Respiratory Sleep Certified Training Programme

Aim

The aim of this programme is to train respiratory professionals at a post-specialty or post-graduate level in respiratory sleep medicine. The two-part programme will guide learners through the knowledge, skills and attitudes required to obtain certification in the main respiratory sleep topics. Five independent modules are available:

  • Obstructive sleep apnoea
  • Central sleep apnoea
  • Hypoventilation syndromes
  • CPAP and NIV
  • Diagnostic techniques

Target audience

All health professionals working in respiratory sleep medicine are eligible to follow this training. Part 2 participants must additionally have access to a sleep laboratory or patients within their institution.

 

Programme overview

Participants can register for one or several of the five topic modules. Each module is divided into two parts, both of which are assessed and certified. Participants must successfully complete Part 1 of a module to be eligible to register for Part 2.

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Part 1 of the training programme provides participants with the opportunity to gain or update their knowledge and basic skills in a specific topic or technique. Key guidelines, readings and learning resources will be provided for preparation. Participants will then need to attend a dedicated session at the Sleep and Breathing Conference on 11-13 April 2019 in Marseille, France. The detailed Part 1 programmes for each module are the following:

Part 2 offers participants the opportunity to put theory into practice. The online portfolio will help participants to build competence in respiratory sleep as they will be requested to complete a portfolio with cases or short assignments. The online portfolio will be assessed by an expert who will provide feedback. Participants successfully completing the online portfolio will receive a training programme certificate for the module. The detailed Part 2 programmes for each module are the following:

 

Fees

ERS Respiratory Sleep Training programme(per module) ERS members/Under 40 years old/Physiotherapists/Technicians/Nurses Non-ERS members
Part 1 € 100 € 120
Part 2 € 150 € 200

* All participants selecting a reduced fee will need to provide a proof of status in order to validate their registration.

 

Registration

Attendance to the Sleep and Breathing Conference is a requirement for participants in this training programme. The next Sleep and Breathing Conference is planned to take place in 2021.

Participants having successfully completed Part 1 of a programme module can register for Part 2 via MyERS.

 

Accreditation

The training programme is certified by EBAP with 69 CME credits altogether across the five modules.

Module Part 1 Part 2
Obstructive sleep apnoea 4 5
Central sleep apnoea 4 5
Hypoventilation syndromes 4 5
CPAP and NIV 6 15
Diagnostic techniques 6 15

 

Learning outcomes

Module learning outcomes are based on the ERS Respiratory Sleep Curriculum:

Obstructive sleep apnoea

  • Differentiate, diagnose, and manage obstructive breathing disturbances during sleep.
  • Select different mechanisms and apply to clinical practice, for example craniofacial and upper airway morphology, function and dysfunction of upper airway muscles, central respiratory control mechanisms.
  • Recognise the limitations of screening methods.
  • Consider risk factors and appraise them in therapeutic decisions.
  • Integrate knowledge of the pathophysiology of upper airway muscles to management of the patient.
  • Describe the characteristics of subjective impairment and signs.
  • Describe the characteristics of the mouth, throat and craniofacial configuration.
  • Explain the role of echocardiography, lung function and cardiological examination.
  • Manage OSA caused by craniofacial and upper airway morphology and consider referral.
  • Detect hypercapnic and hypoxic ventilatory response tests.
  • Interpret oxygen and CO2 as a marker of respiratory response.
  • Produce a sleep history.
  • Appraise sleep questionnaires.
  • Differentiate diagnosis based on symptoms and discriminate comorbidities.
  • Produce recommendations for treatment and consider treatment pathways.
  • Evaluate the cardiovascular, neurobehavioural, and metabolic consequences of OSA for example through interpretation of attention tests/vigilance tests, echocardiogram, and blood test on diabetes and lipids.

Central sleep apnoea

  • Describe the polygraphic and polysomnographic parameters of central sleep apnoea.
  • Describe periodic breathing as a subtype of central sleep apnoea.
  • Differentiate obstructive and central apnoeas and obstructive and central hypopnoeas.
  • Describe the different phenotypes of central sleep apnoea.
  • Define the epidemiology of central sleep apnoea.
  • Critically estimate the clinical relevance of central sleep apnoea regarding daytime impairment and outcome.
  • Describe risk factors and underlying diseases (cardiovascular and non-cardiovascular) inducing central sleep apnoea.
  • Differentiate physiological phenotypes of central sleep apnoea (arousal induced, sleep-wake-transition etc.) as compared to central sleep apnoea as a disease.
  • Describe a hypotheses of pathophysiology of opioid induced sleep apnoea and central sleep apnoea in heart failure.
  • Describe and differentiate treatment options such as oxygen, carbon dioxide, drugs, positive airway pressure options.

