Sleep Medicine 14S (2013) e2–e17

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5th World Congress on Sleep Medicine, 28 September to 2 October 2013, Valencia, Spain – Symposium Information S1: New Diagnostic Technologies for Sleep Disordered Breathing Chair: Thomas Penzel (Germany) Speakers: Thomas Penzel (Germany), Robert Thomas (USA), Robert Poirrier (Belgium), Ludger Grote (Sweden), Pierre Escourrou (France), Chen Lin (USA0029) Learning Objectives: New methods for portable diagnosis of sleep apnea – possibilities and limitations Modern diagnostic methods give new chances to investigate pathophysiology in sleep apnea and cardiovascular consequences in order to improve predictors for outcome Therapy compliance monitoring does become a part of diagnostic follow up studies Target Audience: Sleep physicians who want to learn about new options in diagnostic tools. Sleep physicians who want to see the state of the art in technological developments supporting the diagnosis of sleep disordered breathing. Sleep technologist who want to learn about upcoming developments for the sleep laboratory environment. Summary: The symposium educates about new technical developments for the diagnosis of sleep disorders. This includes education on sleep disordered breathing with consequences for cardiovascular disorders and for sleep fragmentation. One talk is addressing the issues of new technologies in the follow up of compliance with therapy again in patients with sleep disordered breathing. New telemedicine techniques allow a rapid check of patient adherence to therapy with CPAP and other ventilation techniques. In addition to these pathophysiological and technical issues, the management of sleep centers is addressed. Do we need full sleep centers which cope with all sleep disorders? Do we need specialized sleep centers which focus on respiratory or neurological problems alone? Do we need centers which only perform portable sleep studies? Introduction Thomas Penzel (Germany) Cardiopulmonary coupling in the diagnosis of instable sleep and sleep disordered breathing Robert Thomas (USA) Sagittal movement recording for the detection of sleep disordered breathing and sleep stages Robert Poirrier (Belgium)

Autonomic state indicator for the assessment of cardiovascular risk in patients with sleep disorder Ludger Grote (Sweden) Telemedicine approach to assess CPAP compliance Pierre Escourrou (France) Different activation of autonomic nervous system with flow limitation Chen Lin (USA) Management of sleep disordered breathing inside and outside the sleep laboratory Thomas Penzel (Germany) S2: Cognitive Behavioral Therapy for Insomnia (CBT-I): Knowledge Transfer and Treatment Dissemination Co-chairs: Charles M. Morin (Canada), Yun Kwok Wing (China) Speakers: Charles M. Morin (Canada), Yun Kwok Wing (China), Josee Savard (Canada), Rachel Manber (USA), Colin Espie (United Kingdom) Learning Objectives: Describe innovative methods to deliver treatment and transfer knowledge Summarize recent findings on the impact of these treatment delivery models and web-based technologies to disseminate interventions for insomnia/sleep disturbances Target Audience: This symposium is likely to be of significant interest for both sleep clinicians providing insomnia treatment and investigators conducting clinical trials on insomnia therapies. Summary: There is solid evidence that cognitive-behavioral therapy for insomnia (CBT-I) is effective, produces sustained benefits over time, and is well accepted by patients. An important challenge that remains, however, is to translate this evidence into practical applications and to disseminate it to potential users, i.e., individuals with insomnia and health-care practitioners who work with sleep patients in diverse settings. The main objectives of this symposium are to describe innovative methods and technologies to disseminate CBT-I and optimize knowledge transfer. Five speakers from different part of the world will present evidence from recent clinical trials documenting the impact of self-help therapies using the Internet and web-based applications, training workshops, and sleep education programs as implemented in community, hospital, and school settings.

Conference Reports / Sleep Medicine 14S (2013) e2–e17

Introduction Charles M. Morin (Canada) Knowledge transfer through sleep education among schoolaged children Yun Kwok Wing (China) Efficacy of a video-based CBT for insomnia in cancer patients Josee Savard (Canada), H. Ivers, M-H. Savard, J. Villa, C.M. Morin Training dissemination of CBT-I in veterans administration health care system Rachel Manber (USA) A web-based intervention for insomnia Colin Espie (United Kingdom) Internet-delivered CBT for insomnia Charles Morin, L. Ritterband, F. Thorndike, L. Gonder-Frederick, K. Ingersoll Question and answer Charles M. Morin (Canada)


