European Society of Sleep Technologists

Newsletter 2000

Contents:

Message from the Board page : 2

In Memoriam Nathaniel Kleitman page : 3 Theresa Shumard

News from the UK page : 4 Martin King

Educating patients about the purpose of nCPAP therapy : page : 5

A commitment which is not to be neglected Ann Ryckx

Night-to-night variability of apnea indices page : 6 Maud Verhelst

Case Study:

Cataplexy and SOREMPs Without Excessive Daytime Sleepiness in Prader: page : 8

Willi Syndrome. Is This the Beginning of Narcolepsy in a Five Year Old? Mary Jones

European Society of Sleep Technologists ( ESST): Sleep Course page : 9 Arlene Jackson

A Hitchhiker Guide to the sleep galaxy page : 11 Jacob Zomer

Job opportunities page : 12

Board page : 13

Sponsors of the ESST page : 15

Meetings and events page : 16

Membership Application Form page : 17

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MESSAGE FROM THE BOARD

Dear members and friends of the ESST,

It took quite a while before we finished this Newsletter, but we are proud that we succeeded once again. The next letter will be published in September.

In this volume you will find the obituary of Nathaniel Kleitman, who died last year and who we refer to as the 'Father of Modern Sleep Research'. Thanks to our co-operation with the american APT (Association of PolysomnographicTechnologists) we can present both this In Memoriam and a case study on Prader Willy Syndrome.

Martin King wrote an article on Sleep Centres and the British Sleep Society and our vice-president Ann Ryckx tells about eight years of experience with nCPAP therapy in her Sleep Lab in the Swiss mountains. We recommend this article to all of you and we would like to ask you whether you can describe how you inform your OSAS patients and how they are treated so that we can print this in our next Newsletter.

Arlene Jackson wrote an article on the basic course organised by the ESST in May last year.

Our national delegate from Israel, Jacob Zomer gives an overview of all kind of websites involved in Sleep and secretary Maud Verhelst explains that there is a certain risk to decide on nCPAP therapy based on a one nights' polysomnography.

Finally this Newsletter gives 3 options to change work or to start working! You'll find the Agenda for the coming period and a list of our Sponsors, who we all thank very much for supporting our Society.

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

At the 15th Congress of the European Sleep Research Society we will organise a day for our members (and members-to-be). If you have a poster, or if you want to give a lecture
on a Sleep and Wake Disorders related subject, please let us know as soon as possible.

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

PLEASE INFORM OTHER TECHNOLOGISTS ABOUT OUR SOCIETY AND ASK THEM TO BECOME MEMBERS. IN THAT WAY WE WILL BE ABLE TO BUILD A NETWORK OF TECHNOLOGISTS THROUGHOUT EUROPE THAT WILL HELP US TO LEARN FROM EACH OTHER AND TO HAVE THE PLEASURE OF SHARING OUR VIEWS ON SLEEP AND SLEEP TECHNOLOGY.

The board and national delegates of the ESST

OUR NEW WEBSITE: WWW.ESST.ORG

…To die: to sleep; No more; and by a sleep to say we end the heartache and the thousand natural shocks. That flesh is heir to, 't is a consummation. Devoutly to be wish'd. To die, to sleep; To sleep: perchance to dream: ay, there's the rub; For in the sleep of death what dreams may come. When we have shuffled off this mortal coil, Must give us pause. ---from Hamlet By William Shakespeare

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Nathaniel Kleitman, Ph.D.

1895-1999

Theresa Shumard

Nathaniel Kleitman, Ph.D., universally recognized as the “Father of Modern Sleep Research,” and co- discoverer of REM Sleep, died in Los Angeles August 13 at the age of 104. Professor emeritus in the Department of Psychology at the University of Chicago, Kleitman was the world’s first scholar to concentrate entirely on sleep.

Born in Kishinev, Russia in 1895, Kleitman went to Palestine at the age of 17 after witnessing the persecution inflicted upon the Jews. He had aspired to practice medicine in the Holy Land, and briefly studied at the American College in Beirut before settling in Palestine. His stay in Beirut was cut short by the outbreak of World War I. Since he was Russian, he feared the Turks would consider him an enemy alien, so he fled to Rhodes. It was there that he boarded the only ship in port, which happened to be bound for New York.

After becoming a naturalized U.S. citizen in 1918, Kleitman received his bachelors degree from the College of the City of New York, masters degree from Columbia University, and Ph.D. summa cum laude from the University of Chicago in 1923. In 1925, he became a member of the faculty there, and established the world’s first sleep laboratory, where he remained until his retirement in 1960, when he and his family moved to California.

Considered by sleep researchers as their “Bible” at the time, Kleitman published Sleep and Wakefulness in 1939-- the first major textbook devoted to sleep.

