International Symposium - Day Two

The second day of presentations was more along the lines I am familiar with... human beings.

The talks ranged from sleep disordered breathing and fragmentation in people with COPD to standard anthropometric measurements predicting SDB in active NFL players.

The most interesting talk of the many interesting talks came later in the day and was delivered by Dr. Andrew Wellman of Brigham and Women's Hospital in Boston. The title was "A technique for measuring ventilatory control stability (loop gain).

Loop gain is one of those concepts that comes up often in discussions about making CPAP therapy more comfortable for those with sleep apnea - Andrew explained this way - "Loop gain was calcualted by dividing the ventilatory response (the amount by wihich ventilation increased above eupnea when CPAP was turned back to the optimum pressure) by the ventiliatory disturbance (the amount by which ventilation was reduced below eupnea during the dial-down).

I am not doing his presentation justice, but Andrew Wellman is one to watch.

The second day concluded with a festive buffet dinner on the grounds of the Frick Mansion. The highlight of the dinner was the awarding of three young investigator awards in memory of Anne Elizabeth Suratt, the daughter of Paul Suratt one of the founders of the symposium.

The awards went to:

Kevin Grace from the University of Toronto his talk - "On the role of pedunculopontine tegmental neurons in the modulation of the REM sleep state and its respiratory phenotype"

Gaspard Montadon also from the Toronto - "State-dendent modulation of respiratory activity by perfusion of neuropeptides into the pre-Botzinger Complex of the adult rat in-vivo"

Josiane Broussard from the University of Chicago - "Experimental reducation of sleep duration or quality is associated with impaired insulin signaling in the adipocyte"

The symposium concludes today and I will be back with info and final thoughts. Let me say this, I am impressed with the enthusiasm of the young investigators - the field of sleep medicine is in good hands.

11th Symposium on Sleep and Breathing - Day One

I was never one that was particularly good at science. I think most of the instructors took pity on me and gave me a passing grade because my heart was in the right place (so to speak).

My work as the executive director of the American Sleep Apnea Association has so much more to do with the effects on humans of untreated sleep apnea and the challenges of adherence to treatment than with the mechanics of the breathing during sleep and the architecture of the upper airway. Though having something beyond a passing understanding of these topics is important, especially when thinking about the future of treatment for this condition.

So here I am, lovely Pittsburgh, home of the Steelers, Pirates and Penguins and the site of the 11th Symposium on Sleep and Breathing - a meeting held every two years or so that brings together the leading researchers in the field of sleep and breathing from all around the world.

Yesterday was the first full day, with 12 presentations and a featured talk from the Mark T. Gladwin, MD from the University of Pittsburgh it was quite a day.

Dr. Gladwin's speech on nitrite and the biology of hypoxic NO signaling was fascinating and one of the take aways is that cured meats may be helpful.

All of the other presentations were excellent - the format of this year's meeting was different from past years. In lieu of the senior researcher presenting, it is one of the junior researchers presenting work in progress.

All of the presentations provided insights to me and so were educational... the one that struck me the most was from a researcher associated with Dr. Montserrat of Barcelona Spain - Isaac Alemendros. The title of his talk was "Dyanamic changes in brain oxygen partial pressure during obstructive apneas."

The aim of his work was to carry-out a real-time measurment of tissue oxygen partial pressure (PtO2) in the cerebral cortex of rats during recurrent obstructive apneas mimicking those experienced by humans with OSA.

Conclusion - "These data suggest that the cerebral cortex tissue is partially protected from the intermittent hypoxia/reoxygenation stimulus induced by recurrent obstructive apneas."

Translation - It appears that that brain (in rats anyway) protects itself from damage from lack of oxygen during the on again/off again/on again that occurs during apneic events.

Great stuff!