Browsing by Author "Ryan, Frank"
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Item Open Access Canadian Sleep Society/Canadian Thoracic Society position paper on the use of portable monitoring for the diagnosis of obstructive sleep apnea/hypopnea in adults(2010-01-01) Blackman, Adam; McGregor, Catherine; Dales, Robert; Driver, Helen S; Dumov, Ilya; Fleming, Jon; Fraser, Kristin; George, Charlie; Khullar, Atul; Mink, Joe; Moffat, Murray; Sullivan, Glendon E; Fleetham, John A; Ayas, Najib; Bradley, T Douglas; Fitzpatrick, Michael; Kimoff, John; Morrison, Debra; Ryan, Frank; Skomro, Robert; Series, Frederic; Tsai, WillisThe present position paper on the use of portable monitoring (PM) as a diagnostic tool for obstructive sleep apnea/hypopnea (OSAH) in adults was based on consensus and expert opinion regarding best practice standards from stakeholders across Canada. These recommendations were prepared to guide appropriate clinical use of this new technology and to ensure that quality assurance standards are adhered to. Clinical guidelines for the use of PM for the diagnosis and management of OSAH as an alternative to in-laboratory polysomnography published by the American Academy of Sleep Medicine Portable Monitoring Task Force were used to tailor our recommendations to address the following: indications; methodology including physician involvement, physician and technical staff qualifications, and follow-up requirements; technical considerations; quality assurance; and conflict of interest guidelines. When used appropriately under the supervision of a physician with training in sleep medicine, and in conjunction with a comprehensive sleep evaluation, PM may expedite treatment when there is a high clinical suspicion of OSAH.Item Open Access Canadian Thoracic Society 2011 Guideline Update: Diagnosis and Treatment of Sleep Disordered Breathing(2011-01-01) Fleetham, John; Ayas, Najib; Bradley, Douglas; Fitzpatrick, Michael; Oliver, Thomas K; Morrison, Debra; Ryan, Frank; Series, Frederic; Skomro, Robert; Tsai, Willis; The Canadian Thoracic Society Sleep Disordered Breathing Committee,The Canadian Thoracic Society (CTS) published an executive summary of guidelines for the diagnosis and treatment of sleep disordered breathing in 2006/2007. These guidelines were developed during several meetings by a group of experts with evidence grading based on committee consensus. These guidelines were well received and the majority of the recommendations remain unchanged. The CTS embarked on a more rigorous process for the 2011 guideline update, and addressed eight areas that were believed to be controversial or in which new data emerged. The CTS Sleep Disordered Breathing Committee posed specific questions for each area. The recommendations regarding maximum assessment wait times, portable monitoring, treatment of asymptomatic adult obstructive sleep apnea patients, treatment with conventional continuous positive airway pressure compared with automatic continuous positive airway pressure, and treatment of central sleep apnea syndrome in heart failure patients replace the recommendations in the 2006/2007 guidelines. The recommendations on bariatric surgery, complex sleep apnea and optimum positive airway pressure technologies are new topics, which were not covered in the 2006/2007 guidelines.