student, Dept of Health Sciences, University of Calgary), Dr Brenda Hemmelgarn, Dr Sofia Ahmed, Dr Patrick Hanly
  • Obstructive sleep apnea and the rennin-angiotensin system
    • Investigators: David Nicholl (Masters student, Dept of Health Sciences, University of Calgary), Dr Sofia Ahmed, Dr Patrick Hanly
  • Perioperative complications in patients with obstructive sleep apnea
    • Investigators: Dr. Melissa Jack (R2 Anaesthesia), Dr. Willis Tsai, Dr Stafford Dean
    • Funded by Dept of Anaesthesia Trainee Research Funds

Sleep Apnea: Health Care Utilization

  • Using Computer Simulation to Improve the Operational Efficiency of an Academic Sleep Centre
    • Investigators: Dr Sachin Pendharkar, Dr. Tom Noseworthy, Dr Paul Rogers, Dr Ward Flemons, Dr. Diane Bischak
    • Funded by AHFMR
  • Health care utilization by patients with sleep disordered breathing
    • Investigators: Paul Ronksley (PhD student), Dr Brenda Hemmelgarn, Dr Willis Tsai
    • Funded by AHFMR
  • A methodological approach to the identification of sleep disorders using electronic health data.
    • Investigators : Carl Severson (BHSc student), Dr. Sachin Pendharkar, Dr. Willis Tsai

Sleep Apnea:-Treatment

  • Predictive accuracy of a remotely controlled mandibular positioner in identifying favorable candidates for oral appliance therapy
    • Investigator: Dr John Remmers
    • Funded by UTI
  • Efficacy of the ReFlow system in treating central sleep apnea refractory to CPAP
    • Investigator: Dr. John Remmers
    • Funded by Respironics
  • Adherence to CPAP therapy in OSA patients with and without co-existing insomnia
    • Investigators: Dr Tammy Moroz, Dr Patrick Hanly