Kleitman’s enchantment by sleep led him on a journey not yet traveled. His ideas were thought original and even bold by some since sleep previously had been dismissed as merely a state of quiescence. Kleitman often used his family, students and even himself as research subjects, keeping precise records of his two daughters’ sleep from childhood through adulthood. Kleitman once forced himself to stay awake for 180 hours to reveal the effects of sleep deprivation. He and an assistant, housed 150 feet underground in Mammoth Cave, Kentucky, spent more than a month documenting their daily variations in wakefulness and body temperature free from the regulating influence of sunlight and daily schedules, to determine how changing the normal 24-hour routine of sleep and wakefulness affected mental performance.

Kleitman demonstrated the difficulties of adjusting to shifting time schedules and emphasized the importance of considering the body’s regular rhythms in the scheduling of shift workers. He made these observations in 1948 having spent two weeks on the submarine Dogfish.

(Kleitman was often experimenting with his own sleep)

Kleitman once said, “Many sleep theorists, it seems, disregard the obvious explanation of our sleep pattern. They figure that we must sleep eight hours because it takes that long to restore some depleted substance in the body or get rid of some accumulated poison….This does not mean that no benefits accrue from sleep, as one can quickly discover by going without sleep for any length of time.”

(Reprinted with permission by the Association of Polysomnographic Technologists)

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News from the UK

Martin King

A difficult time for Sleep Centres in the UK.

Health care in the UK is free to people at the time and point it is given. The needs of an areas population are identified and money is allocated to hospitals within that district to provide the health care. This means a department is given money to do a specific amount of work but can spend that money in a way that it thinks is best. A sleep centre is therefore not given a set amount of money for a specific test or treatment but can choose what type of test or treatment it provides.

Within this last year the publication of the Wright report questioned the value of treating patients with Obstructive Sleep Apnoea with CPAP. This allowed district administrators to withdraw money for this treatment because “ there is insufficient evidence” to demonstrate CPAP was effective. This has caused significant problems for many sleep centres. Some centres no longer have the money to buy CPAP machines and now have a long list of patients who have OSA but for whom they can not buy treatment.

Evidence to demonstrate the efficacy of CPAP against a placebtablet or placebo CPAP pressure ( less than 5 cmH20) has now been presented. The argument has been made that CPAP does help patients and that local districts should give enough money to Sleep Centres to buy CPAP machines.

These events have had a significant effect on the expansion and development of Sleep Medicine in the UK and has even caused some small centres who only worked with OSA and CPAP to close.

British Sleep Society.

The British Sleep Society is a professional society for all those within the UK and Ireland working in clinical or research areas of sleep. Our membership also includes several European and overseas members who attend our meetings. The BSS has dramatically increased it’s membership (doubled) over the last year. We have a 2 day scientific meeting in the late summer and a 2 day technologists meeting in the Spring months. Our society is more active than ever before and is particularly involved in producing recommendations of practice. We have no structured training course for technologists or doctors and historically people have gone to the USA for training courses. The first technician from the UK attended the ESST course in Den Haag and we hope that more will take this excellent opportunity in the future.

Technician Placements in the UK

Technologists or scientists who would like to work in a UK sleep centre or arrange a short visit as part of their personal development should contact the Hon’ Sec’ of the BSS. ( www.british-sleep-society.org.uk).

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Educating patients about the purpose of nCPAP therapy :

A commitment which is not to be neglected.

Ann Ryckx

Experience over 8 years in the « sleep laboratory » at the Luzerner Clinic in Montana, convinced me how crucially important it is to provide patients with full information about their nCPAP therapy. The success of the treatment depends largely on two factors :

on whether or not the patients are informed about their diagnosis and the complications which may develop therefrom ;

and on their awareness and understanding (mechanism and technical maintenance) of the nCPAP treatment.

After screening tests at a day clinic, patients who are suspected to be suffering from sleep apnea disorder are admitted to our clinic for 3 consecutive nights. Following admission, patients receive a clinical examination by a doctor, who undertakes a specific assessment of their sleep disorders. He establishes their level of daytime fatigue by reference to a specific questionnaire and the Epworth scale.

At the first night of the patient’s stay at the clinic a full polysomnographic examination with video cctv is performed. The technician explains the procedure to each patient, so that he can be reassured and feel comfortable with what is involved. The following day, analysis of this first night’s tests is made.

Patients are then invited into our laboratory, so that the results of the analysis can be explained to them on screen.

It is, in my experience, very important for patients to be given, at this stage, the opportunity to relate to us, technicians, their own version of their condition. We ask them to state the results of the tests carried out prior to their admission to our clinic. Most patients will describe their symptoms – and often assert they only became aware of them from their partners. By paying attention to patients’ sensibilities, we are generally better placed to choose the most opportune way of explaining sleepapnea to them.

