Brush up on respiratory-related sleep disorders for the Pulmonary Board Exam

Sleep medicine accounts for about 10% of the total score on the Pulmonary Board Exam, yet many early career pulmonologists have only minimal exposure to sleep medicine during fellowship and beyond.

“Sleep medicine and respiratory physiology are closely intertwined,” said Swetha Gogineni, MD. “This pulmonary board review session will focus specifically on the respiratory-related sleep disorders to help bridge that gap between what we are exposed to in training and in practice, and what we are expected to know for the exam.”

“It’s more than the board exam,” she continued. “We have a national shortage of sleep physicians, and oftentimes pulmonologists are expected to help take care of these patients. It’s easy to get into a rhythm of just titrating pressures, but it’s important to understand the physiology, not only for the exam but for patient care.”

Dr. Gogineni, a Pulmonology & Critical Care Fellow at Loyola University Medical Center, will chair Sleep Medicine for the Pulmonary Board Review: Respiratory-Related Sleep Disorders on Tuesday at 9:15 am CT. The review will focus on three discrete clinical areas—normal sleep, central sleep apnea, and obstructive sleep apnea and obesity hypoventilation syndrome.

The different subtypes of sleep apnea and obesity hypoventilation syndrome are obvious areas for board questions, Dr. Gogineni noted. In the real world of clinical practice, knowing the parameters of normal sleep and recognizing deviations can be just as important.

“The key components are knowing the normal physiology and the normal changes that we all undergo during sleep, even as normal individuals,” Dr. Gogineni said. “For example, healthy adults tend to hypoventilate a bit during normal sleep. Blood pressure tends to fall, and the heart rate slows; even the parameters of what we consider to be normal are different during sleep.”

These and other physiologic changes are expected, she said, and can easily be tolerated by healthy individuals. But swings in blood pressure, heart rate, and respiration can be more problematic for individuals with preexisting cardiovascular and other conditions.

“Normal sleep parameters also matter if you happen to be working in an ICU or some other setting with 24/7 coverage,” Dr. Gogineni said. “It’s good to know what can be expected during sleep and doesn’t deviate too much from the norm—or what’s out of line and immediate cause for concern.”

The review course is a quick refresher on sleep medicine that is intended to give attendees a solid understanding of the basics. Presenters are allowing ample time for audience questions.

“We want to fully prepare you for the sleep medicine portion of the Pulmonary Board Examination,” Dr. Gogineni said. “Remember, sleep medicine is 10% of the exam, which is not an insignificant amount. This is a prime opportunity to brush up on the basics and ask all your questions, especially the questions you didn’t know you had. This is going to be a high-energy, high-yield hour.”