2014 Annual Report

Society of Anesthesia and Sleep Medicine
Annual Report • October 2014 

I am pleased to present the 2014 Annual Report for the Society of Anesthesia and Sleep Medicine (SASM), which has now been operating for over three years. This last year has been one of rapid growth and major undertakings. The SASM is grateful to the Svinicki Association Management, Inc. (SAM I) in Wisconsin for their professional ad-ministrative services. This has been of great support to the SASM in its growth. expan-sion and success. There are two important initiatives that the SASM has been working on last few years, which bore fruit now. These are the new affiliation with the International Anesthesia Research Society (IARS), together with the creation of a new section on "Respiration and Sleep" in its journal, Anesthesia and Analgesia (A&A). The sec-ond initiative is the Obstructive Sleep Apnea Death and Near Miss Registry 

New Affiliation with IARS and New Section on "Respiration and Sleep" in Anesthesia and Analgesia Journal 

In July of this year, the IARS and the SASM signed an affiliation agreement. Each has a mutual goal to increase the amount of published literature addressing respiration and sleep medicine. As part of the affiliation agreement, A6cA will be designated as the offi-cial journal of the SASM. David Hillman, MD. has been appointed as the Section Editor for Respiration and Sleep. 

Dr. Hillman is the Past President of the SASM. He is the past head of the Department of Pulmonary Physiology and Sleep Medicine at the Sir Charles Gairdner Hospital in Perth, Western Australia. and Director of the West Australian Sleep Disorders Research Institute. He is a Clinical Professor at the University of Western Australia, Immediate Past President of the Australasian Sleep Association, and founding chair of Australia's Sleep Health Foundation. 

Assembling submitted articles under "Respiration and Sleep" will help to focus on this important area, benefiting education and encouraging research. Abnormal breathing during sleep plays an important role as a predictor of outcomes during anesthesia and is a modifiable risk factor. A few examples include the associations between OSA and difficult airway, sleep hypoventilation and perioperative respiratory insufficiency, and opioids exacerbating abnormal breathing. The neurophysiological underpinnings (un-consciousness, ventilatory depression, reduced muscle activation) are profound. The problems of advanced lung disease, morbid obesity, and neuromuscular disorders are shared between the states of anesthesia and sleep-disordered breathing. 

As a small society, the SASM can greatly increase its impact through our affiliation with the IARS. The goals of the SASM align with the mission and vision of the IARS in terms of research and education. The Board is confident that this affiliation will bring many benefits to the SASM, as well as to clinicians and researchers worldwide. In this context, the principal goal for Dr. Hillman will be to increase the number of sleep-related articles published in the A&A journal, thereby increasing exposure of the readership to the field of sleep medicine. We would like to encourage SASM members to submit their scien-tific work on "Respiration and Sleep" to Anesthesia and Analgesia. SASM is also encour-aging members to submit reviews, commentaries and CM E materials as well. 

The Obstructive Sleep Apnea Death and Near Miss Registry 

The SASM has partnered with the Anesthesia Quality Institute to launch a new Registry: The Obstructive Sleep Apnea Death and Near Miss Registry. Norman Bolden, MD, leads this effort. which involves collaboration with the ASA Closed Claims Project at the University of Washington in Seattle. The goal of this new registry is to identify perioperative recurring patterns or themes underlying death or adverse events sus-pected to be related to OSA, with the goal of risk stratification and mitigation to im-prove patient safety during anesthesia. The Registry seeks to obtain a large number of case reports to achieve these goals. Any medical provider can submit anonymous cases. however patients are not allowed to submit cases. 

I would greatly encourage SASM members to submit case reports to the Obstructive Sleep Apnea Death and Near Miss Registry. Case report instructions and forms are available on the OSA Death and Near Miss Registry website: 

http://depts.washington.edu/asaccp/projects/obstructive-sleep-apnea-osa-death-near-miss-registry 

Finance
Our financial affairs are in good order with continuing enthusiastic support from our many sponsors, who are listed in the meeting program and on our website. We have worked hard to ensure that our administrative costs remain modest, allowing us to re-invest our funds in our educational program, outreach activities, and in supporting re-search. In 2013, we were very pleased to inaugurate our research award, and at our Annual Meeting in October of 2014 we will announce the recipient of a second re-search award.