We insist on showing patients the results of the analysis, we explain them the different steps which are carried out throughout analysis. ( Epoche by epoche sleep-stage scoring ref. Rechtschaffen und Kales, arousal-analysis, respiratory analysis, PLM analysis etc…) Patients generally tend to be impressed by the number and duration of their apnea attacks, and by their oxygen levels. They also tend to believe that their partners had exaggerated their symptoms. It is therefore important to explain all the apparent signs of sleepapnea, these explanations being supplemented by viewing the video’s footage taken during the previous night. Patients are shown the effects on their heart-beat after desaturation, and occasionally we need to explain other problems related to rhythms.

Patients are then informed about the cause of obstruction and the pathophysiology of the syndrome by reference to a leaflet or an encyclopedic atlas. We can, moreover, with an interactive CD-Rom, enable the patients to visualize obstruction and its consequences. All these items make the task of explaining a course of therapy all the easier. At this moment, also by CD-Rom CPAP-therapy is fully explained to them.

During the afternoon, the patients undergo their first nCPAP trial (Autosetâ ). We make patients lie down for a nap during this procedure. Many patients have a tendancy to hyperventilate at the first impression of positive pressure. We therefore insist they take slow, regular, shallow breaths to avoid periodic breathing. We observe them and show them how to take the mask off, lest they should awake in a state of anxiety. If they’re confident, most patients go to sleep during this procedure.

That night, CPAP-titration is carried out on Autosetâ .

The next morning, the patient undergoes (if it has not already been done) an examination of his rhinopharynx for the purpose of:

  1. excluding any abnormalities
  2. evaluating nasal permeability
  3. making an objective evaluation of the collapsibility of the hypopharynx.(Müller Manœuvre)

The degree of pressure, coupled with the patient’s impressions of the previous night, enable us to decide, along with the patient, the ideal choice of device for his needs – For the the choice we consider several factors : the pressure ; the variability of pressure ; nasal congestion ; lifestyle ; regular trips by airplane, the technical manageability of the patient etc…..

We demonstrate how patients have to maintain their equipment, right down to the smallest detail. This then becomes an exercise for patients to carry out themselves. We ensure that clear instructions (leaflet or videotape) is delivered with each device. We recommend and urge all patients to become familiar with the operating instructions.

The only test to be undertaken in the following and last night of the patient’s stay at our hospital is an oxymetry.

The next morning, we go over the operating instructions for the last time.

The patient receives the addresses and telephone numbers of the Home Care Provider and the hospital. We insist that patients contact their home care provider if they encounter any problems with the treatment, however minor they may be. The support groups are requested to contact the patient at home, a month after each treatment began – but preferably earlier if possible.

Last year we concluded a study on CPAP-compliance among our patients. The first control at the hospital took place 3-6 months after initiating their therapy. At this point, we are able to resolve any (mostly minor) problems patients may have experienced as a result of their treatment. A humidifier integrated into the program can often, it is found, work wonders! The study carried out over the following years clearly showed positive improvements in CPAP-compliance after this first control with re-instruction and encouragement.

The different procedures outlined above may, at first sight, appear excessive and over the top. However from my own experience, I am firmly convinced that such steps are beneficial to all concerned. They cause me to question the practice which is advised by the Health Insurance Companies, to perform the majority of analysis and even CPAP-initiation to be carried out in ambulatory conditions. We observe far too frequently that patients, especially those who are elderly, can be confused by some of the intricacies of the therapy – and that even three nights at our clinic can be all too short for some patients.

Follow-up to the treatment in Switzerland is ensured through regional support groups for pulmonary diseases and has necessitated an increase in the numbers of staff for patients support The Luzerner Clinic works in close collaboration with these groups, especially in an advisory role and through the provision of continual training.

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Night-to-night variability of apnea indices

Maud Verhelst

In our centre, the diagnosis of OSAS is made by 2x24 hours ambulatory polysomnography. This approach has the advantage that it provides insight not only in respiratory parameters but also in sleep quality and excessive daytime sleepiness. In view of financial restrictions by the government, the question arose if a single night screening might be sufficient. The answer to this question is also important for another reason : CPAP treatment is given when the apnea-index (AI) is ≥ 15. Can such an important therapeutical decision be taken on the basis of a single night recording?

On the other hand little is known about night-to-night variability of apnea indices. There is only limited literature with conflicting results. This study therefore investigates the night-to-night variability of apnea indices.

Methods

The polysomnographic records of 50 patients with an apnea index ≥ 5 in at least one of the two nights were retrospectively screened (45 men and 5 women).

