Expert Discussions on Sleep-Wake Medicine, Part 2 - Identifying the Consequences and Improving Outcomes in Patients Exhibiting the Symptom 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 |
 | Leslie P. Lundt, MD Director, Foothills Foundation Psychiatrist, Private Practice Boise, ID |
 | Terri E. Weaver, PhD, RN, FAAN, ATSF, FAASM Dean Emerita Professor Emerita of Biobehavioral Nursing Science College of Nursing University of Illinois Chicago Chicago, IL Professor Emerita of Nursing University of Pennsylvania Philadelphia, PA |
 | Mary B. O'Malley, MD, PhD Program Director, Sleep Fellowship Norwalk Hospital Sleep Disorders Center Norwalk, CT |
Excessive sleepiness is associated with negative consequences including car crashes, impaired
productivity, and poor work performance. Emerging data also indicate that sleep deprivation, a
frequent underlying cause of excessive sleepiness, is associated with physiological impairments such
as insulin resistance and impaired glucose tolerance, that may increase the risk for Type 2 diabetes.(1) For
patients with psychiatric disturbances, the symptom of excessive sleepiness may be part of the clinical
presentation. Alternatively, this symptom may arise from an undiagnosed sleep-wake disorder, such as
obstructive sleep apnea (OSA), or from iatrogenic effects of psychotropic medications.
Management of excessive sleepiness begins with determination of the underlying etiology and is
accomplished through nonpharmacologic and/or pharmacologic interventions. For patients with OSA,
adherence to continuous positive airway pressure (CPAP) therapy is a key factor influencing functional
outcomes.(2) In this neuroscienceCME podcast series, faculty experts will discuss the risks of excessive
sleepiness and sleep deprivation, the interaction of sleep-wake disturbances and psychiatric illness, and
interventions that alleviate the symptom of excessive sleepiness and improve patient outcomes.
Module 1: Examining the Risk of Sleep Deprivation and Excessive Sleepiness
Module 2: Adherence and Efficacy with Continuous Positive Airway Pressure in Obstructive Sleep Apnea
Module 3: Sleep-Wake Disturbances in Patients with Psychiatric Disorders and Management of Excessive
Sleepiness
- Knutson KL, Spiegel K, Penev P, Van Cauter E. The metabolic consequences of sleep deprivation. Sleep Med Rev 2007;11:163-178.
- Weaver TE. Adherence to positive airway pressure therapy. Curr Opin Pulm Med 2006;12:409-413.
To examine the deleterious impact of sleep deprivation and excessive sleepiness on physical and mental health, as well as activities of daily living; to identify factors that influence adherence to and efficacy of CPAP therapy; to explore the relationship between sleep-wake disturbances and psychiatric illness; to examine options for the management of excessive sleepiness that include nonpharmacologic and pharmacologic strategies, as well as referral for a sleep consult.
At the end of this CE activity, participants should be able to:
- Relate how sleep deprivation and untreated excessive sleepiness impact health and function.
- Describe the influence of adherence to CPAP therapy on efficacy of this therapy for achieving improved functional outcomes in patients with OSA.
- Explain the interaction between sleep-wake disturbances and risk for psychiatric illness.
- Identify nonpharmacologic and pharmacologic treatment interventions for the management of the symptom of excessive sleepiness.
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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#886407722) for 1.0 continuing education contact hours.
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1.0 contact hours (0.1 CEUs)
Universal Program Number: 376-000-07-024-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.
Leslie P. Lundt, MD
Dr. Lundt received her degrees from Johns Hopkins University and Rush Medical College and was Chief Resident in San Francisco. She is a board certified psychiatrist and addiction medicine specialist. She has maintained a clinical and research practice for the past 18 years. She has been highlighted as the local doctor on morning and evening news for ABC, NBC, and CBS television network affiliates. Dr. Lundt's first book, Think Like a Psychiatrist, is now in its second edition.