Under the excellent fiscal stewardship of our Treasurer, Girish P. Joshi, MBBS, MD, our governance arrangements ensure appropriate oversight. Most importantly, there is a monthly financial reporting structure in place to the President and the Treasurer. We have worked hard to increase our membership and sponsorship from various sources to ensure a strong financial position. 

Organizational Structure
Our organizational structure has evolved over the last year, reflecting expansion of our activities and changing emphases. In 2013, there was a change in our Board structure with an increase in the number of member-elected directors from 7 to 9 Directors, and a provision was added that allows the Board to appoint up to 3 additional Board Appointed Directors. The reason for these changes is to allow us to increase our activi-ties and to facilitate reporting relationships with our various committees. Each of our major committees has direct representation at the Board level. As a result of the in-crease of Directors, more people can now share the workload of the Board. The Board has worked diligently to raise the profile of the SASM and to serve the interests of the SASM membership.

A Pediatric Subcommittee was added to the Clinical Committee last year to better rec-ognize the special needs, demands, and perspectives of pediatrics. This subcommittee has been most active in the past year with various initiatives and projects. As a result, the SASM Board is proposing the Pediatric Subcommittee to be formally recognized as the SASM Pediatric Committee.

Two new initiatives in the organization structure for the upcoming year have begun. In North America and Great Britain, there are a number of anesthesiologists with dual specialties in anesthesia and sleep medicine. Tracey Stierer, MD from John Hopkins University has agreed to lead the SASM Sleep Medicine Clinical Practice Group. This group will meet at the SASM Annual Meeting for formal networking and exchange of practical ideas. Sleep-disordered breathing during pregnancy predisposes to preeclampsia and can have a major effect on the health of the newborn otherwise re-sulting in prematurity or stillbirth. These issues merit attention and Alexandra Bullough, MD, MBChB, FRCA from Loyola University will organize a SASM Obstetric Group in 2014-5. 

Administration
The Wisconsin based Svinicki Association Management, Inc. (SAMI) provides SASM with management and administrative services. Their systems have supported the Board and the SASM committees with individualized service. Most importantly, SAM I provides support to our members. Their support has enabled the SASM Board and the different committees to function at a high level. 

Membership
We have introduced innovations in our membership drive to broaden our membership base due to the splendid efforts of Stavros Memtsoudis, MD, PhD and his committee. One of the new initiatives is departmental membership. The drive has been extremely successful with a significant increase in our membership, which now totals 1,208 members. 

Communication
Our website continues to flourish. The website has been ably updated by Michael Pilla, MD and his committee to present a modern format. Further work to enhance the ap-peal and function of the website is ongoing. The Scientific Update Subcommittee, under the outstanding guidance of Susana Vacas, MD, PhD, provides continuing educational material to our members via the website. There are regular, bi-monthly featured arti-cles and scientific updates of recently published literature. Satya Krishna Ramachandran, MD. and his diligent committee, produce excellent newsletters at a reg-ular interval of three times a year. The SASM newsletter is a rich source of information and is posted on the SASM website. The circulation of the SASM newsletter is an im-portant task due to our connection to the IARS and the World Anesthesia Network. The newsletter is posted on these websites as well. 

Educational Programs
In October at our Annual Scientific Meeting, before the American Society of Anesthesiologists (ASA) Annual Meeting, we will showcase all of our educational activ-ity. This year, it has been magnificently organized under the direction of Peter Gay, MD and Girish P. Joshi, MBBS, MD, FFARCSI and their committee. We have continued our one and a half day format with a Thursday half-day of workshops segueing into our Friday full day meeting of invited papers and poster presentations. This year's theme. Safety in Surgical Patients with Sleep Disordered Breathing, takes us into a territory that is close to our hearts.

Again, scientific papers are an important component of the meeting and we are keen to see this grow, as the meeting provides a perfect opportunity to exchange ideas with an expert group focused on the sleep-anesthesia interplay. The Abstract Subcommittee is ably led by Anthony Doufas, MD, PhD. 

