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New Insights Into Sleep-Wake System Neurobiology and Pathophysiology of Insomnia

neuroscienceCME Clinical Navigator

Premiere Date: Friday, May 16, 2014

This activity offers CE credit for:

  1. Physicians (CME)
  2. Other


All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Saturday, May 16, 2015
Note: Credit Is No Longer Available

Faculty


Andrew D. Krystal, MD, MSAndrew D. Krystal, MD, MS 
Professor of Psychiatry and Behavioral Sciences
Duke University School of Medicine
Durham, NC

Karl Doghramji, MDKarl Doghramji, MD 
Professor of Psychiatry
Jefferson Medical College
Director, Sleep Disorders Center
Thomas Jefferson University Hospital
Philadelphia, PA

Thomas Roth, PhDThomas Roth, PhD 
Chief, Division Head
Sleep Disorders and Research Center
Henry Ford Hospital
Detroit, MI

Thomas E. Scammell, MDThomas E. Scammell, MD 
Professor of Neurology
Harvard Medical School
Beth Israel Deaconess Medical Center
Boston Children's Hospital
Boston, MA

Statement of Need

Insomnia can affect many aspects of an individual’s life: impairing concentration and memory, increasing the risk of incident depression or recurrence of a depressive episode, diminishing a patient’s ability to enjoy family and social relationships, and increasing the risks of falls and motor vehicle accidents.

Clinical research provides evidence that insomnia is a disorder of hyperarousal demonstrated by a number of physiologic measures, such as increased heart rate.1 It is hypothesized that hyperarousal may occur in association with a shift in the balance between systems that promote sleep and those that promote wakefulness.

This neuroscienceCME Clinical Navigator is the first of a two-part series, and will describe the neurobiology of the sleep-wake system so that clinicians understand more about the role of neurotransmitters, including orexin, and the nature of how the hyperarousal state may lead to insomnia.


  1. Stepanski E, Glinn M, Zorick F, Roehrs T, Roth T. Heart rate changes in chronic insomnia. Stress Med. 1994;10(4):261-266.

Activity Goal

This educational activity centers on the CMEO Make One Change Statement. This statement is crafted from pertinent quality measures or clinical guidelines as a performance challenge to all participants.

The Make One Change Statement for this activity is: Clinicians will describe the neurobiology of the sleep-wake system, including the roles of neurotransmitters and the nature of the hyperarousal state.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Describe the neurobiology of the sleep-wake system, including the role of neurotransmitters and the nature of the hyperarousal state.

Financial Support

Supported by an independent educational grant from Merck & Co., Inc.

Target Audience

Physicians, physician assistants, and other health care professionals interested in sleep-wake medicine.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/TST886 (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neurosciencecme.com/technical.asp.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Krystal has disclosed that he has received grant support from Astellas Pharma Inc.; Janssen Pharmaceuticals, Inc.; Novartis Corporation; Sunovion Pharmaceuticals Inc.; and Teva Pharmaceuticals USA. He serves as a consultant to AstraZeneca; Eisai Inc.; Jazz Pharmaceuticals, Inc; Johnson and Johnson; Merck & Co; Roche; Somnus Therapeutics Inc; Teva Pharmaceuticals USA; and Vantia Ltd.

Dr. Doghramji has disclosed that he serves as a consultant to Aptalis; Jazz Pharmaceuticals, Inc.; and Vanda Pharmaceuticals. He is a stock shareholder in Merck & Co., Inc.

Dr. Roth has disclosed that he has received grant support from Cereve; and Proctor and Gamble. He serves as a consultant to Aptalis; Cereve; Intec Pharma ltd.; Jazz Pharmaceuticals, Inc.; Merck & Co; Novartis Corporation; Shire Pharmaceuticals Inc.; Sunovian Pharmaceuticals Inc.; and Teva Pharmaceuticals USA. Inc. He is on the speakers bureau of Purdue Pharma L.P.

Dr. Scammel has disclosed that he has received grant support from Eisai Co., Ltd. He serves as a consultant for Cereve; Ferrer; Jazz Pharmaceuticals Inc.; Merck & Co., Inc.; and Purdue Pharma L.P.

Tony Graham, MD (peer review) has no disclosures to report.

Frances C. Daniel, MPH (planning committee) has no disclosures to report.

Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

Sandra Haas Binford, MAEd (planning committee) has no disclosures to report.

Unlabeled Use Disclosure

Faculty of this CME activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

CME Outfitters, LLC, the faculty, and Merck & Co., Inc. do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).

CN-037-051614-44

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