We compared the mean duration of the apneas, the maximum duration of the apneas, the AI in the total sleep time (TST) and the AI in the total sleep period (TSP) in both nights for the whole group. The apnea variability between night1 and night 2 was calculated as a relative percentage by the following formula :

0.5 x (AI TST 1 – AI TST 2) : 0.5 x (AI TST 1 + AI TST 2).

Results

 

 

 

Night 1

 

Night 2

Night 2 – Night 1

Mean duration (s)

 

22 ± 7

23 ± 8

0.5 ± 5

 

Maximum duration (s)

 

50 ± 26

52 ± 32

2 ± 20

AI TST

 

21 ± 21

24 ± 27

 

10 ± 15

AI TSP

 

16 ± 15

17 ± 16

1.3 ± 7

Table 1

Table 1 lists the mean values with standard deviations of the analysed characteristics in both the first and second night and the absolute difference between first and second night.

Absolute differences where analysed by Student’s t-test. There was no significant difference for all parameters even if individual differences were quite substantial. Figure 1 shows the relative difference of apnea indices in TST between the two nights. Most patients differed in the range 10-30 %.

For example: a patient with an apnea index of 15 (TST) in one night may have an index of 10 or 20 in the following night.

The cut-off point for CPAP treatment was reached only by 23 patients in the first or second night. From these 23 patients only 4 reached this value in the first night and 3 in the second night.

Conclusion

Night-to-night variability of the apnea index was small for this group. As substantial individual variability does exist, single night recording induces a certain risk. For the decision to treat a patient with CPAP (at a cut-off point AI=15) the risk is 13-17%. This means for example that for a patient with clear clinical syptoms of OSAS but with an apnea index of only 10 in the first night a second polysomnography is strongly recommended.

Figure 1

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Case Study: Cataplexy and SOREMPs Without Excessive Daytime Sleepiness in Prader Willi Syndrome. Is This the Beginning of Narcolepsy in a Five Year Old?

Mary Jones

I'd like to share with you a very interesting case about a five-year old female patient who was brought to our lab by her mother, complaining that her daughter snored. Starting at one-and-a-half years of age, the child began to fall down when she laughed. She was evaluated by a neurologist at Yale University who made the diagnosis of cataplexy. Presently, her events can occur one to two times per day, and more typically, once per week. She looks as if she is turning to rubber, and in most cases, she falls to the ground. On some occasions, she will try to hold onto something to prevent falling.

The patient's mother can interrupt these episodes of paralysis by calling to her daughter; if she doesn't interrupt these episodes, they may last 30 to 60 seconds. The patient's face will alternate between a full smile and flaccid
paralysis. This will alternate back and forth many times. Additionally, there is jerking of the neck as if she is trying to keep her head up, but she loses complete muscle control. The patient's arms are affected. As mentioned, there
is global weakness. The patient is awake during these episodes. She'll respond to her mother's call to start breathing and other similar commands. The patient's mother reports that her daughter is not sleepy, she does not regularly nap, and is not interested in napping if the mother suggests it. The patient did not understand questions relating to sleep paralysis and hypnogogic hallucinations.

At present, this child snores. Now, a year ago, the mother observed distinct episodes where the child would stop breathing for approximately 20 seconds while asleep. Mom could not differentiate between ceasing attempts or whether
there was some obstruction. Noteworthy is that the patient's mother has not heard apneas more recently; this may be due to a number of interventions-growth hormone and a strict 800-1000 calorie per day diet. These two interventions may have made a difference in her sleep disordered breathing (growth hormone increases muscle tone). The patient's weight was 40 lbs. at three-and-a half years of age, and now, two years later, she weighs 38 lbs. with a four-inch addition in her height.


(1680 - Painting at the Prado by Juan Carreno de Miranda, most certainly of a Prader Willi Syndrome girl)

She has no reports of nightmares or night terrors. Although she is potty trained during the day, she does have nocturnal enuresis. Socially, this child is doing well. She has friends with whom she plays. She is not doing so well intellectually. She has significant developmental delay in speech, intellectual functioning, and motor coordination. Reduced motor
tone is affected by her condition.

Tested at Yale University at the age of one-and-a-half, she did not have the hallmarks of Prader Willi Syndrome: a deletion on her fifth chromosome. Two years later, she was tested at the University of Connecticut for a new marker
and it was found that she had an abnormality on her 15th chromosome. She had two contributions from her mother and none from her father. This is called uni parent disomy. This testing confirmed the clinical impression of Prader Willi
Syndrome. She has a number of outbursts-many of them related to food. Her demands can be repetitive.


