Course Curriculum
Laboratory Methodology Course
Course Objective:
To provide essential training and education in polysomnography and sleep laboratory methodology to sleep technologists, respiratory therapists, laboratory managers, physicians, nurse practitioners and other health professionals.
Course Curriculum:
- Normal Human Sleep
- Basic definitions
- Circadian rhythms
- NREM and REM sleep physiology
- Distribution of sleep stages
- Developmental sleep
- Sleep related pathologies
- Major consequences of sleep disorders
Introduction to Clinical Polysomnography
- The use of polysomnography in sleep medicine
- Standard recording parameters
- Bioelectrical signal derivations
- Transduced signal derivations
- Use of ancillary equipment
- Patient safety
Sleep Stage and Arousal Scoring
- Sleep stage scoring parameters
- Rechtschaffen and Kales sleep stage scoring criteria
- AASM sleep stage scoring criteria
- Scoring arousals
- Developing pattern recognition skills
- Documenting atypical findings
- Sleep stage scoring workshop
Abnormal Record Scoring and Interpretation
- Diagnostic aspects of sleep disordered breathing
- Obstructive SDB
- Sleep related hypoventilation
- Cheyne-Stokes respiration and other forms of central sleep apnea
- CPAP induced and CPAP emergent central apnea
- Drug induced SDB
- SDB and COPD
- SDB and neuromuscular disease
- Overview of respiratory transducers
- Scoring and tabulation of respiratory events
- Identifying and scoring periodic limb movements
- Atypical sleep EEG patterns
- Drug effects on sleep
- NREM and REM parasomnias
- ECG interpretation for the sleep laboratory
- Artifact recognition
- Abnormal record review
Polysomnography Instrumentation
- Principles of signal processing and common mode rejection
- Polarity convention
- Amplifiers and filters
- Analog to digital conversion
- System referencing
- System calibration
- Signal display
- Electrical safety
- Quality issues in polysomnographic recordings
Electrode and Sensor Application
- International 10/20 system of electrode placement
- Head measurement workshop
- Paste application technique
- Collodion application technique
- Placement of body sensors
- Oximetry
- Electrode application workshop
Overnight Testing Procedures
- Patient assessment
- Bio-calibrations
- Patient monitoring
- Troubleshooting
- Documentation
CPAP and Bi-level Positive Airway Pressure (PAP) titration
- Overview of PAP therapy and basic principles of operation
- Titration protocols and policies
- Effects of rebound sleep
- Bi-level PAP therapy
- Modes of operation
- Complex titrations
- Adaptive servo-ventilation (ASV)
- Ensuring long-term success with PAP therapy
CPAP / Bi-Level PAP Workshop
- Equipment demonstration
- Mask fitting
- Review of titration procedures
- Desensitization techniques
Measurement and Evaluation of Excessive Daytime Sleepiness
- Common causes of daytime sleepiness
- Subjective vs. objective measures of sleepiness
- Multiple sleep latency testing
- Maintenance of wakefulness testing
- MSLT /MWT record review
Scoring Variables and Report Formulation
- Standard definitions
- Scoring variables calculations
- Report formats / histograms
- Report accuracy
Patient Follow-up and CPAP Therapy Compliance
- Enhancing CPAP therapy compliance
- Monitoring CPAP compliance
- Current reimbursement requirements
- Interpretation of download reports
- Patient interaction
- Follow-up routines
- Patient support groups
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