Sleep Medicine Committee – Iran University of Medical Sciences

 

Faculty Members:

 

Dr. Mirfarhad Ghalebandi, Professor

 

Dr. Fatemeh Kashani Nasab, Assistant Professor

 

Dr. Mahboobeh Khoozan

 

Introduction:

Research has consistently shown that sleep is a fundamental pillar of physical and mental health, with sleep disorders imposing significant medical, economic, and social consequences. Breakthroughs in understanding sleep physiology, the prevalence of sleep disorders, their public health importance, the burden of sleep diseases, alongside advances in diagnostic and therapeutic approaches, have led to the global expansion of sleep science, particularly in developed societies. Consequently, there has been a growing need to train physicians and researchers in providing specialized educational, research, and therapeutic services in sleep medicine. This necessity culminated in the establishment of sleep medicine as a subspecialty in developed countries. Although sleep has always been of interest to the general public and scholars alike, the specialized approach to it and the development of postgraduate programs in sleep medicine have been relatively recent on a global scale.

 

In Iran, over the past two decades, there has been an increasing focus on sleep medicine within academic and professional circles. The Iranian Sleep Medicine Society was established in December 2005, aiming to expand this medical branch through organizing specialized seminars and conferences and striving to launch fellowship programs in sleep medicine. In December 2011, a postgraduate education program (fellowship) in sleep medicine was officially approved by the Ministry of Health and Medical Education. The sleep medicine postgraduate program at Iran University of Medical Sciences was approved in 2017 by the Secretariat of the Council of Medical Education and Specialties of the Ministry of Health, Treatment, and Medical Education, with the Psychiatry Department conducting the training of fellows since 2018. Following decisions by scientific and executive committees within the Ministry of Health, specialists from psychiatry, neurology, pulmonology, otolaryngology, pediatrics, occupational medicine, internal medicine, and anesthesiology are eligible to join the sleep medicine training program. This 12-month multidisciplinary clinical fellowship program equips graduates to work in prevention, diagnosis, treatment, and care of patients with sleep disorders, offering their specialized knowledge and skills in educational, research, and health services to the community. This program collaborates effectively with all related specialties for diagnosis, treatment, and prevention of diseases without interfering with any specialty or subspecialty programs.

 

Sleep Medicine Education in Psychiatry:

The topic of sleep disorders is integrated into the educational curriculum for psychiatric residents at Iran University of Medical Sciences as part of a three-month rotational program. During this period, psychiatric residents become familiar with various sleep disorders through patient visits in clinics, journal club sessions, and case presentations. Skills such as understanding electroencephalography, conducting and interpreting polysomnography, and identifying sleep stages are developed. The overarching goal of sleep disorder education for psychiatric residents is to equip them with the knowledge, attitude, and skills necessary for individual responsibilities as psychiatrists and to become effective members of the medical team for diagnosing, treating, and preventing common sleep disorders, thereby maintaining and enhancing the health of the population.

 

Expected Outcomes for Graduates of the Sleep Medicine Fellowship Program:

Graduates are expected to:

• Establish effective professional communication with patients, their companions, health team members, and health officials to address patient or community issues.
• Diagnose diseases through proper history taking, clinical and paraclinical evaluations, and recording findings.
• Choose and apply appropriate preventive, diagnostic, therapeutic, and care approaches with proficiency and skill to resolve patient issues.
• Teach various groups, including patients, their companions, the general and academic community, about their specialty, ensuring patient rights to different treatment methods.
• Collaborate and interact constructively in the national research system.
• Engage constructively with specialists from different fields and courses.
• Play an effective role in improving community health status by proposing or implementing various solutions.
• Adhere to professional ethics in all actions.

Professional Responsibilities of Graduates:

Professional responsibilities of graduates, categorized by their roles, include:

• Diagnostic, Therapeutic, and Care Role:

Establish effective professional communication with patients, their companions, health team members, and social services officials to address patient issues.

Create medical records for patients.

Take detailed histories, perform specialized examinations, and document findings.

Logically request diagnostic paraclinical tests.

Conduct authorized diagnostic procedures.

Request necessary specialist consultations.

Diagnose diseases and record them.

Select the appropriate treatment approach, including medication, surgery, or rehabilitation, non-invasive actions (positive pressure, jaw advancing prostheses, etc.), definitive or palliative and supportive treatments for patients, and apply them within the limits associated with the specialty. In complex and specialized cases, manage the patient as a team and refer to relevant specialties as needed.

Rationally prescribe medication for pharmacological treatments.

Prescribe necessary rehabilitation measures.

Follow up on patients and refer them as needed.

Cooperate in treating other diseases with relevant specialists.

Record information and organize related medical documents.

• Preventive Role:

Assess and examine communities at risk, such as sensitive job workers including bus and heavy vehicle drivers, pilots, flight control personnel, etc., obese individuals, individuals with dementia, diabetes, cardiovascular patients, people with snoring, screening sleep problems in hyperactive children or those with learning disabilities, etc.

Treat underlying diseases that could lead to sleep disorders in the related specialty and refer cases to other specialties.

• Educational Role:

Educate patients, companions, health team members, academics, and the community as needed.

Participate in developing educational texts and guidelines in the specialty and general areas related to the health system.

• Consultative Role:

Provide specialized consultation to patients, companions, other specialists, health system managers, and legal and organizational bodies.