Prader Willi Syndrome is the most common genetic disorder leading to obesity. The diagnostic criteria for Prader Willi Syndrome include: hypotonia and feeding problems in infancy, obesity, hypogonadism, short stature, temperature instability, and sleep disturbances. Many patients with this syndrome have multiple sleep abnormalities, including fragmented REM, variable REM latency, spontaneous frequent arousals, disordered breathing and nocturnal hypoxemia. Because they are so variable, the nature of their sleep abnormalities is different from that of narcolepsy. The involvement of the hypothalamus in Prader Willi Syndrome may providence additional evidence of the role that the hypothalamus plays in sleep mechanisms.

We studied her to evaluate sleep disordered breathing. In the overnight polysomnogram, she had a 94 percent sleep efficiency. The patient fell asleep in one-and-a-half minutes. She entered into REM 6.5 minutes after falling asleep
which signifies a SOREMP. This first REM period was substantial in duration. Sleep stage distribution was relatively normal with a slight decrease in Stages 3, 4 and REM. SDB analysis revealed 16 breathing events throughout the entire night resulting in a RDI of 3/hr. This SDB was contained mainly in REM sleep, with a resultant RDI in REM of 11/hr. She had 36 events of at least a four-percent decrease in her oxygen level during sleep. Only 2 events were less than 88 percent. The study therefore revealed no significant evidence of sleep disordered breathing. However, if the patient were to gain weight, she may be more prone to sleep disordered breathing. The Multiple Sleep Latency Test revealed borderline sleepiness-an average of 8.9 minutes with 2 SOREMPs. Of note is that the patient'REM period on the fourth nap was prolonged at 12 minutes in duration. Three SOREMPs (one at night, two in the day) with cataplexy
support the diagnosis of narcolepsy. Overall, this is a clinical picture consistent with the beginnings of narcolepsy. What doesn't support the diagnosis of narcolepy is the lack of excessive daytime sleepiness, documented by an MSLT score of 8.9 minutes.The physician's recommendations include HLA screening to see if the patient has the correct halotype for narcolepsy. Inquiries will be made to see if there is sleepiness in any blood relative. The fact that daytime sleepiness
has not reached the pathologic level suggests that this may just be the beginning of this disorder.

(Reprinted with permission by the Association of Polysomnographic Technologists)

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European Society of Sleep Technologists ( ESST) : Sleep Course.

Arlene Jackson

When I was asked if I would like to go to Holland for a weeks course on sleep I was stunned. Despite the fact it was my wedding anniversary (only number 2) I was looking forward to going. I had previously met with Maud Verhelst

(the course organiser and committee member of the ESST) at the BSS technician’s meeting in Stevenage. There we had a long chat about what the course would entail and I was surprised by the comprehensive and varied contents in the course.

I took off from Luton airport one Sunday afternoon in May and landed at Amsterdam 40 minutes later. I then caught a train to The Hague and taxi to my hotel. A quick painless trip. That night was Pizza and anticipation of a week alone and the course.

The next day dawned and the course was starting early at 08.30 am, so I had a very early breakfast. In the dining room were 3 other people all staring into their continental breakfasts not saying much. I had no idea how many people were attending this course so I did not know that other delegates would be staying in my hotel. I set off on the walk to the hospital where the course was being held.

I met with Maud and some of her colleagues, luckily, on their way to the lecture theatre. There were 11 students from all over Europe. After introductions I recognised 4 people from my hotel who I subsequently chummed up with.

We tended to have lectures in the morning and then practical sessions in the afternoon. By the end of the first day and after a few drinks at the beach and dinner in a lovely Italian restaurant I felt like I had known everyone for ages. The biggest disappointment for me was that I only spoke English and some pigeon French, the rest of the group spoke at least 3 other languages. All of the other delegates spoke English so there were no language barriers. I even managed to pick up a few Icelandic and Russian words. The students all came from very different sleep backgrounds and had different levels of experience and it was fascinating to hear what type of work they did and the resources they had. A students description of Sleep Medicine in Iceland was particularly fascinating.

 

 

(Lethuania, Belgium, United Kingdom, Switzerland and Iceland)

 

All the lectures were in English, their content was varied and informative and I learnt a lot which underpinned my existing knowledge in the field of sleep medicine . Handouts and a course work book provided some good reference material and there was always the opportunity to discuss points with lecturers or students over the sit down lunch which was provided.

The course included: standardised terminology, techniques and scoring system for human sleep, common sleep disorders, electrode placement, computerised EEG recording systems, actigraphy techniques and a range of therapeutic techniques. The practicals, although mostly class room based, gave us all the opportunity to see what goes on in a wider european context and the night at the local sleep laboratory was also informative. The groups we were split into were small enough so that the teaching could be directed to match the groups abilities and knowledge.

In summary I found the course content varied and informative. I felt I learned a lot and the course underpinned my existing knowledge in the field of sleep medicine. The different sleep backgrounds and culture of delegates and speakers gave the course a distinctive quality which made for quite an experience. I feel that everyone came away with something positive even if I felt somewhat guilty that everyone spoke English the entire time. The travel arrangements were easy and the course fee probably good value.

