Expert Discussions on Sleep-Wake Medicine, Part 1 - Recognition, Neurobiology, and Cognitive Impact of Excessive Sleepiness
neuroscienceCME Podcast
Premiere Date: Monday, December 10, 2007This activity offers CE credit for:
- Physicians (ACCME/AMA PRA Category 1)
- Nurses (CNE)
- Pharmacists (ACPE)
- Psychologists (APA)
- Social Workers (NASW)
- Certified Case Managers (CCMC)
All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™
Credit Expiration Date:
Wednesday, December 10, 2008
Note: Credit Is No Longer Available
 | Charles B. Nemeroff, MD, PhD Professor and Chair Department of Psychiatry Mulva Clinic for the Neurosciences Director, Institute of Early Life Adversity Research Dell Medical School The University of Texas at Austin Austin, TX |
 | Thomas Roth, PhD Chief, Division Head Sleep Disorders and Research Center Henry Ford Hospital Detroit, MI |
 | Boadie W. Dunlop, MD Assistant Professor of Psychiatry & Behavioral Sciences Emory University School of Medicine Atlanta, GA |
 | David F. Dinges, PhD Professor and Chief, Division of Sleep and Chronobiology Director, Unit for Experimental Psychiatry Department of Psychiatry University of Pennsylvania School of Medicine Philadelphia, PA |
Sleep-wake disturbances are common in the US primary care population and have a deleterious impact
on overall patient health and well-being.(1) Excessive sleepiness is a common symptom of sleep-wake
disorders, and is defined as an intense drive for sleep even during inappropriate circumstances. Although
primary sleep-wake disorders are one origin of excessive sleepiness, this symptom may also arise from
psychiatric, neurologic, and medical conditions as well as secondarily from iatrogenic medication effects.
Recent neurobiological advances have provided insight into the relationship between sleep, wakefulness,
and attention. Imaging studies indicate that the same brain regions exhibiting the greatest declines
in activity during sleep are also those that are most active during performance of attentional and
executive function tasks.(2,3) Given this overlap in cortical regions that mediate wakefulness and cognitive
processing, an association between excessive sleepiness and neurocognitive impairments is not
surprising. In this neuroscienceCME podcast series, faculty experts will provide clinically relevant practice
points regarding the recognition, neurobiology, and cognitive consequences of untreated symptoms of
excessive sleepiness.
Module 1: Recognition, Prevalence, and Etiologies of Excessive Sleepiness
Module 2: Neurobiology of Sleep, Wakefulness, and Attention
Module 3: Cognitive and Behavioral Impact of Sleep Deprivation and Excessive Sleepiness
- Alattar M, Harrington JJ, Mitchell CM, Sloane P. Sleep problems in primary care: a North Carolina Family Practice Research Network (NC-FP-RN) study. J Am Board Fam Med 2007;20:365-374.
- Kaufmann C, Wehrle R, Wetter TC, et al. Brain activation and hypothalamic functional connectivity during human non-rapid eye movement sleep: an EEG/fMRI study. Brain 2006;129:655-667.
- Raz A. Anatomy of attentional networks. Anat Rec B New Anat 2004;281:21-36.
To examine risk factors and etiologies of the symptom of excessive sleepiness; to explore recent advances in the neurobiology of sleep, wakefulness, and attention, and their application to clinical practice; and to examine the influence of sleep loss and excessive sleepiness on neurocognitive performance.
At the end of this CE activity, participants should be able to:
- Define excessive sleepiness and identify common risk factors and etiologies of this symptom.
- Describe cortical systems involved in the regulation of sleep, wakefulness, and attention, and delineate the impact of excessive sleepiness on these cortical regions.
- Recognize the impact of sleep deprivation and excessive sleepiness on neurocognitive performance.
Physicians, physician assistants, nurse practitioners, nurses, psychologists, social workers, certified case managers, pharmacists, and other healthcare professionals interested in mental health and sleep-wake medicine.
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Medical Education to provide continuing
medical education for physicians.
CME Outfitters, LLC, designates this educational activity for
a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians
should only claim credit commensurate with the extent of
their participation in the activity.
CNE Credit (Nurses):
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State Nurses Association, an accredited approver by the
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Note to Nurse Practitioners: The content of this CNE activity pertains to Pharmacology.
CEP Credit (Psychologists):
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by the American Psychological Association to sponsor
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NASW Credit (Social Workers):
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by the National Association of Social Workers (provider
#886407722) for 1.0 continuing education contact hours.
