June 2009

Notes from the Section

• The Board of Registered Polysomnographic Technologists has eliminated the A-STEP Self-Study (online) Module requirement for candidates applying for the RPSGT exam through Pathway #2, effectively exempting respiratory therapists who want to take the exam from additional educational requirements. READ ARTICLE
• Nominations for our 2009 Specialty Practitioner of the Year are well underway. Visit the SECTION WEB SITE to access the easy-to-use online nominations form.
• Sleep RTs know how obesity affects sleep. Folks at “The Biggest Loser” do too, and when the show turned to Respironics to assess their contestants, Respironics turned to AARC members Pam Minkley and John Seymour to carry out the studies. READ MORE

Can Treatment for Sleep Disorders Help People with TBI?
A new study out of the University of Texas Health Science Center suggests treating sleep disorders in people with traumatic brain injury (TBI) may be of questionable benefit. Researchers tested 57 adults for sleep disorders and subsequently treated 22 for sleep problems (13 with obstructive sleep apnea received CPAP; 4 with periodic limb movements and 5 with hypersomnia/narcolepsy were managed pharmaceutically). While treatment did resolve the problems on subsequent polysomnography, little change was seen on either the mean sleep latency test or Epworth Sleepiness Score among the OSA patients, and no significant changes in mood, quality of life, or cognitive performance were noted after any of the therapies. The researchers emphasize the number of people in their study was small, and believe larger studies are warranted to further investigate the area. READ PRESS RELEASE

Sleep, Age, and Caffeine
Researchers who conducted a double blind, cross-over study among people age 20-30 and those age 45-60 suggest the combination of age and caffeine increases vulnerability to the circadian waking signal, particularly in older people. All the participants underwent a nocturnal sleep episode in the laboratory. A period of daytime recovery sleep took place following a 25 hour period of wakefulness. Three hours before daytime sleep recovery participants received either a caffeine or placebo capsule, with a remaining capsule taken an hour before daytime sleep recovery. Results showed:

• Middle-aged subjects had greater decrements of sleep duration and sleep efficiency than young subjects during daytime recovery under placebo compared to nocturnal sleep.
• Caffeine decreased sleep efficiency, sleep duration, slow-wave sleep, and REM sleep during daytime recovery sleep similarly in both age groups.
• Caffeine also reduced N-REM sleep EEG synchronization during daytime recovery sleep.

“We propose that lower brain synchronization due to age and caffeine produces greater difficulty in overriding the circadian waking signal during daytime sleep and leads to fragmented sleep,” write the authors. “These results have implications for the high proportion of the population using caffeine to cope with night work and jet lag, particularly the middle-aged.” The study appeared in the March 31 issue of Sleep Medicine. READ ABSTRACT

REML Impacts CPT Scores in Schizophrenics
Researchers publishing in the April issue of Psychiatry and Clinical Neurosciences find shortened rapid eye movement latency (REML) is linked to cognitive problems in patients with schizophrenia. The study was conducted among 15 inpatients who were being treated with risperidone. The investigators gauged the impact of sleep disturbances on the patients’ cognitive abilities by correlating the polysomnographic profile with results on the continuous performance test (CPT). REML was negatively correlated with errors of omission and reaction time, and positively correlated with hit rate. Reduced slow wave sleep was not linked to CPT performance. READ ABSTRACT

One Time Sedative Does Help with CPAP Compliance
Sleep RTs generally believe a sedative during CPAP titration can work wonders for future compliance with CPAP. Now researchers from the Walter Reed Army Medical Center confirm it. Their study of 400 consecutive patients finds those who maintained good compliance with CPAP (defined as using CPAP for more than 4 hours a night on more than 70% of nights) were significantly more likely to have received a nonbenzodiazepine sedative during titration, 77% versus 57.8%. The patients were assessed for CPAP compliance after 4-8 weeks of the therapy. The study appeared in a recent issue of CHEST. READ ARTICLE