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A Hitchhiker Guide to the sleep galaxy

Jacob Zomer

Dear fellows, sleep techs.

The net is like a vast ocean of information, and just like the old sea going navigators, a good pilot, and an experienced captain can be the difference between fruitful surfing, and crashing on the rocks of frustrations.

The best captain that I know of is the "Copernic" multi-search engine, which can be downloaded for free at http://www.copernic.com, (Copernic - The Smart Software to Search the Web!). Once you start using it, you will never want to use another. It uses many of the search engines available on the net simultaneously, and ranks the results according to your search criteria.

Another good way to start a search on the net is to enter the site called http://www.mainportals.com Guide to the Main Internet Portals by subject and by countries that contains a multi-search engine.

We can also start our journey by joining the web ring and surf on its waves to our destination. http://www.webring.org/

We are setting sail on our quest for many reasons, such as shopping, education, work and amusement. In the following list I wish to share with you some of my favorite sites, classified according to these categories, and I hope that you will find them helpful and enjoyable.

(Most of the sites are interconnected but that’s the nature of the web.)

Other treasures can be found and downloaded at: Download of the Millennium - ZDNet Downloads http://cgi.zdnet.com/contests/contest48.html

Education

Welcome to NAPS: New Abstracts and Papers in Sleep http://www.websciences.org/bibliosleep/NAPS/ Keep updated at your fields of interest.

SLEEP SYLLABUS http://www.sleephomepages.org/sleepsyllabus/ a sleep course.

BITS OF SLEEP - The Sleep Research CDROM homepage – try the demo! http://www.unizh.ch/phar/sleepcd/

Try also the Sleep Well to get some fresh water: http://www.stanford.edu/~dement/

Shopping

Remware Services for Polysomnography http://www.remware.com/

The Electrode Store: EMG and EEG electrodes, needles and electrodiagnostic supplies http://www.electrodestore.com/

Special Products from Neuromedical Supplies http://www.neuro.com/neuromed/specprod.htm

CPAP headquarters: Snore Net http://www.snorenet.net/

The mall (rather new but promising shopping site for sleep products) http://www.sleepmall.com/themall.html

Amusement

Napster (What is it?) http://www.napster.com/ Music files at MP3 format.

World Nap Organization http://www.bluemarble.net/ A funny look at sleep.

Work

Sleepnet.com Sleep Links http://www.sleepnet.com/sleeplinks.shtml

Open Directory - Health: Conditions and Diseases: Sleep Disorders

http://www.dmoz.org/Health/Conditions_and_Diseases/Sleep_Disorders/

Sleep Medicine Home Page http://www.users.cloud9.net/~thorpy/

American Society of Electroneurodiagnostic Technologists http://www.aset.org/

Association of Polysomnographic Technologists http://www.aptweb.org/

Sleep Home Pages http://www.sleephomepages.org/

P.S

If you find a new site you would like to share with all of us, please email me at jzomer@netvision.net.il and I will review it.

P.P.S.

with special thanks to our sponsor, at http://www.sleepmate.com sensors and more for sleep labs

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JOB OPPORTUNITIES

 

  1. Centre Hospitalier Luxembourg is looking for a paramedical or a nurse for a full-time job with contract and to start immediately, with good knowledge of sleep analysis and the computer, for night- and day-shifts. Candidate capable to work independently.
    Language: French and English, preferable German and/or Luxembourgish.
  2. Salary: Luxembourgish norms for paramedics (high compared to the rest of Europe).
    If you are interested please mail or phone:
    +32 2 252.31.73 or +35 2 44 11.62.01.
    Inform everyone.

     

  3. Looking for work as a sleeptech in the swiss Alps? Please contact :
  4. Ann Ryckx, Luzerner Höhenklinik Montana, 3962 Montana-Vermala, CH. E-mail:

    ann.ryckx@LHM.GSD.LU.CH"

     

  5. The Centre de Médecine du Sommeil in Genolier (near by Geneva/Switzerland) is in search of a PSG technologist.

For information : CMS - CP 44 - 1272 Genolier – Switzerland - tel. +41 22 366 93 12 fax +41 22 366 93 13


From left to right:

Jacob Zomer–Cinzia Castronovo–Monique Thijssen–Ann Ryckx–
Maud Verhelst–Martin King–Maxime Elbaz–Jo Tiete

Board

Cinzia Castronovo President Italy

Ann Ryckx Vice-President Switzerland

Elena Diaz Gállego Treasurer Spain

Maud Verhelst Secretary The Netherlands

Maxime Elbaz Member at Large France

Sharon Keenan Honorary Member U.S.A.

