2016 Annual Report

Society of Anesthesia and Sleep Medicine
Annual Report • October 2016

This 2016 Annual Report for the Society of Anesthesia and Sleep Medicine (SASM), now brings to a close our fifth year of successful operation. This year has gone by with many exciting events thanks to our devoted members and central office. The Officers and members are extremely grateful to Jane Svinicki and the Svinicki Association Management, Inc. (SAM I) staff in Wisconsin for their professional administrative ser-vices with special kudos to our now officially appointed Executive Director, Marie Odden. This relationship has proven a great benefit to the growth, expansion and suc-cess of SASM.

SASM continues its close affiliation with the International Anesthesia Research Society (IARS). The new section on "Respiration and Sleep" in Anesthesia and Analgesia (A&A) is one-year-old. The implementation of an Obstructive Sleep Apnea Death and Near Miss Registry started in May 2014 and will now be completed in 2016. 

Affiliation with International Anesthesia Research Society and New Section on "Respiration and Sleep" in Anesthesia and Analgesia Journal
The affiliation between the two organizations, IARS and the SASM, is ongoing and we are succeeding in our goal to increase the amount of published literature addressing respiration and sleep medicine. David Hillman, MD, a Past President of SASM, is a Clinical Professor at the University of Western Australia, Past President of the Australasian Sleep Association, and founding chair of Australia's Sleep Health Foundation. He has been appointed as the Section Editor for Respiration and Sleep and has the role of the SASM liaison to IARS. This partnership aligns fully with the mission and vision of the IARS in terms of research and education. The SASM has achieved the principal goal 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. There have been many papers submitted to the Respiratory and Sleep section of the IARS A&A Journal since its inception in 2014 and we would encourage SASM members to submit their scientific work on respiration and sleep including reviews, commen-taries and CME to Anesthesia and Analgesia. 

The Obstructive Sleep Apnea Death and Near Miss Registry
SASM has also partnered with the Anesthesia Quality Institute to launch a new Registry. The Registry started to accept cases in May 2014 and will be completed in December 2016. Norman Bolden, MD, leads the Obstructive Sleep Apnea Death and Near Miss Registry. This project involves collaboration with Karen Posner, PhD, of the ASA Closed Claims Project at the University of Washington in Seattle. The goal of this OSA registry is to identify perioperative recurring patterns or themes underlying death or adverse events suspected to be related to OSA, with the goal of risk stratification and mitigation to improve patient safety during anesthesia. We are nearing our goal to collect 100 cases before analysis would be started with now the additional guidance of Satya Krishna Ramachandran, MD. 

The SASM Pediatric Committee is also interested in establishing a Pediatric Obstructive Sleep Apnea Registry and discussion is underway between the SASM Pediatric Committee and OSA Death and Near Miss Registry Subcommittee. 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 still in good order with continuing broad support from our many sponsors, who are listed in the meeting syllabus 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. For the past three years, we were very pleased to give out an annual research grant, and at our Annual Meeting in October of 2016 we will announce the recipient of a fourth research grant recipient. 

Under the excellent fiscal stewardship of our Treasurer, Dennis Auckley, MD, our gov-ernance 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. 

As will be presented at this Annual Meeting, our financial support has diminished this year for a number of foreseen and unforeseen events. The very generous startup grants from our ResMed and Phillips Respironics colleagues have now been consumed and we are now competing in an ever more challenging medical societal world. We can only maintain our success with ongoing support from our present devoted followers and also continue to seek out new generous partners. The membership dues and meeting registration have always been very low for SASM and this year we will ask the member-ship for a very modest increase. 

Organizational Structure
Our organizational structure has evolved over the last year, reflecting expansion of our activities and changing emphasis. Two new initiatives in the organization structure oc-curred in 2014 with the formation of the SASM Sleep Medicine Clinical Practice Group and SASM Obstetric Subcommittee. 

In North America and Great Britain, there are a number of anesthesiologists with dual specialties: anesthesia and sleep medicine. This year we are seeking new leadership for the SASM Sleep Medicine Clinical Practice Group. The goal of this group is to have for-mal networking and exchange of practical ideas and if members are interested, they are urged to apply for this Chair position. 

Sleep-disordered breathing during pregnancy can have a major effect on the health of the newborn, otherwise resulting in prematurity or stillbirth. Alexandra Bullough, MD, from Loyola University organized a SASM Obstetric Subcommittee in 2014-15. This group has been most productive resulting in collaborative efforts in US, Canada and Europe. 

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. In 2015, we have added re-duced rate for foreign members and also European departmental membership as well. The drive has been extremely successful with a significant increase in our membership, which now totals over 1.000 members with individual members. Gold Patron members and departmental members. 