CCMC Credit (Certified Case Managers):
This program
has been approved for 1 hour by the Commission for Case
Manager Certification (CCMC).
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as a provider of continuing pharmacy education.
1.0 contact hours (0.1 CEUs)
Universal Program Number: 376-000-07-023-H01-P
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Charles B. Nemeroff, MD, PhD, Moderator
Dr. Nemeroff was born in New York City in 1949 and educated in the New York City Public School System. After graduating from the City College of New York in 1970, he enrolled in graduate school at Northeastern University and received a Master's degree in Biology in 1973. He received his MD and PhD (Neurobiology) from the University of North Carolina at Chapel Hill. His residency training in psychiatry was conducted at both the University of North Carolina and at Duke University, after which he joined the faculty of Duke University. At Duke he was Professor of Psychiatry and Pharmacology and Chief of the Division of Biological Psychiatry before relocating in 1991 to Emory University School of Medicine in Atlanta, Georgia, where he is the Reunette W. Harris Professor and Chairman of the Department of Psychiatry and Behavioral Sciences. His research has concentrated on the biological basis of the major neuropsychiatric disorders, including affective disorders, schizophrenia, and anxiety disorders. His clinical research is focused on the use of genetic, neuroendocrine, neuroimaging and neurochemical methods to comprehensively understand the pathophysiology of depression. In recent years he has uncovered the neurobiological mechanisms that mediate the increased risk for depression in victims of child abuse. He has also contributed to other seminal findings such as the burgeoning area of research concerning the relationship of depression to cardiovascular disease, as well as to identifying predictors of specific antidepressant treatment responses.
Dr. Nemeroff has received numerous honors during his career, including the A.E. Bennett Award from the Society of Biological Psychiatry (1979), the Judith Silver Memorial Young Scientist Award from the National Alliance for the Mentally Ill (1989), both the Kempf Award in Psychobiology (1989) and the Samuel Hibbs Award (1990) from the American Psychiatric Association (APA), and the Gold Medal Award and the Research Prize (1996) from the Society of Biological Psychiatry. In 1993 he was awarded the Edward J. Sachar Award from Columbia University and the Edward A. Strecker Award from The Institute of Pennsylvania Hospital. In 1997, he was the recipient of the Gerald Klerman Award from the National Depressive and Manic-Depressive Disorders Association and the Selo Prize from the National Alliance for Research in Schizophrenia and Depression. In 1998 he was the recipient of the Research Award in Mood Disorders from the American College of Psychiatrists and in 1999 he received the Bowis Award from the same organization. He was awarded the Menninger Prize in 2000 from the American College of Physicians, the Research Award from the American Foundation for Suicide Prevention in 2001, and the Burlingame Prize from the Institute of Living in 2002. In 2006 he received the American Psychiatric Association Research Mentoring Award and Vestermark Award. Dr. Nemeroff served as the Editor-in-Chief of Neuropsychopharmacology (2001-2006). With Alan F. Schatzberg, MD, he is co-Editor of the Textbook of Psychopharmacology, soon to be in its Fourth Edition, published by the American Psychiatric Association Press. He has served on the Mental Health Advisory Council of the National Institutes of Mental Health and the Biomedical Research Council for NASA. He is past President of the American College of Neuropsychopharmacology and the American College of Psychiatrists. He is currently a member of the Board of Directors of the American Foundation for Suicide Prevention and President of its Scientific Council. He is chair of the APA Committee on Research Training. In 2002 he was elected as a member of the Institute of Medicine of the National Academy of Sciences.
He is currently the recipient of several research grants from the NIH, including a Conte Center for the Neurobiology of Major Mental Disorders, and has published more than 850 research reports and reviews.
Thomas Roth, PhD
Dr. Roth is a Clinical Professor in the Department of Psychiatry at the University of Michigan College of Medicine, Ann Arbor, and Director of the Sleep Disorders and Research Center at Henry Ford Hospital, Detroit, Michigan. He received his PhD from the University of Cincinnati, Cincinnati, Ohio. He is currently Chairman of the World Health Organization (WHO) worldwide project on sleep and health and has served on several WHO national and international committees. Formerly, Dr. Roth served as Chair of the National Institutes of Health's National Center of Sleep Disorders Research. He is a past president of the American Academy of Sleep Medicine, the National Sleep Foundation, and the Sleep Research Society. He has also chaired committees of the Association of Professional Sleep Societies, the American Academy of Sleep Medicine, and the World Federation of Sleep Research Society. Dr. Roth's research has included sleep loss, sleep fragmentation, sleep pathologies, and the effects of pharmacologic agents on sleep-wake function.