• Research Role:

Collaborate in health system and academic research projects.

Publish or report the results of conducted research to health system authorities.

Report diseases and health issues related to the specialty in the community and propose corrective measures to health system authorities and issue necessary warnings regarding sleep problem hazards.

• Managerial Role:

Lead and manage the health team in the related specialty.

 

Course Titles in the Sleep Medicine Fellowship Program:

Normal Sleep

Sleep Physiology

Epidemiology of Sleep Disorders

Classification of Sleep Disorders

Neurobiology of Sleep

Biological Rhythms of Sleep

Clinical Pharmacology of Sleep and Wakefulness

Physiology and Pathophysiology of Respiratory Disorders During Sleep

Anatomy of the Upper Airway

Methods for Performing, Analyzing, and Interpreting Nighttime Polysomnography

Methods for Performing, Analyzing, and Interpreting Polysomnography in Children

Insomnia

Causes and Types of Insomnia

Evaluation Methods and Approaches to Insomnia

Neurological and Psychiatric Diseases and Insomnia (Anxiety, Depression, etc.)

Pharmacological Treatment Methods for Insomnia

Non-pharmacological Treatment Methods for Insomnia (CBT, etc.)

Sleep Hygiene

Sleepiness

Causes and Approaches to Sleepiness

Narcolepsy, Diagnostic and Treatment Methods

Methods for Performing, Analyzing, and Interpreting the Sleepiness Test (MSLT)

The Role of Sleepiness in Sensitive Occupations (Driving)

Methods for Performing, Analyzing, and Interpreting the Wakefulness Test (MWT)

Safety, Job Performance, Sleep Deprivation, and Sleepiness

Respiratory Disorders During Sleep

Diagnostic Methods for Respiratory Disorders

Obstructive Sleep Apnea

Central Sleep Apnea

Nighttime Hypoventilation Syndromes

Non-surgical Treatment Methods for Respiratory Disorders During Sleep

Cardiovascular Complications and Respiratory Disorders During Sleep

Endocrine Complications and Respiratory Disorders During Sleep

The Role of Sleep Apnea in Safety and Occupational Accidents

Stroke and Sleep Apnea

Titration and Its Types

Surgical Treatment Methods for Sleep Apnea

Comprehensive Examinations of the Upper Airway

 

Applications, Complications, and Efficacy of Surgical Treatments for Snoring and Obstructive Apnea

Imaging of the Upper Airway and Cephalometric Analysis

The Role of Surgical Treatments in the Use of CPAP

The Role of Pharyngeal Surgeries in Treating Apnea

The Role of Nasal Surgeries in Treating Respiratory Disorders During Sleep

Jaw Template Studies

Diagnosis and Examination of Jaw Relationships and Occlusion

Necessary Treatment Methods

Maxillary Surgery Le Fort 1 "Advancement

Mandibular Surgery Sagittal Split "Advancement

Chin Surgery "Advancement

Circadian Rhythm Disorders

Advanced Onset and End of Sleep

Delayed Onset and End of Sleep

Irregular Onset and End of Sleep

Shift Work, Its Types, and Determining Occupational Fitness

Complications Resulting from Shift Work and Ways to Combat Them

Jet Lag and Ways to Combat It

Parasomnia

Sleepwalking

Nightmares and Night Terrors

Bruxism

Movement Disorders in Sleep REM

Nocturnal Enuresis

Parasomnia in Children

 

Movement Disorders During Sleep

Seizure Disorders During Sleep

Restless Legs Syndrome

Periodic Limb Movement Disorder During Sleep

Sleep Disorders and Neurological and Psychiatric Diseases

Sleep Disorders and Occupational Activities

Sleep Disorders and Neurological Diseases

Sleep Disorders and Respiratory Diseases

Sleep Disorders in Children

Medical Ethics in Sleep Disorders

Legal Aspects of Sleep Disorders (Disability and Compensation Compensation)

The Role of Age in Sleep Disorders

Sleep Disorders and Physical Diseases (Gastrointestinal, Renal, etc.)

Sleep Disorders and Women

Sleep Disorders and Cardiovascular Diseases

Portable Polysomnography Methods

 

Lecture and Seminar Program

The lecture and educational program of the Sleep Medicine Committee is announced through the following information channel.

https://psychiatry.iums.ac.ir/

 

Sleep Laboratory of the Psychiatry Department

Location: Rasul Akram Hospital (SA), 7th Floor, Building No. 2.

Tests performed in the sleep laboratory include:

Nighttime Polysomnography (PSG)

PAP Titration

Split Night

Daytime Sleepiness Test (MSLT)

Wakefulness Test (MWT)

 

The laboratory has two separate bedrooms, allowing for the accommodation of two patients simultaneously each night.

 

Clinics

Sleep Disorders Clinic at Rasul Akram Hospital (SA)

Saturdays 9 AM to 12 PM, Dr. Fatemeh Kashani Nasab

Mondays 1 PM to 4 PM, Dr. Fatemeh Kashani Nasab

In the aforementioned clinics, there is the possibility of offering pharmacological and non-pharmacological treatments for patients with sleep disorders.

 

Online Appointment Booking for Rasul Akram Hospital (SA) Clinics:

http://nobat.rasoolhospital.ir/