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Course Outline

ASHS 303
Principles of Polysomnography (3,0,0)
Continuous Intake, 2000


Course Description

The Polysomnography Program is comprised of three courses offering the student the most current information regarding sleep medicine, and technical considerations from patient setup to the technology used during the over-night recording, interpretation of the recording, data compilation and presentation.

Polysomnography 303 is the third of three courses designed to provide the most current information on the technical and clinical aspects of Polysomnography, as well as the methodology used by the Polysomnographic Technologist in the sleep laboratory. This course includes patient interaction and describes the capture of bio-electric activity, over-night recording techniques, the interpretation of and data presentation for the compilation of the final report.

The TRU Polysomnography Program will prepare the student to challenge the American Board of Registered Polysomnographic Technologists exam.

Timelines

You have eight months from the date that you received this material to complete all course work including the final exam.

Educational Objectives/Outcomes

  1. Describe the basis of the 10 &emdash; 20 system and its advantages.
     
  2. Describe the measurements and measuring procedures.
     
  3. Understanding the common errors and modifications that may be encountered.
     
  4. Describe the special circumstances that may be experienced.
     
  5. Understand the three main parameters recorded in all sleep studies
    • EEG
    • EOG
    • EMG
       
  6. Describe the general considerations in all sleep studies
    • Paper speed
    • Filtering
    • Sensitivity
       
  7. Describe special considerations in staging sleep in pathology
    • Narcolepsy
    • Sleep apnea syndrome
    • Arousals
       
  8. Summarize sleep stage data.
     
  9. Describe how sleep stages are defined as standardized by the Rechtschaffen and Kales scoring system.
     
  10. List the criteria used to score each sleep stage.
     
  11. Define and classify artifacts.
     
  12. Describe the artifacts and its elimination technique.
     
  13. Describe the physiological aspects leading to arrhythmias during sleep.
    • Abnormalities
    • Sympathetic tone
    • Parasympathetic tone
       
  14. Understand the effects sleep has on heart rate and rhythm.
    • Atrioventricular blocks
    • Ventricular arrhythmias
    • Supraventricular tachycardia
       
  15. Describe the relationship between sleep and arrhythmias and their therapeutic implications for the following:
    • Obstructive sleep apnea
    • Sudden infant death syndrome
       
  16. Describe a multiple sleep latency test (MSLT).
     
  17. Describe the methods for administering MSLT.
    • General considerations
    • Recording montages
    • Specific procedures
       
  18. Describe the standards for interpreting MSLT and measuring latencies.
     
  19. Recognize the need for initial calibrations before an all night study.
     
  20. Understand the presentation of the data provided in a final report.

Prerequisites

Completion of ASHS 301, Sleep and Sleep Disorders and ASHS 302, Polysomnography Instrumentation or permission from Program Coordinator. 

Texts/Materials

You must access either locally or through the Thompson Rivers University bookstore the following reference text:

  • Principles and Practice of Sleep Medicine. Fourth Edition. Kryger, Dement, and Roth. W.B. Saunders Co., Toronto, 2000. ISBN 0-7216-7670-7.

These above materials contain all of the essential information you require to complete the course work. The additional references given below are only supplemental and for your own information if you desire. Note these supplemental references are useful for ASHS 301 and 303 as well.

  1. Sleep Disorders Medicine, Basic Science, Technical Considerations, and Clinical Aspects. Second Edition. Sudhansu Chokroverty, Butterworth Heinemann. 1999. ISBN 0-7506-9954-X.

  2. Sleep. Volume 19, Number 9, 1996. Sleep Disordered Breathing. ISSN 0160-8105. American Sleep Disorders Association and Sleep Research Society.

  3. Current Concepts. Peter J. Hauri; The Upjohn Company. 1992. ISBN 0-89501-062-3. Available through the Association of Polysomnographic Technologists, PO Box 14861. Lenexa Kansas 66285-4861, (913) 541-1991.

  4. Polysomnography: Technical Aspects in Adolescents and Adults. Sharon A. Keenan. Journal of Neurophysiology 9 (1): 21- 31, Raven Press Ltd., New York, 1992. American Electroencephalographic Society.

Student Evaluation

You will receive information with your course materials stating the name of your course facilitator and the best way to contact this person. Although it is your course facilitator's responsibility to contact you as soon as possible after your have received the course material, this initial contact is sometimes difficult to make. I encourage you, therefore, to attempt to contact your assigned course facilitator by mail, email, or by telephone upon receipt of your course information. You should establish a mutually agreeable time when you can contact each other on a regular basis.

Your course facilitator will be experienced in a variety of aspects in polysomnography instrumentation. The assigned course facilitator will be able to answer most of your inquiries directly and will find other answers through contacts at TRU and/or in the field. Your course facilitator's responsibilities include:

  1. Contacting you after you have received the course material.
  2. Answering organizational questions regarding the course.
  3. Maintaining liaison with TRU regarding your progress or concerns.
  4. Answering directly or helping you to contact appropriate resources regarding any content questions which you may have.
  5. Setting the midterm and final examination dates and supervising or arranging for supervision of the exam.

Assignments

The only assignments are the self-tests at the end of each section. You are required to complete these self-tests and grade yourself. Do not send these to your course facilitator for evaluation, but simply use them to identify areas you may need to review for course facilitator assistance. No other assignments are required.

Exams

The exams are short answer and multiple choice. Exams are mailed out in a sealed envelope to the exam invigilator. You will need to send in your Examination Office Information Form.

You must contact your course facilitator or the distance education office a minimum of one month prior to your desired date of writing.
 
When the exam has been completed you will pass it on to the invigilator who will copy the answer sheet to keep on file in case of loss in the mail, and then send the answer sheet and the exam back to TRU in the enclosed self-addressed envelope for marking. The student must never leave the sight of the invigilator while doing the exam.

Midterm 1 20%

Midterm 2 30%

Final 50%

The approximate content of the exams are:

The polysomnograph 50 - 60%
Bio-electrical potentials 40 - 50%
Ancillary equipment 10 - 20%
Midterm #1 - Module A, B
Midterm #2 - Module C, D
Final Exam - Comprehensive (A, B, C, D)

A grade of 60% or better is required for a certificate of successful completion.

Course Topics

Module A: The International Ten-Twenty System of Electrode Placement
Module B: Methodology/Staging Sleep in Pathology
Module C: Sleep Stage Scoring
Module D: Recording Artifacts
Module E: ECG and Associated Cardiac Arrhythmias During Sleep
Module F: Measuring Daytime Sleepiness
Module G: Reports