Division of Respirology

Sleep Medicine

St. Joseph’s Healthcare/Private Clinic
The sleep medicine rotation is based at two sites. The majority of clinical exposure to patients being investigated for sleep disordered breathing will be at a busy private practice which includes a high volume sleep lab. There is also opportunity to obtain grounding in the basic theory and practice of interpretation of sleep studies working with the sleep physicians and technicians based at St. Joseph's Healthcare.

Medical Expert

  1. Have detailed understanding of physiologic changes during sleep, particularly with respect to control of breathing.
  2. Obtain a history relevant to sleep disorders including:
    • Symptoms that indicate sleep pathology
    • Clinical factors that predict the presence or absence of particular sleep disorders
    • History of sleep habits and ritual
    • Sleep hygiene
    • Family history where relevant
    • Specific risk factors for disease
  3. Demonstrate knowledge of the epidemiology, prevention, pathogenesis, clinical manifestations, laboratory testing, treatment, prognosis, and complications of:
    • Obstructive Sleep Apnea
    • Central Sleep Apnea
    • Cheyne-Stokes Respiration
    • Sleep Hypoventilation
    • Obesity Hypoventilation Syndrome
    • Neuromuscular disorders
  4. To describe the treatments available for these disorders including the continuous and bi-level positive airway pressure (CPAP and BiPAP), oral appliances and upper airway surgery.
  5. To describe the major symptoms and clinical presentations of non-respiratory sleep disorders such as:
    • Narcolepsy
    • Primary Insomnia
    • Restless Legs Syndrome
    • Periodic Limb Movement Disorder
    • A Parasomnias
  6. To describe of general principles of good sleep hygiene.
  7. To have a general understanding of the link between sleep apnea and cardiovascular disease.
  8. To understand how a polysomnography is performed
  9. To interpret a polysomnography including:
    • Recognition of normal or disrupted sleep architecture
    • Recognition of sleep stages and arousal from sleep
    • Scoring of respiratory events including apneas, hypopneas, increased upper airway resistance, and hypoventilation
    • Have an appreciation of the indications and limitations of the following investigations:
        • PSG
        • MSLT
        • NWT
        • Snore-sat
        • Oximetry

Communicator

Answer typical questions about polysomnography to a patient and their family.

Collaborator

Demonstrate an appreciation for a multi-disciplinary approach to sleep disorders and will appropriately consult with other health care persona in the treatment of sleep disorders

Manager

Learn to allocate finite resources for sleep studies.

Health Advocate

Understand the societal implications of sleep-related disorders, including those related to operating a motor vehicle.

Scholar

Recognize the importance of lifelong learning in the field of sleep medicine where there are rapid technological advances.

Professional

Understand the ethical and legal implications of sleep medicine, including those related to operating a motor vehicle.