Hypoventilation syndromes

  • Differentiate, diagnose, and manage hypoventilation during sleep.
  • Classify secondary hypoventilation syndromes.
  • Recognise symptoms, clinical presentation and pathophysiology of obesity hypoventilation syndrome.
  • Explain consequences of obesity hypoventilation syndrome (polyglobulia, cor pulmonale).
  • Explain illness and the risks of obesity, and offer advice on how to decrease BMI through physical activity, training and diet.
  • Analyse symptoms, clinical presentation and pathophysiology of hypoventilation in neuromuscular diseases.
  • Review insight into the different neuromuscular disorders of various origins, caused by accidents, operations, familial inheritance.
  • Compare respiratory failure stages in neuromuscular disorders.
  • Define hypercapnic respiratory failure.
  • Evaluate and diagnose daytime hypercapnia by control of blood gases, transcutaneous capnography, and body weight and clinical muscle assessment.
  • Interpret blood gases.
  • Assess indications for noninvasive ventilation, application or supervision of mask and interface.
  • Perform respiratory muscle testing (e.g. maximal inspiratory pressure, maximal expiratory pressure).
  • Relate the influence of comorbid respiratory disorders on breathing during sleep.

CPAP and NIV

  • Describe different types of positive airway pressure therapy.
  • Assess the appropriate use of the different therapies.
  • List different types of positive pressure interfaces and how these may suit different patients.
  • Recognise the concepts of compliance and adherence.
  • Initiate continuous positive airway pressure (CPAP), auto-continuous positive airway pressure (autoCPAP) based or with prediction formula, and select the appropriate device.
  • Use noninvasive ventilation (NIV) in obstructive lung disease: example COPD.
  • Use NIV in neuromuscular disease: example motor neurone disease/ALS.
  • Acquire problem-solving strategies for CPAP and NIV.

Diagnostic techniques

With regard to polysomnography and polygraphy:

  • Define and describe apnoeas and hypopnoeas.
  • Differentiate obstructive and central apnoeas.
  • Define and differentiate obstructive and central hypopnoeas.
  • Describe and define other breathing disturbances (periodic breathing, atactic breathing, treatment emergent central sleep apnoea).
  • Differentiate phasic and sustained oxygen desaturations.
  • Make the difference between the apnoea-hypopnoea-indices based on polysomnography (relation to total sleep time) and polygraphy (relation to measurement time).

With regard to polysomnography also:

  • Describe the parameters (e.g. EEG, EOG, EMG, microphone, flow, thermistor, effort, oxygen saturation, ECG, movement, body position).
  • Analyse sleep stages.
  • Describe arousals, movement, leg movements.
  • Describe variations of sleep parameters during life-time.
  • Describe somnological disorders other than sleep related breathing disorders (insomnia, periodic limb movements/restless legs syndrome, narcolepsy).
  • Describe polysomnographic characteristics of insomnia, movement disorders, narcolepsy.

With regard to the evaluation of daytime sleepiness:

  • Evaluate daytime sleepiness based on self-assessment questionnaires, technical tests and electrophysiological tests.
  • Describe the Epworth Sleepiness Scale as validated self-assessment questionnaire, describe the test and interpretation of the results.
  • Describe the Stop-Bang-Questionnaire as combined tool including symptoms and risk factors.
  • Describe technical tests such as driving simulator or vigilance test as objective additional tools for the evaluation of sleepiness and daytime performance.
  • Describe the Multiple Sleep Latency Test and the Maintenance of Wakefulness Test and describe the interpretation of the results.
  • Describe the relevance of MSLT and MWT in the evaluation of driving performance and narcolepsy.

For additional information please contact education@ersnet.org

 

Organising committee

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Anita Simonds

ERS Vice President. Consultant in respiratory and sleep medicine. Professor of respiratory and sleep medicine

National Heart and Lung Institute, Imperial College London, United Kingdom

 

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Winfried Randerath

Chief physician and medical director

Bethanien Hospital, Clinic for Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care Institute for Pneumology at the University Witten/Herdecke, Germany

 

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Sophia Schiza

Head of Sleep Disorders Unit, Associate Professor of Respiratory Medicine

University of Crete Medical School, Greece