Terri E. Weaver, PhD, FAAN, RN
Dr. Weaver is recognized nationally and internationally for her research on the affect of illness on the conduct of daily behaviors and assessment of treatment adherence and outcomes in sleep disorders. She developed the first instrument to measure functional status in disorders of excessive sleepiness. This measure has been employed in outcomes research and clinical trails both nationally and internationally. Dr. Weaver is the Principal Investigator of an international multi-center clinical trail designed to evaluate the efficacy of continuous positive airway pressure (CPAP) treatment for milder obstructive sleep apnea syndrome (OSA). This protocol goes beyond the traditional outcome measures of physiologic sleep and daytime sleepiness by including the evaluation of functional status as the primary endpoint. Dr. Weaver and colleagues were the first to characterize the acute decline in adherence observed over the first week of CPAP treatment. This work was extended in a study designed to isolate factors contributing to this non-adherence, in which Dr. Weaver serves as the Principal Investigator. This work was conducted as part of a Specialized Center of Research SCOR) grant in collaboration with the Center for Sleep and Respiratory Neurobiology, School of Medicine and the Division of Sleep and Chronobiology, Department of Psychiatry, School of Medicine, University of Pennsylvania. Dr. Weaver's current research is supported by the National Heart Lung and Blood Institute of the National Institutes of Health. Dr. Weaver is a member of the Hartford Center for Gerontological Nursing Excellence (School of Nursing), Senior Fellow at the Leonard Davis Institute for Health Economics (LDI), and member of the Center for Sleep and Respiratory Neurobiology and Institute on Aging, School of Medicine, University of Pennsylvania. Dr. Weaver is a member of the American Sleep Disorders Association and Sleep Research Society and a Fellow of the American Academy of Nursing. Collaborating with Dr. Rogers, Dr. Weaver will work with trainees interested in outcomes of sleep disorders and will provide the core sleep content for all trainees. Her current funded research activities will give postdoctoral nursing fellows the opportunity to pursue patient-oriented research in outcomes studies.
Mary B. O'Malley, MD, PhD
Dr. O'Malley is the Fellowship Director for the Program in Sleep Medicine at the Sleep Disorders Center, Norwalk Hospital, Norwalk, CT. She is also a clinical instructor in the Department of Psychiatry at New York University, where she teaches sleep medicine for the Department of Psychiatry and Neurology at New York University Medical Center. Dr. O'Malley also maintains a private practice in adult general psychiatry in Fairfield, CT.
Dr O'Malley received her PhD degree in neurobiology from The Rockefeller University and her medical degree from Cornell University Medical College in New York. She completed an internship in internal medicine at Norwalk Hospital, followed by a fellowship in sleep medicine and a residency in psychiatry at New York University/Bellevue Medical Centers.
Dr O'Malley is board certified in sleep medicine and psychiatry. She is a Laughlin Fellow of the American College of Psychiatry and is a member of the American Psychiatric Association and the American Sleep Disorders Association. Dr O'Malley has authored or coauthored in both basic and clinical research. She coauthored a chapter on alerting medications in Principles and Practice of Sleep Medicine; a pocket reference manual on psychiatry for clinicians in training, The Saint Frances Guide to Psychiatry; and a chapter on insomnia in Psychiatry On Call, Principles and Practice.
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. Lundt has disclosed that she receives grants from Cephalon, Inc. She serves as a consultant to Cephalon, Inc., and Takeda Pharmaceuticals North America, Inc. She serves on the advisory boards of Cephalon, Inc., and Takeda Pharmaceuticals North America, Inc. She is on the speakers bureaus of Cephalon, Inc., Forest Laboratories, Inc., Pfizer Inc., sanofi-aventis, Sepracor Inc., Takeda Pharmaceuticals North America, Inc., and Wyeth Pharmaceuticals. She owns stock in Elan Pharmaceuticals, Inc., Pfizer Inc., Sepracor Inc., and VANDA Pharmaceuticals.
Dr. Weaver has disclosed that she receives research support from Pro-Tech Services, Inc., Respironics, Inc., and Respironics Sleep and Respiratory Foundation. She serves as a consultant to Jazz Pharmaceutical and sanofi-aventis. She receives other financial support, in the form of license agreements, from Aspire Medical, Inc., Jazz Pharmaceutical, Merck & Co., Inc., Organon Pharmaceuticals USA, Inc., RTI Health Solutions, sanofi-aventis, and Sleep Solutions, Inc.
Dr. O'Malley has disclosed that she serves on the speakers bureau of Cephalon, Inc.
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