Aims: To understand the nature of sleep and gain an overview of normal sleep; to appreciate the changes in sleep associated with aging; to recognize various stages of sleep on a polysomnograph (this will be introduced in this unit, but extended significantly later in the course); to understand the range of sleep disorders, their presentation and diagnosis, including respiratory disturbances (OSA, central apnoea, pulmonary disease), sleep deprivation and fragmentation and general medical disorders which impact on sleep; to understand the epidemiology of sleep disorders and their impact on public health. Content: Normal Sleep: This module will explain the definitions of sleep states and describe the progression of sleep through the night. The cyclic nature of sleep in humans and animals will be examined with some discussion of factors that affect sleep architecture, including age and drugs. Introduction to Sleep Stage Scoring: This module will define the various stages of sleep from a practical standpoint, based on polysomnograph records. Candidates will be introduced to the standard methods of scoring sleep states which will be expanded during the practicum. Normal sleep and its variations will be the primary focus, with some discussion on the effects of drugs. Respiratory Disturbances and Sleep: Respiratory sleep disturbance has a long history of comment in the literature generally, whereas, understanding of the medical significance of this has been a relatively recent phenomenon. This module will present an overview of the types of respiratory disturbances associated with sleep and the clinical presentation and evaluation of these. The natural history of sleep disordered breathing changes during the human lifestyle and the concept of a developmental path for sleep apnoea will be discussed. Obstructive Sleep Apnoea: OSA has arguably been the most obvious type of sleep disordered breathing throughout history. Severe OSA is a major impediment to quality of life and is potentially life-threatening, not only as cause of impairment of day-time function, but as a predisposing factor to cardiovascular disease and stroke. OSA will be discussed in terms of its occurrence and polysomnographic identification. Reference will be made to OSA throughout life and treatments, however, these will dealt with in more detail in the Sleep and Breathing Units I,II and III. Central Apnoea: The occurrence and identification of central apnoea will be introduced. This module will give an overview of the range of this phenomenon from apnoea of infancy to Cheyne-Stokes respiration. Introduction to Respiratory Scoring: This module will introduce respiratory scoring, which is very often a major part of scoring a polysomnographic study. It will define the guidlines used to identify and mark respiratory events throughout a polysomnographic study using the recommendations taken from the Report of The Academy of Sleep Medicine Task Force. The types of devices used to measure respiratory variables will also be discussed. The Importance of Sleep: The importance of sleep in the maintenance of physical and psychological wellbeing will be covered.
~5 hours online lectures over 1 semester plus directed reading and independent study
1xonline quiz (40%), 1xexam (60%)