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Excessive Sleepiness and Psychiatric Illness: Many Sides to the Story

neuroscienceCME TV

Premiere Date: Wednesday, August 8, 2007

This activity offers CE credit for:

1. Physicians (ACCME/AMA PRA Category 1)
2. Nurses (CNE)
3. Pharmacists (ACPE)
4. Psychologists (APA)
5. Social Workers (NASW)
6. Certified Case Managers (CCMC)

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

Credit Expiration Date:
Friday, August 8, 2008
Note: Credit Is No Longer Available

Faculty

Charles B. Nemeroff, MD, PhD  Professor and Chair Department of Psychiatry Mulva Clinic for the Neurosciences Director, Institute of Early Life Adversity Research Dell Medical School The University of Texas at Austin Austin, TX

Mary B. O'Malley, MD, PhD  Program Director, Sleep Fellowship Norwalk Hospital Sleep Disorders Center Norwalk, CT

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

Statement of Need

Core symptoms of sleep-wake disturbances often co-occur in many psychiatric disorders including depression, bipolar disorder, and schizophrenia. Excessive sleepiness, a primary symptom of sleep disorders, is defined as difficulty maintaining wakefulness and an intense drive for sleep even in inappropriate circumstances. Excessive sleepiness is highly prevalent in patients with major depressive disorder (10% to 20%) and atypical depression (36.2%)(1), and is an iatrogenic effect of many psychotropic drugs that may result in impairments including increased motor vehicle accidents and occupational hazards. Patients with psychiatric disorders also represent an "at-risk" population for the development of obstructive sleep apnea, and should be evaluated if they exhibit symptoms of sleep apnea, are overweight, or are on chronic neuroleptic treatment.(2)

This overlap of symptoms and disorders has resulted in a performance gap for clinicians. What tools can aid in differentiating between a primary sleep disorder and psychiatric illness? What questions should clinicians be asking their psychiatric patients to uncover sleep-wake disturbances? What course of treatment should be pursued? When is a referral to a sleep specialist appropriate? In this evidence-based neuroscienceCME TV activity, the experts will provide insights and strategies to aid clinicians in developing and implementing a decision tree for the practical management of sleep disturbances in patients with psychiatric illness.

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1. Baldwin DS, Papakostas GI. Symptoms of fatigue and sleepiness in major depressive disorder. J Clin Psychiatry 2006;67(suppl 6):9-15.
2. Winkelman JW. Schizophrenia, obesity, and obstructive sleep apnea. J Clin Psychiatry 2001;62:8-11.

Activity Goal

To provide recommendations and practical tools that will enable clinicians to improve recognition, diagnosis, and management of symptoms of excessive sleepiness in persons with psychiatric disorders.

Learning Objectives

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

• Distinguish symptomatology of primary sleep disorders and primary psychiatric disorders.
• Identify iatrogenic causes of excessive sleepiness associated with the management of common psychiatric disorders.
• Describe two assessment tools that clinicians can utilize for the recognition and diagnosis of sleep-wake disturbances.
• Design and implement a decision tree for the practical management of excessive sleepiness in patients with psychiatric illness.

Target Audience

Physicians, physician assistants, nurse practitioners, nurses, psychologists, social workers, certified case managers, pharmacists, and other healthcare professionals with an interest in mental health.

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 educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CNE Credit (Nurses):
CME Outfitters, LLC, is an approved provider of continuing nursing education by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

It has been assigned code 6WASUP-PRV-068. 1.0 contact hours will be awarded upon successful completion.
Note to Nurse Practitioners: The content of this CNE activity pertains to Pharmacology.

CEP Credit (Psychologists):
CME Outfitters is approved by the American Psychological Association to sponsor continuing education for psychologists. CME Outfitters maintains responsibility for this program and its content. (1.0 CE credits)

NASW Credit (Social Workers):
This program was approved by the National Association of Social Workers (provider #886407722) for 1 continuing education contact hour.

CCMC Credit (Certified Case Managers):
This program has been approved for 1 hour by the Commission for Case Manager Certification (CCMC).

CPE Credit (Pharmacists):
CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.0 contact hours (0.1 CEUs)
Universal Program Number: 376-999-07-009-L01 (live presentation) 376-999-07-009-H01 (recorded programs)

Credit request forms/activity evaluations can be completed online at www.neuroscienceCME.com (click on the Testing/Certification link under the Resources tab - requires free account activation), and participants can print their certificate or statement of credit immediately. Otherwise, participants should fully complete and return both the credit request form and activity evaluation located within the course guide for this activity. A certificate or statement of credit will be mailed within 4-6 weeks to all who successfully complete these requirements.

Disclosure Declaration

All faculty participating in CME Outfitters continuing education activities are required to disclose any conflict(s) of interest related to the content of their presentation(s) as defined by the ACCME's Standards for Commercial Support, and other accrediting and regulatory bodies. Full disclosure of faculty relationships will be made on this website and within the activity course materials prior to the premiere date of this activity.

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