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Professor
MONICA MARIA FRANCESCA PULIGHEDDU (Tit.)
STEFANIA REDOLFI
LUDOVICA TAMBURRINO
Period
First Semester 
Teaching style
Convenzionale 
Lingua Insegnamento
ITALIANO 



Informazioni aggiuntive

Course Curriculum CFU Length(h)
[40/64]  NEUROPHYSIOPATHOLOGICAL TECHNIQUES [64/00 - Ord. 2020]  PERCORSO COMUNE 5 40

Objectives

KNOWLEDGE AND UNDERSTANDING: the student will have to show knowledge relating to the genesis of physiological sleep and to the pathological aspects and conditions that can cause an alteration. The student must show knowledge relating to the genesis of biological signals, the type of sensors suitable for their registration and the different types of investigations in the polygraphic field and demonstrate knowledge of the main pathological conditions that can affect the respiratory system and how these can be associated with sleep disorders.
APPLICATION SKILLS: the student must be able to apply the theoretical knowledge acquired to recognize and distinguish the different sleep pathologies, knowing how to orientate not only on the diagnostic framework but also in the therapeutic choice to be adopted and in the differential diagnosis with other disorders. The student must be able to apply the theoretical knowledge acquired to recognize and distinguish the different types of signals recorded with particular focus on the interpretation of the traces and must be able to apply the theoretical knowledge acquired to juggle the diagnostic framework related to the exams clinical and instrumental used for the study of respiratory diseases.
AUTONOMY OF JUDGMENT: the student will be able to interpret the anamnestic and instrumental data to formulate a diagnostic judgment in relation to sleep pathologies. The student will be able to correctly interpret and analyze how polygraphic investigations differ and vary in terms of results and therapeutic choices in the framing of sleep disorders and will be able to evaluate and analyze the patient's respiratory picture in a comprehensive way. thanks to the application of theoretical and practical knowledge provided during the course.
COMMUNICATION SKILLS: the student will be able to carry out the development and outcome of diagnostic procedures and therapeutic interventions in the field of sleep medicine both in the neurological and respiratory context in adult and pediatric age.
LEARNING SKILLS: the student will learn to acquire new information and implement their cultural background in a critical way through the consultation and critical interpretation of recent scientific literature and will be able to analyze the signals recorded through the interpretation of the traces presented and discussed during the lessons.

Prerequisites

Neurophysiopathology 5 (basic and clinical PSG)
Knowledge of the topics covered in the Neurophysiology, Electroencephalography and Applied Neurophysiology module is required.
Neurophysiological techniques 7 (PSG)
Knowledge of topics covered in the Electroencephalography, Applied Neurophysiology and Electronics and Instrumentation for Biomedical Investigations module is required.
Pathophysiology of the respiratory system
Knowledge of topics covered in the Human Anatomy and Physiology module is required.

Contents

Neurophysiopathology 5 (basic and clinical PSG)
- Anatomical and physiological bases of sleep;
- Normal and physiological sleep structure;