activation of hypoxic and related pathways in peripheral and central tissue that also may relate to RLS genetics and peripheral as well as brain features of RLS. Finally brain connectivity imaging, spectroscopy and recent neurophysiological studies provide an interesting picture of divergent paths for expression of the disease. These involve altered thalmo-connectivity and possibly spinal systems with putative somewhat separate pathways and neurochemistry expressing the hyperarousal versus periodic leg movements of RLS. The insights provided by these studies on the biology of RLS impact developments for better diagnosis, evaluation and treatment of RLS. Introduction Richard P. Allen (USA) MEIS1, iron and RLS: Genetic effects on iron regulation and blood brain barrier in RLS James R. Connor (USA) RLS biological pathways: hypoxic and related pathways in brain and peripheral systems Christopher J. Earley (USA) Genetics and developmental issues in RLS biology Juliane Winkelmann (USA)

S3: Converging Understanding of the Biology of Restless Legs Syndrome Chair: Richard P. Allen (USA) Speakers: Richard P. Allen (USA), James R. Connor (USA), Christopher J. Earley (USA), Juliane Winkelmann (USA), Yong-Won Cho (South Korea) Learning Objectives: Biological significance of RLS genetics for brain development and iron regulation Role of hypoxic and related pathways in expression of RLS symptoms Differing pathways and neurochemical systems for spinal and cortical excitability in RLS Brain connectivity differences supporting development of RLS symptoms Possibilities of biologically based developments of new approaches to diagnosis, evaluation and treatment of RLS Target Audience: Intermediate to advanced clinical and scientific interest in RLS and new diagnostic and treatment considerations developing from understanding the biology of RLS. Summary: A wide range in disparate biological features of RLS have each been advanced as the biological basis for RLS, e.g.: peripheral nervous system, spinal mechanisms, dopaminergic systems (A11, nigro-striatal), thalamo-pathways, cortical arousal, pain/sensory systems, glutamatergic activation, hypoxic pathways, iron regulation, genetics. There is now the beginning of understanding how these various biological features of RLS converge to reveal both underlying biological diatheses for RLS and pathways for expression of the disease. This symposium will present some of the initial findings that begin to reveal this complicated biological network for RLS. First, new advances in understanding the biological significance of RLS genetics reveal pathways for producing both basic iron regulation problems, particularly at the blood-brain-barrier and also basic alterations in development of major brain systems, particularly the nigro-striatal system. Second, alternate pathways leading to expression of the disease have been found involving

RLS Cortical/spinal excitability, PLM vs hyperarousal: Iron, dopamine and glutamate Richard P. Allen (USA) Brain imaging: MRI connectivity, iron and dopamine Yong-Won Cho (South Korea) Question and answer Richard P. Allen (USA) S4: The Autonomic Nervous System and Sleep in Human Narcolepsy: Do Patients Have an Increased Cardiovascular Risk? Chair: Pietro Cortelli (Italy) Speakers: Pietro Cortelli (Italy), Daniela Grimaldi (USA-Italy), Stine Knudsen (Denmark), Yves Dauvilliers (France), Rolf Fronczek (The Netherlands) Learning Objectives: Gain insight in what is known about how the autonomic nervous system is affected in hypocretin-deficient human narcolepsy Learn the results of several recent sleep studies with autonomic measurements in human narcolepsy Understand the broader impact of hypocretin deficiency in human narcolepsy in relation to possible cardiovascular risk and obesity Target Audience: Advanced topic for clinical sleep specialists and basic researchers with a special interest in the autonomic nervous system effects of hypocretin deficiency in human narcolepsy. Summary: Almost all narcolepsy with cataplexy patients lack the neuropeptide hypocretin (orexin). The hypocretin system plays a key role in the complex interaction between sleep and the autonomic nervous system. It is hypothesized that hypocretin deficiency thus affects cardiovascular risk factors in narcolepsy. In this symposium results of several recent studies will be presented, with a focus on


Conference Reports / Sleep Medicine 14S (2013) e2–e17

the autonomic nervous system in relation to sleep in human narcolepsy. This includes blood pressure rhythms and spectral analysis of heart rate variability as a reflection of sympathovagal balance during sleep, which reveals an abnormal sleep-cardiovascular system interaction. Furthermore, recent data indicate a reduced heart rate response to arousals and leg movements during sleep in narcolepsy patients that lack hypocretin. In another study, a higher percentage of ‘non-dipping’ blood pressure profiles (defined as

Abstracts of the 5th World Congress on Sleep Medicine, 28 September-2 October 2013, Valencia, Spain.

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