Research Award
The Research Committee, under the wonderful guidance of Roop Kaw. MD, adjudicates our second research award from twelve submissions. The award attracted an outstand-ing field of applicants from both clinical and basic science and we will be announcing the result at the Annual Meeting. Roop Kaw, MD is also leading the effort of preparing a white paper on research areas of interest to the SASM. 

Clinical Committee 

Our Clinical Committee, under the superb leadership of Dennis Auckley, MD and Bhargavi Gali, MD, has led our first steps in developing clinical standards and promot-ing education about sleep amongst anesthesiologists and about anesthesiology amongst sleep physicians. They are most productive and have completed the following: 

• Clinician Educational Documents: Both the brochure and recommendation docu-ments were completed and posted to our website in late March 2014 under educa-tion and training-education resources. 
• Clinician One Page Algorithm: This one page flyer is for use as a quick check re-source to be hung on a wall. This is in production. 

1. Clinician Slide Sets: 
   1. A) Basics of OSA/Background: A slide set for the website will be available for down-load for all clinicians. This is being developed. 
   2. B) Clinical Perioperative Issues and Management: Another slide set for the website will also be available for download with information on OSA in the perioperative set-ting for those involved in perioperative care. 

• Nursing Education: Current plans are to produce a nursing-directed white paper on OSA in the perioperative setting for the ASPAN newsletter. 
• Patient Information Brochure: This will give basic sleep apnea information to pa-tients, and be available as a two page (or back and front) brochure that can be down-loaded from our website. It will serve as a template that can be modified to meet an institution's unique requirements. This is in production. 

Pediatric Committee 

The goal of this newly formed committee is to promote and take part in scholarly activ-ity (e.g. clinical and bench research, guideline development, systematic review/meta-analysis) as it relates to the medical or surgical management of children and adoles-cents up to the age of 18 years with sleep disordered breathing (SDB). and to interpret what it means for the health care provider responsible for their care and ensure this knowledge reaches them. 

The SASM Pediatric Committee, under the marvelous guidance of Kimmo Murto, MD, FRCPC, has worked hard in the past year. The Pediatric Committee is performing a sur-vey on the clinical pathway of adenotonsillectomy in children. The survey will address the variation in the procedure and hope to improve safety and address patients' needs. The committee has submitted a proposal of an SASM pediatric symposium with six top-ics to the IARS March 2015 Annual Meeting in Hawaii. 

SASM Consensus Statement Task Force 

In recent years, there have been significant advances in knowledge as it relates to anes-thesia and sleep-disordered breathing. Recently, the ASA published their 2014 Practice Guideline on the issue. There is still a need to develop this further regarding the preop-erative screening of patients with sleep-disordered breathing. Frances Chung, MB BS and Dennis Auckley, MD are leading the effort in this area. The SASM Consensus Statement Task Force has worked diligently with the literature review and will meet face-to-face on Thursday, October 9. 2014 at the SASM Annual Meeting to discuss the available evidence in the literature. 

Involvement in Activity of Other Professional Societies
For the second year, the SASM provided a panel session at the IARS Annual Scientific Meeting earlier this year. The SASM Board, committee chairs and committee members were invited to speak at numerous national and international anesthesia meetings, and at many sleep medicine meetings as well. The American Academy of Sleep Medicine has formed a new committee of "Anesthesia and Sleep Medicine" under the direction of Tracey Stierer, MD. The SASM has had panel sessions at the meeting of American College of Chest Physicians for the last few years. David Hillman, MD has successfully organized a full day postgraduate symposium on anesthesia and sleep related issues with a strong contribution from SASM members to be presented at the American Thoracic Society in May 2015. As previously mentioned, we are now formally affiliated with the IARS and the SASM has a new Section Editor for "Anesthesia and Sleep Medicine" in the AM journal. Many members gave refresher courses and lectures in the panels at the ASA. The ASA has been supportive of our Society and we are currently in the process of applying for a formal affiliation with them. 

Conclusion
We have had a year of rapid growth and huge expansion with important initiatives. I have found it very rewarding to be President of the SASM and to engage with the many interesting and creative people who have contributed to this effort.

Nonetheless. the SASM needs more help from its members. If you would like to serve in any capacity, please submit your request at the SASM website with your CV. The Board and I look forward to serving you in the coming year. 

Frances Chung
President