- Panoramic of the main instrumental diagnostic techniques applied for the framing of sleep disorders;
- Polygraph examination reporting;
- Classification of sleep disorders;
- Notes on respiratory disorders in sleep;
- Insomnia: diagnosis and hints of treatment (medium-term and chronic forms, non-pharmacological treatment, pharmacological treatment);
- NREM sleep parasomnias (arousal disorders, somnambulism, pavor, sleep related eating disorder) ;
- REM sleep parasomnias (terrifying dreams, sleep paralysis, behavioral disorder in REM sleep);
- Hypermotor epilepsy sleep;
- Movement disorders in sleep (restless legs syndrome, nocturnal myoclonus, rhythmic movements in sleep, propriospinal myoclonus, excessive fragmentary myoclonus, myoclonic jerks);
- Circadian rhythm disorders (phase anticipation disorder, phase postponement disorder, shift work disorder, jet lag);
- Hypersomnias of central origin (narcolepsy, idiopathic hypersomnia, recurrent hypersomnia chronic sleep deprivation).
Neurophysiological techniques 7 (PSG)
- Sleep medicine: historical background and instrumental requirements of the sleep medicine center;
- Identification of polygraphic parameters: sensors classification, signal characteristics and acquisition modalities (Electroencephalogram, Electroculogram, Electromyogram, Electrocardiogram, Snoring and respiratory noise, Thoracic and abdominal breathing, Oxygen saturation, Photoplethysmogram, Endoesophageal pressure, Temperature);
- Artifact recognition and detection in the polygraphic field;
- ASDA classification of polygraph levels and framing of dynamic and on site recordings;
- The subjective and objective evaluation of excess sleep: framework of the indicated polygraphic surveys (MSLT, MWT, hints on sleepiness evaluation scales, driving test);
- The evaluation of sleep defect: actigraphy;
- Interpretation of tracings: scoring and analysis of cardio-respiratory monitoring, staging of polysomnography, definition of reports;
- Definition of indices (AHI, ODI, RDI, PLM);
- Ventilation modalities and the role of the technician in the therapeutic setting of sleep respirators (CPAP, BiPAP, interfaces and mask selection, circuits, filters, ventilator maintenance).
Pathophysiology of the respiratory system
- Hints of Anatomy, Physiology and Pathophysiology of the Respiratory System;
- Respiratory function test;
- Hemogas analysis and instrumental investigations of respiratory disorders;
- Obstructive Airway Diseases;
- Pulmonary Restrictive Diseases;
- Respiratory failure;
- Respiratory diseases associated with sleep and nervous system disorders (ALS, neuromuscular diseases, Overlap Syndrome, OHS);
- Respiratory disorders in sleep: diagnosis and therapy (obstructive sleep apnea syndrome, central apnea syndrome clinical forms, medical comorbidity and pathophysiology, alveolar hypoventilation, nocturnal respiratory insufficiency);
- NIV and Complex Ventilation Modes.

Teaching Methods

Neurophysiopathology 5 (basic and clinical PSG)
Lectures with examples, guided experiences with real instrumentation aimed at the acquisition of the concepts explained with practical examples. Practical exercises with presentation of clinical cases and films recorded in the Sleep Medicine Centre. Presentation and analysis of tracings.
Neurophysiological techniques 7 (PSG)
Lectures with examples, guided experiences with real instrumentation aimed at the acquisition of the concepts explained with practical examples. Practical exercises of interpretation and analysis of polygraphic traces aimed at scoring and sleep staging. Practical exercises of identification and recognition of the main types of artifacts recorded on polygraphic traces. Practical exercises with setting and recognition of the types of ventilators used for respiratory disorders in sleep.
Pathophysiology of the respiratory system
Lectures with examples, guided experiences with real instrumentation aimed at the acquisition of the concepts explained with practical examples. Practical exercises of interpretation and analysis of clinical cases. Practical exercises of interpretation of instrumental investigations used for the study of respiratory pathologies. Practical presentation of the main ventilation modes.

Verification of learning

The number of sessions is defined in accordance with the Faculty regulations. Extra appeals for out-of-course students may be requested from the teacher for justified reasons. The integrated course includes a joint oral test on the three modules of the course. During the test, questions will be asked to assess the candidate's ability to express himself correctly in relation to the subject, his ability to explain the concepts presented and to apply his knowledge. The assessment is objective, defined on the basis of the percentage of the correctness of each answer (which is associated with a fixed score, not known to the candidate, based on the level of difficulty). The final mark will be the weighted average of the results obtained in the three modules. The evaluation will be expressed in thirtieths

Texts

Neurophysiopathology 5 (basic and clinical PSG)
Course handouts and material provided by the teacher free of charge to the students accessible through the course website. For further information you can consult the following texts:
-Manuale di Medicina del Sonno S. Coccagna
- American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed.
Darien, IL: American Academy of Sleep Medicine, 2014.
- Principles and practice of sleep medicine (Kryger, Roth, Dement).
- Manuale di Medicina del Sonno (Coccagna, Smirne), 1993.
Neurophysiological techniques 7 (PSG)
Course handouts and material provided by the teacher free of charge to the students accessible through the course website. For further information you can consult the following texts:
- AASM Manual of Sleep Scoring.
Pathophysiology of the respiratory system
Course handouts and material provided by the instructor free of charge to students accessible through the course website.

More Information

Registration for exams will be done by accessing the University website.
Students who have attended no less than 70% of the total number of lectures and no less than 50% of each module and have attended all the hours scheduled for the professional activity will be able to take the exam.

Questionnaire and social

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