National Delegates

Martin King United Kingdom

Sirkku Pullinen Finland

Sabine Scholz-Martin France

Jacob Zomer Israel

Jo Tiete Luxemburg

Monique Thijssen The Netherlands

Cinzia Castronovo, Hospital San Raffaele, Via Prinetti 29 - 20127 Milano, Italy
tel.: +39-02-26431 - fax.: +39-02-26433394, E-mail: Castronovo.Vincenza@hsr.It

Ann Ryckx, Luzerner Höhenklinik Montana - 3962 Montana-Vermala/VS, Switzerland
tel.: +41-27-4858181 - fax.: +41-27-4817364, E-mail: ann.ryckx@lhm.gsd.lu.ch

Maud Verhelst, MCH - Westeinde Ziekenhuis, Lijnbaan 32 - 2512 VA Den Haag, The Netherlands
tel.: +31-70-3303016 - fax.: +31-70-3882636, E-mail: Verhelst@Westeinde.Ziekenhuis.nl

Elena Diaz Gallego, Clinica Ruber, Juan Bravo 49 - 28006 Madrid, Spain
tel.: +34-1-3093243 - fax.: +34-1-8593720, E-mail: Cetes@Mad.Servicom.es

Maxime El Baz, Sleep Center of Hôtel-Dieu Hospital of Paris, 1, Place du Parvis Notre Dame - 75181 Pais Cedex 04 - France
Tel :33-1-42-34-82-44 - Fax:33-1-42-34-82-27, E-mail: Maxime.Elbaz@htd.ap-hop-paris.fr

Sirkku Pullinen, Tampere Universitary Hospital, Fin-36280 Pikonlinna - Finland
tel.: +358-32473315 - fax.: +358-32473006, E-mail: Sirkkup@Nettilinja.fi

Jacob Zomer, Sleep Medicine Center, 80 Sheinkinstreet 65223 Tel-Aviv - Israel
tel.: +972-3-5601341 - Fax.: +972-3-5661557, E-mail: JZomer@Netvision.net.il

Monique Thijssen, MCH - Westeinde Ziekenhuis, Lijnbaan 32, 2512 VA Den Haag - The Netherlands
tel.: +31-70-3302721 - fax.: +31-70-3882636, E-mail: Thijssen@Westeinde.Ziekenhuis.nl

Jo Tiete, Centre Hospitalier Luxembourg, 4, rue E. Barblé, L-1210 Luxembourg -Luxembourg
tel.: +352-44116201 - fax.: +352.44116205, E-mail: Tiete.Jo@chl.lu

Sabine Scholz-Martin, CHU- Montpellier, Hospital Gui de Chauliac, 34295 Montpellier Cedex 5 - France
tel.: +33-467337823 - fax.: +33-467337285, E-mail: Scholzmart@aol.com

Martin King, Papworth Hospital NHS Trust, Papworth Everard,Cambridge CB3 8RE - United Kingdom
Tel.: +44-1480-830541 - Fax.: +44-1480-830620, E-mail : Martin.King@Papworth-TR.Anglox.nhs.uk

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SPONSORS OF THE ESST

ASTRO-MED INC.

ERICH JAEGER GmBH

GOTTLIEB WEINMANN

MAP

RESMED

ASTRO-MED INC.

Grass Instrument Division of Astro-Med Inc. have a complete line of PSG equipment as well as transducers, electrodes and accessories. Moreover analog and digital system for polysomnography and EEG; polygraph systems for physiological research, consumables including paper and electrodes.

ERICH JAEGER GmBH

A complete line: full polysomnographie devices and sleepscreens combined with Windows based Matrix Analyses Software.

GOTTLIEB WEINMANN

Gerate fur Medizin und Arbeitsschutz GmbH+Co

Many different sleep apnea devices. Innovative CPAP valves for reduction of sound disturbance during CPAP administration.

MAP

Medizintechnik fur Arzt und Patient GmbH

Recognised as leading manufacturer and distributor with a complete line of new sleep apnea theraphy and ambulatory diagnostic products as MESAM® IV (the system for early recognition and monitoring of sleep related breathing disorders), POLY-MESAM® (the cardiorespiratory sleep lab for today's physician), Max® nCPAP and Moritz® biLEVEL, ambulant therapy systems for sleep apnea and other sleep related breathing disorders diagnostic and recording systems.

RESMED

Designs, manufactures and markets worldwide a broad range of products for the diagnosis and treatment of obstructive sleep apnea. The products, sold under the SULLIVAN® brand name, include the CPAP, VPAP, Auto

Set and the bubble Cushion Mask

AutoSet and the bubble Cushion Mask System.

