WCSA - sessions

Have you ever heard the expression - an embarrassment of riches? Well, for this relatively new student of the field - I can't be too new, when I can say that I ran into people that I had seen, not once, but three times in the past month - there was so much information I am still processing it as I write this entry.

There were a number of different tracks to follow - my interest was more on treatment than the basic science. The basic science is important, but people contacting the ASAA are looking for treatment alternatives.

There was however one session on basic science that I was particularly interested in attending - Session 014 - Control of ventilation and upper airway patency. One speaker, Dr. Andrew Wellman spoke about loop gain - I can't begin to explain it, but here is a link to an abstract of article published in the back in 2004 - "Blue Journal"

All I can say at this point is that this is important, and with careful study I will understand (and yes there will be a test at the end - lol).

There were sessions on oral appliances, bariatric surgery, oral surgery... not ground-breaking stuff, but as David Rapoport, a member of the ASAA board, suggested,what was said stirred up his thinking about these issues and will likely help him move in new directions.

There were two other sessions that I will comment on - Session - 017 Lifetime care of the sleep apnea patient with obstructive sleep apnea. The co-chairs Dr. Phillip Westbrook and Dr. Meir Kryger. Among the presenters were David Rapoport who offered an interesting presentation on "What patients are we talking about?" He challenged the audience to think about defining patients in a different way than has been done traditionally. It is not just a question of respiratory disturbance or sleepiness... but both. David will likely revisit this discussion at his presentation during the National Patient Sleep Conference in Bloomington, MN at the end of the month.

It was during this session that A.W.A.K.E. support groups was mentioned by Dr. Lawrence Epstein in his presentation on caring for patient after the diagnosis is made.

Dr. Westbrook, who is one of the many "fathers" of sleep medicine came up with a list of "What the patient should know" based on his extensive experience. I offer them here in abbreviated form:

1. Always inform your doctors you have OSA - especially surgeons
2. Make sure your spouse on the details, so he/she can communicate them if you can't
3. Avoid narcotics they make apnea worse
4. Avoid alcoholic beverages - use in moderation if you must
5. Avoid or use caution using sleeping pills
6. Quit smoking
7. Avoid sleeping at high altitudes - above Denver's
8. Avoid using machinary (including cars) until treated
9. Bring CPAP to hospital - especially for surgery
10. Lose weight
11. Get a yearly examine to monitor blood pressure and for the presence of diabetes
12. There was a slide of Humpty-Dumpty lying on a psychatrist's couch and the doctor is telling him to avoid sitting on walls.

I should also mention that Dr. Guilleminault chaired a session on Upper Airway Resistance... I was hopeful to learn more - I remain confused.

Finally, there was a debate on the topic of portable monitoring for diagnosis of sleep apnea. It pitted Dr. Neil Douglas from Scotland who is favor against Dr. Nancy Collop who spoke against it. Notwithstanding the documentation presented by Dr. Collop... the audience found for Dr. Douglas - though noone's mind was changed by the presentation... hmmm, interesting.

The ASAA was mentioned a second time, during the debate. Dr. Collop mentioned in passing that the letter to the editor published in the July issue of the Journal of Clinical Sleep Medicine did influence the AASM to issue an interim postion statement of the use of portable monitoring - YEAH! Oh, and the Institute of Medicine report influenced them as well.

I just touched the surface of the three days in Montreal and have not mentioned the posters. I will say that this was a rewarding experience in the information received, people met and connections established and the sense that I am where I need to be.

Next, after the conference.