Talks：

Deal with difficulty cases of sleep breathing disorder in sleep laboratory: from the points of view of sleep technician.

Name：

梁信杰(Shinn-Jye Liang)

Position：

Director of medical ICU

Affiliation：

1.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China medical University Hospital. 2.Sleep center, China medical University Hospital.

Email：

d6142@mail.cmuh.org.tw

Photo：

Research Interests：

Critical care and pulmonary disease

Selected Publications：

◆ The relationships of sleep apnea, hypertension, and resistant hypertension on chronic kidney disease Medicine (Baltimore). 2016 Jun; 95(23) Chih-Ping Chang, MD, Tsai-Chung Li, PhD, Liang-Wen Hang, MD, Shinn-Jye Liang, MD, Jen-Jyn Lin, MD, Che-Yi Chou, MD, Jeffrey J.P. Tsai, MD, PhD, Po-Yen Ko, MD, and Chiz-Tzung Chang, MD, PhD ◆ Risk of obstructive sleep apnoea in patients with rheumatoid arthritis: a nationwide population-based retrospective cohort study. BMJ Open. 2016; 6(11) Nov 28. Te-Chun Shen, Liang-Wen Hang, Shinn-Jye Liang, Chien-Chung Huang, Cheng-Li Lin, Chih-Yen Tu, Te-Chun Hsia, Chuen-Ming Shih, Wu-Huei Hsu,2 and Fung-Chang Sung ◆ The modified SAVE score: predicting survival using urgent veno-arterial extracorporeal membrane oxygenation within 24 hours of arrival at the emergency department Crit Care. 2016; 20: 336. Wei-Cheng Chen, Kuo-Yang Huang, Chih-Wei Yao, Cing-Feng Wu, Shinn-Jye Liang, Chia-Hsiang Li, Chih-Yeh Tu, and Hung-Jen Chen, ◆ Diagnostic Pitfalls of Discriminating Lymphoma-Associated Effusions. Medicine (Baltimore). 2015 May; 94(17) Hung-Jen Chen, MD, Kuo-Yang Huang, MD, Guan-Chin Tseng, MD, Li-Hsiou Chen, MD, Li-Yuan Bai, MD, Shinn-Jye Liang, MD, Chih-Yen Tu, MD, and Richard W. Light, MD

Abstract：

Overnight polysomnography (PSG) remains the “gold standard” in the diagnosis of sleep disorders of breathing (SDB). In clinical practice, but approximately 85% of tested patients are suspected of having sleep-related breathing disorders. Common pitfalls and challenges in sleep laboratory for sleep technologist are raised here and the talk will be focus of on that. For example, the severity of obstructive sleep apnea (OSA) can variable from night to night of PSG findings. Many people experience worse sleep during their first night in a sleep laboratory that is so call “first night effect”. Some patients requiring supplemental oxygen when his baseline oxygen saturation is in the range of 85-88% without any associated respiratory events on waking state. However, supplemental O2 may also blunt hypoxic ventilatory drive and worsen ventilation. Poor compliance and tolerance to CPAP is well recognized limitation. Initial unpleasant or unsuccessful CPAP titration contributes to attrition. Sometimes it will let titration failure. Here, we will discuss some extremely cases with a relevant scenario to provide the sleep technicians to see the pathophysiological theory in practice. Audience can see how a decision will impact different study results, both positively and negatively.