Boadie W. Dunlop, MD
Dr. Boadie W. Dunlop is an Assistant Professor and Director of the Mood and Anxiety Disorders Program in the Department of Psychiatry and Behavioral Sciences at Emory University in Atlanta, Georgia. The primary focus of his work is on the pathophysiology and treatment of major depressive disorder and anxiety disorders. He has a particular interest in the role of dopamine dysfunction and associated deficits in motivation, reward and decision-making in psychiatric illnesses. Dr. Dunlop currently serves as a principal investigator for several industry-sponsored trials of emerging treatment approaches to the treatment of major depression and generalized anxiety disorder. He also serves as a co-investigator for federally-sponsored projects exploring biological predictors of response to antidepressant treatments. Additionally, Dr. Dunlop has served as an investigator on projects exploring the efficacy of transcranial magnetic stimulation (TMS) in treatment-resistant depression and the role of dopamine-related genes in cognitive processing tasks.
Dr. Dunlop has co-authored a book, Contemporary Diagnosis and Management of Anxiety Disorders, and three book chapters on the neurobiological aspects of major depression and antidepressant medications. Among his peer-reviewed publications are studies of the metabolic side effects of antipsychotics, adjunctive treatments for major depression with excessive sleepiness and social phobia, and the role of dopamine in the pathophysiology of major depression. Dr. Dunlop also serves as a psychotherapy supervisor and coordinator for education on anxiety disorders for Emory psychiatry residents and medical students.
Dr. Dunlop received his medical degree from Mayo Medical School in 1997 and completed his psychiatric residency at Emory University in 2001. He then served as a Staff Psychiatrist at the Atlanta Veterans Affairs Medical Center for two years before returning to Emory to complete a fellowship in Clinical Neuroscience. He was appointed Assistant Professor at Emory in 2004.
David F. Dinges, PhD
David F. Dinges, PhD, is Professor and Chief of the Division of Sleep and Chronobiology, and Director of the Unit for Experimental Psychiatry in the Department of Psychiatry, and Associate Director of the Center for Sleep and Respiratory Neurobiology at the University of Pennsylvania School of Medicine. His laboratory performs a wide range of experiments involving intensive physiological and behavioral monitoring of humans undergoing performance stressors and acute or prolonged perturbations sleep and circadian neurobiology. As a behavioral neuroscientist, Dr. Dinges focuses on the causes of human cognitive and neurobehavioral failure due to stress, sleep loss and disturbances of circadian rhythms, and the implications of these unmitigated effects on health and safety. He has also conducted extensive scientific work on development and validation of behavioral, technological and pharmacological interventions for these effects. He has over 200 publications and during the past 30 years his research has been supported by grants from the NIH, NASA, the Air Force Office of Scientific Research, Department of Transportation, and the Department of Homeland Security. Dr. Dinges' findings have been extensively used to advise Federal and private regulatory policies regarding duty hours and fatigue management. He currently leads the Neurobehavioral and Psychosocial Factors Team for the NASA funded National Space Biomedical Research Institute. He is a member of the NIH NINR Council. He has been President of the U.S. Sleep Research Society and served on the Board of Directors of the American Academy of Sleep Medicine and the National Sleep Foundation. He currently serves as President of the World Federation of Sleep Research and Sleep Medicine Societies, and Editor-in-Chief of the journal SLEEP. He has been the recipient of numerous awards for teaching and research, including the 2004 Decade of Behavior Research Award from the American Psychological Association, and the 2007 NASA Distinguished Public Service Medal.
Disclosure Declaration
It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all its CE activities. Faculty must disclose to the participants any significant relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.
