Cognitive Effects of OSA and Treatment-Refractory Symptoms
- Credit Type
- CME
- Credit Amount
- 0.25
- Release Date
- 11/17/2009
- Expiration Date
- 11/16/2010
- Activity Type
- Videocast
Patients with obstructive sleep apnea (OSA) often display excessive sleepiness and associated cognitive and behavioral impairment both at initial presentation and after optimization of positive airway pressure (PAP) therapy. The seriousness of these symptoms is highlighted by the increased risk of motor vehicle accidents in patients with OSA. Cognitive tasks, such as the psychomotor vigilance task and the n-back test, have consistently identified performance deficits in patients with OSA-related excessive sleepiness. This is supported by neuroimaging studies demonstrating altered brain anatomy, axonal signaling, and neuronal metabolism in brain regions that regulate cognitive function. Continued cognitive impairment and residual sleepiness in patients optimized on PAP suggest that these changes may be irreversible. Pharmacologic agents that improve such cognitive parameters as memory, alertness, and executive function are used to treat patients in whom functional impairment is refractory to PAP treatment. These treatment options also derepress activation in brain regions important for normal cognitive functioning.
Jointly sponsored by Albert Einstein College of Medicine, Montefiore Medical Center, and Asante Communications
This activity is supported by an educational grant from Cephalon, Inc.
Release Date: 11/17/2009
Expiration Date: 11/16/2010
Activity Goal
Employing a combination of didactic and practical case-based presentations, the goal of this interactive symposium is to highlight scientific and clinical data emphasizing the relationship between sleep/wake disorders and the associated neurocognitive, neurophysiologic, and executive consequences.
Intended Audience
This activity is intended for sleep specialists and other health care providers interested in sleep/wake medicine.
There are no prerequisites for this educational activity.
Statement of Need
Developed for community-based sleep clinicians and designed to provide a scientific rationale for individualized assessment and treatment of patients with sleep/wake disorders, this program presents the neurobiologic basis and potentially irreversible consequences of untreated disturbances in sleep-wake consolidation.
Learner’s Gap
Sleep/wake disorders significantly reduce the restorative value of sleep. Characterized by their heterogeneity and profound effects on patient function, the disorders are often prevalent, underrecognized, and undertreated. Inadequate treatment is associated with significant morbidity and mortality, an association gaining increased attention among clinical researchers. Healthcare- associated costs are prohibitively burdensome, estimated at nearly USD 100 billion per annum. Data from numerous epidemiologic and randomized controlled studies clearly demonstrate that patients with disrupted sleep/wake patterns have significantly impaired daytime function and experience excessive sleepiness, a debilitating symptom with far-reaching consequences. Sleep clinicians need to improve their understanding of the morbidity associated with sleep/wake disorders, to communicate the issues to their colleagues and to their patients, and to tailor therapies accordingly.
Learning Objectives
At the completion of this initiative, the participants should be better prepared to:
- Discuss the morbidity associated with sleep/wake disorders across neurocognitive, neurophysiologic, and executive domains
- Explain the neurophysiologic basis of the potentially irreversible neurocognitive, memory, and executive deficits in patients with obstructive sleep apnea and other sleep/wake disorders
- Evaluate potential neuropsychologic and executive deficits in patients with sleep/wake disorders
- Utilize nonpharmacologic and pharmacologic treatment modalities to improve sleep/wake consolidation and patient function
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Albert Einstein College of Medicine and Montefiore Medical Center, and Asante Communications. Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
Albert Einstein College of Medicine designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Credit Designation Conflict of Interest Statement
The Conflict of Interest Disclosure Policy of Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical, product, or device company. Any presenter whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to present. Albert Einstein College of Medicine also requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States. Faculty participating in this activity have indicated the following disclosure information:
Michael J. Thorpy, MD
Cephalon, Inc.; Jazz Pharmaceuticals (consultant, speakers bureau)
The staff at Albert Einstein College of Medicine has no disclosures to report other than the following:
Steven Jay Feld, or a member of his household, owns securities in Bioheart, Inc.; Chelsea Therapeutics, Inc.; and Pharmacopeia, Inc.
Chris Ontiveros, PhD, (senior scientific associate, Asante) has no conflicts of interest with commercial interests related directly or indirectly to this educational activity.
Method of Participation
There are no fees for participating in and receiving credit for this activity. The participant must read the objectives and enduring material, and answer the multiple-choice post-test. Please complete the evaluation form which provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his/her views on future educational needs. A score of at least 70% is required to successfully complete this activity. Credit is available through November 16, 2010.
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Copyright Information
Copyright © 2009 Albert Einstein College of Medicine and Montefiore Medical Center, and Asante Communications. All rights reserved. No part of this syllabus may be used or reproduced in any manner whatsoever without written permission, except in the case of brief quotations embodied in articles or reviews.
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