FMC Sleep Centre, Information for Health Professionals


Medical Expert

  1. The resident will be able to obtain a history relevant to sleep disorders. This includes:
    • symptoms that indicate sleep pathology
    • clinical factors that predict the presence or absence of particular sleep disorders
    • history of sleep habits and rituals; sleep hygiene
    • family history, where relevant
    • impact of sleep disorder on the patient’s quality of life and health
  2. The resident will demonstrate knowledge of the epidemiology, prevention, pathogenesis, clinical manifestations, laboratory testing, treatment, prognosis and complications of:
    • Obstructive Sleep Apnea
    • Central Sleep Apnea
    • Cheyne-Stokes Respiration
    • Sleep Hypoventilation Syndromes / Chronic Respiratory Failure
    • Insomnia
    • Narcolepsy
    • Restless Legs Syndrome and Periodic Limb Movement Disorder
    • Parasomnias
  3. The resident will demonstrate an approach to the diagnosis and management of the following common sleep related complaints:
    • Hypersomnolence
    • Insomnia
    • Abnormal nocturnal behaviour
    • Snoring
  4. The resident will be able to manage
    • Obstructive Sleep Apnea
    • Central Sleep apnea
    • Sleep Hypoventilation / Chronic Respiratory failure
    • Insomnia- including initiation of cognitive - behavioural therapyestless Legs Syndrome and/or Periodic Limb Movement Disorder
  5. The resident will be able to interpret findings on Polysomnography/MSLT/MWT including:
    • Recognition of normal or disrupted sleep architecture
    • Recognition of sleep stages and arousals from sleep
    • Scoring of respiratory events including apneas, hypopneas, increased upper airway resistance, hypoventilation and Cheyne-
    • Stokes Respiration
    • Evidence for Parasomnias such as REM Behaviour Disorder, sleep walking , and bruxism
    • Evidence for Narcolepsy / abnormal MSLT
  6. The resident will understand the limitations of diagnostic tests in Sleep Medicine including:
    • PSG +/- transcutaneous CO2
    • MSLT, MWT
    • Ambulatory, level 3 testing for sleep disordered breathing
    • Clinical prediction rules
    • Empiric trials of therapy


The practice of sleep medicine requires humane, informed and open discussions with patients about their symptoms, disease and course of treatment. Effective and empathetic listening skills including the use of verbal and non-verbal communication skills will be demonstrated.


Sleep physicians work with several other members of the sleep healthcare team to achieve optimal outcomes for patients. Our Sleep Centre uses a multidisciplinary approach and patients will see several health care providers throughout their evaluation and treatment. The Respirology resident will consult with other physicians and health care professionals and contribute effectively to the team’s objectives and management plan. An understanding of the roles and responsibilities of other health care providers is required for effective leadership and participation within this model of patient care. To this end the resident will attend one night of overnight polysomnography and will attend at least one RRT-led CPAP clinic.


Appropriate health care resource utilization is integral to the practice of sleep medicine especially in a time of changing resources, guidelines and protocols. As a manager the Respirology resident will incorporate quality assurance and resource allocation into daily activities. The Sleep Centre’s wait list time is long (up to one year) and this provides an excellent incentive and opportunity to consider alternate care models and/or triage systems for our patients.

Health Advocate

The Respirology resident must recognize his/her overall role within society and his/her ability to influence public policy as well as individual patient care. The physician must be prepared to advocate for patients and for communities. Physician advocacy for individuals and for communities is often required with regard to securing funding and qualification for CPAP, BiPAP and supplemental oxygen therapy.


Sleep Medicine is a relatively young field with significant gaps in knowledge and thus many opportunities for research. The sleep Respirology resident will demonstrate awareness of the current state of knowledge and ask questions where data is lacking. A commitment to lifelong learning in this rapidly evolving field is essential. Ongoing journal clubs, research and teaching opportunities will enhance this competency of fellows.


As a physician, there is a need for commitment to professional standards including ethical practice. In addition, the Respirology resident will specifically demonstrate an understanding of provincial legislation for reporting of unfit drivers.