Dr. Nemeroff consulted to, served on the Speakers' Bureau and/or Board of Directors, has been a grant recipient, and/or owned equity in one or more of the following: Abbott Laboratories, Acadia Pharmaceuticals, American Foundation for Suicide Prevention( AFSP), American Psychiatric Institute for Research and Educations(APIRE), AstraZeneca Pharmaceuticals, BMC-JR LLC, Bristol-Myers Squibb Company, CeNeRx, Corcept Therapeutics, Cypress Bioscience, Inc., Cyberonics, Inc., Eli Lilly and Company, Entrepreneur's Fund, Forest Laboratories, Inc., George West Mental Health Foundation, GlaxoSmithKline, H. Lundbeck A/X, i3 DLN, Janssen LP, National Alliance for Research on Schizophrenia and Depression( NARSAD), National Institute on Mental Health, Neuronetics Inc., NFMH, NovaDel Pharma Inc., Otsuka America Pharmaceutical, Inc., Pfizer Inc., Quintiles Transnational Corp., Reevax, UCB Pharma, Wyeth-Ayerst. Currently, Dr. Nemeroff serves on the Scientific Advisory Board for AstraZeneca Pharmaceuticals, Johnson & Johnson, Pharma Neuroboost, Forest Laboratories, Inc., National Alliance for Research on Schizophrenia and Depression, and Quintiles Transnational Corp. He is a grant recipient from the American Foundation for Suicide Prevention, National Alliance for Research on Schizophrenia and Depression, and the National Institute of Health. He serves on the Board of Directors of American Foundation for Suicide Prevention, APIRE, NovaDel Pharma, Inc., Mt. Cook Pharma, Inc., and the George West Mental Health Foundation. He owns equity in CeNeRx and Reevax. He owns stock or stock options in Corcept Therapeutics, Inc. and NovaDel Pharma, Inc.
Dr. Roth has disclosed that he receives grants from Cephalon, Inc., GlaxoSmithKline, Neurocrine Biosciences, Inc., Pfizer Inc., sanofi-aventis, Schering-Plough Corporation, Sepracor Inc., Somaxon Pharmaceuticals, Inc., Syrex, Takeda Pharmaceuticals North America, Inc., TransOral Pharmaceuticals, Inc., Wyeth Pharmaceuticals, and Xenoport, Inc. He serves as a consultant to Abbott Laboratories, Acadia Pharmaceuticals, Inc., Acoglix, Actelion, Alkermes, Inc., ALZA Corporation, Ancil, Arena Pharmaceuticals, AstraZeneca Pharmaceuticals, Bristol-Myers Squibb Company, Cephalon, Inc., Cypress Bioscience, Inc., DOV Pharmaceutical Inc., Elan Pharmaceuticals, Inc., Eli Lilly and Company, Evotec Inc., Forest Pharmaceuticals, Inc., GlaxoSmithKline, Hypnion Inc., H. Lundbeck A/S, Hoffmann-La Roche Inc., Johnson & Johnson, King Pharmaceuticals, Inc., McNeil, MediciNova, Inc., Merck & Co., Inc., Neurim Pharmaceuticals, Neurocrine Biosciences, Inc., Neurogen Corporation, Novartis Pharmaceuticals Corporation, Orexo AB, Organon Pharmaceuticals USA, Inc., Orginer, Prestwick Pharmaceuticals, Inc., Proctor & Gamble, Pfizer Inc., Purdue Pharma LP, Resteva, sanofi-aventis, Schering-Plough Corporation, Sepracor Inc., Servier, Shire Pharmaceuticals, Somaxon Pharmaceuticals, Inc., Syrex, Takeda North America Pharmaceuticals, Inc., TransOral Pharmaceuticals, Inc., VANDA Pharmaceuticals, VivoMetrics, Wyeth Pharmaceuticals, XenoPort, Inc., and Yamanouchi Pharma America, Inc. He is on the speakers bureaus of sanofi-aventis and Takeda Pharmaceuticals North America, Inc.
Dr. Dunlop has disclosed that he receives grants from AstraZeneca Pharmaceuticals, Bristol-Myers Squibb Company, National Institute of Mental Health, Novartis Pharmaceuticals Corporation, and Ono Pharmaceutical USA, Inc. He serves as a consultant to Cephalon, Inc., Shire Pharmaceuticals, and Wyeth Pharmaceuticals.
Dr. Dinges has disclosed that he receives grants from Cephalon, Inc. and Merck & Co., Inc. He serves on the speakers bureau of Cephalon, Inc. He serves as a consultant to ALZA Corporation, Arena Pharmaceuticals, Cephalon, Inc., GlaxoSmithKline, Mars Pharmaceutical, Merck & Co., Inc., Neurogen Corporation, Pfizer Inc., Proctor & Gamble, and Takeda Pharmaceuticals North America, Inc.
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