Ñ

we also acknowledge the following companies for their support:

SYNECTICS SLEEP AB

Evaluate apnea, nocturnal myoclonus, reflux and more with the portable Synectics medical MicroSleep Series. Products include: MicroSleep Screening Unit MkIII Digitrapper / pH Meter, pH recording units. Response and solid state pressure systems for UARS and esophageal pressure.

EPM Systems

Offers the widest range of specialty sensors for monitoring sleep disorders as: airflow sensors, body position sensors, limb movement sensors, disposable EEG electrodes, respiratory monitoring belts, upper airway resistance sensor.

OXFORD INSTRUMENTS

A pioneer in sleep diagnostics, offers a full line of instrumentation for sleep recording (portable systems) and analysis. Products include: Sleep analysis system, Medilog vision, Medilog MPA-S, Questar Neural Network Sleep Analysis System.

NICOLET

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MEETINGS AND EVENTS

May 26-27, 2000 Stockholm, Sweden

The sleepy driver and Pilot – Causes, Risks and Countermeasures

This is a satellite symposium of the 17th Congress of the International Association of Accident and Traffic Medicin.For detailed information and registration:

Please contact: http://www.ki.se/cnsf/iaatm2000/sleepy1.html

 
September 12-16, 2000 Istanbul, Turkey
15th Congress of the European Sleep Research Society For information contact: Cerrahpasa
Medical Faculty, Dept. of Neurology, Sleep Disorders Unit, Cerrahpasa 34303 Istanbul, Turkey
Tel / Fax: (90) 212 632 96 96 email: info@tsrs.org.tr www.tsrs.org.tr

second announcement: www.tsrs.org.tr/html/second.html

2-6 October 2000

2-6 April 2000

Holland Sleep – School for Sleep Medicine & Techn

organizes 5 day courses in Basic Sleep Medicine and Polysomnography for physicians, psychologists, sleep technologists and people working in allied health companies. Costs: 1250 Euro.

For information: HollandSleep@Westeinde.Ziekenhuis.nl or www.hsr.nl/school

8-10 november 2000

15th Congrés de la Société Française de recherche sur le sommeil and th 7th journées du groupe sommeil de la soiété de pneumologie de langue française.

Please find the address of the admnistratif secretary: Société le Corum, Esplanade Charles de Gaulle, BP 2200, 34027 Montpellier Cedex 1. Tel: 00-33-4-67616761 Fax 00-33-4-67616684

E-mail:gestion@corum-montpellier.fr

Scientifique secretary Mrs Claude Anfruns, Service de Neurologie B, Hôpital Gui de Chauliac,

34295 Montpellier Cedex 5. Tel 00-33-467337359 Fax 00-33467337285

E-mail: association-etude-sommeil@wanadoo.fr

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MEMBERSHIP APPLICATION FORM 2000 and 2001

The membership fee remains equivalent of 40 Euro for 2 years. To simplify the method of payment, payment by credit card is available. Only members who have payed their dues will receive a membership card.

Name Mr/Ms ______________________________________________________________________

Home Address _______________________________________________________________________

City, Zip Code _______________________________________________________________________

Country _________________________________________________________________

Phone __________________________________________________________________

Professional Address _______________________________________________________

City, Zip Code ___________________________________________________________

Phone___________________________________________________________________

Fax_____________________________________________________________________

Please send correspondence to:

 home address

 work address

Please indicate which phone number should be published in the addresses directory :

 work _ day _ night ;  home

Payment can be made by choosing among the following options:

PREFERABLE:

Send or fax the form below to:

Maud Verhelst

ESST Secretary

MCH - Centre for Sleep and Wake Disorders

PO Box 432

2501 CK Den Haag

The Netherlands

FAX: +31-70-3882636

OPTIONS:

We also accept international bank transfer to the following address:

ESST, European Society of Sleep Technologists

c/o CARIPLO, Cassa di Risparmio delle Provincie Lombarde

Segrate , Milano, ITALY

Account number : 20338/1

Please, in any case, send this membership application form to the Society address.

Active members will receive the ESST Newsletter (twice a year), the ESST membership card, the addresses directory of European Technologists (only on request), reduced international conference fees and the opportunity to compete for international research and travel awards.

Join us in this new Society: we will try to update our knowledge in sleep field by the cooperation and exchange of information between us.

Date____________________ Signature________________

 

CREDIT CARD ESST

 

MEMBERSHIP FEE 40 euro

Name __________________________________________________

Address ________________________________________________

Please indicate

MASTERCARD  EUROCARD  VISA 

Card Number: 

Date of expiration

____ / ____ / ____

Signature ________________________

Today’s Date ___/ ___ / ___

DEMOGRAPHIC DATA

(optional)

Years employed as sleep technologist ____________________________________

Professional Experience _______________________________________________

Other Professional Membership __________________________________________

Types of studies performed _____________________________________________

Other Remarks_______________________________________________________

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