Communication
Our website continues to flourish under the leadership of Michael Pilla, MD, and his committee. The website has been redesigned to better conform to the IARS website following affiliation. The Scientific Updates Subcommittee, under the outstanding guid-ance of Susana Vacas, MD, PhD, provides continuing educational material to our mem-bers via the website. There are regular, bi-monthly featured articles and scientific up-dates of recently published literature. Satya Krishna Ramachandran, MD, and his dili-gent committee, produces excellent newsletters at a regular 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 important task due to our con-nection to the IARS and the World Anesthesia Network. The newsletter is posted on these websites as well. 

Educational Programs
This 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 organized under the direction of Girish P. Joshi, MBBS, and Roop K. Kaw. MD, and their committee. We have continued our one-and-a-half-day for-mat with a Thursday half-day and a Friday full day meeting of invited papers and poster presentations. This year's theme, PERIOPERATIVE SLEEP-DISORDERED BREATHING: IT'S NOT JUST SLEEP APNEA. has important implications for the broader issues and ailments for our hospitalized sleep medicine patients. 

Abstracts are an important component of the meeting. The SASM meeting provides a perfect opportunity to exchange ideas with an expert group focused on the sleep-anes-thesia interplay. Malin Jonsson Fagerlund, MD, PhD. and Toby Weingarten, MD, ably lead the Abstract Subcommittee. This year, we again have over 40 abstracts with awards to be presented to the best presenters. 

Research Award
The Research Committee, under the wonderful guidance of Anthony Doufas, MD, adjudicates our fourth research award from a number of submissions. The award attracted an outstanding field of applicants from both clinical and basic science and we will be an-nouncing the result at this Annual Meeting. Sadly, with our present financial situation, we may suspend the award for the 2017 Annual Meeting unless separate sponsorship is found. 

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

1) Clinician Educational Documents:
OSA Perioperative Help Sheet for Providers
OSA, Anesthesia and Surgery Patient Education Brochure 

2) Clinician Slide Sets:
A) OSA: An Overview
B) Evaluation and Management of OSA in the Perioperative Period 

Nursing Education: Current plans are to produce a nursing-directed white paper on OSA in the perioperative setting for the ASPAN newsletter. 

Pediatric Committee
The goal of the Pediatric Committee is to promote and take part in scholarly activity (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, and to interpret what it means for the health care provider responsible for their care and ensure this knowl-edge reaches them.

The Pediatric Committee, under the marvelous guidance of Kimmo Murto, MD, FRCPC, has worked hard in the past two years. The Pediatric Committee is performing a North American survey of pediatric anesthesiologists and otolaryngologists on the "admission practices for children under adenotonsillectomy". The survey will address the variation in the procedure and hope to improve safety and address patients' needs. 

The committee presented a SASM pediatric symposium at the IARS March 2015 Annual Meeting in Hawaii on the topic. "OSA in Children and its Perioperative Management." 

The committee is also using Delphi approach to identify topics for systematic reviews among national and international experts. In addition, SASM, under the leadership of Kimmo Murto, MD. FRCPC, and SAMBA (Girish Joshi. MBBS. and Steve Butz, MD) is developing a consensus guideline to answer questions on children and adenotonsillectomy.

SASM Obstetric Subcommittee
SASM Obstetric Subcommittee, under the leadership of Alexandra Bullough, MD, has been most active. The group has multiple teleconferences to work on a number of issues that are of interest to obstetricians, anesthesiologists and neonatologists. An in-ternational group has been formed in the past year with members from the US, Canada and Britain. 

The group has worked on developing questions for educational purposes in obstetric antenatal clinics. This includes screening questions for obstructive sleep apnea. A survey on recognition of obstructive sleep apnea in pregnancy has been completed and the abstract will be presented at the SASM Annual Meeting this year. 

SASM Guideline 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 preoperative screening of patients with sleep-disordered breathing. Frances Chung, MBBS. and Dennis Auckley, MD, are leading the effort in this area. The SASM Guideline Task Force has worked diligently with the literature review and met face-to-face on October 9, 2014, at the SASM Annual Meeting, and held multiple teleconferences in 2015 to work on developing the guideline for preoperative screening and preparation of patients with OSA for surgery. This guideline was completed and recently published this year in Anesthesia and Analgesia. 

Involvement in Activity of Other Professional Societies
For the fourth 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 also had panel sessions in 2015 at the meeting of American College of Chest Physicians and a full day workshop at this year's American Thoracic Society, organized by Dr. Najib Ayas and titled, "Workshop Project: Research Priorities in Perioperative OSA." and will lead to a special publication. 

We were most pleased to participate with the Asian Society of Anesthesia and Sleep Medicine, ably organized by Mathew Chen, MD, who organized our full day meeting, "Updates on Perioperative Management of Obstructive Sleep Apnea." Our separate sponsorship allowed us to produce this meeting without further financial burden to SASM. We are presently exploring participation with the European Society of Anesthesia in December of 2017 with a SASM presentation within their program. 

Conclusion
We continue to be blessed with solid membership growth and have many important initiatives from different enthusiastic SASM Chairs and Board Members. This will be a year of some further changes as several new and eager replacements will take on new tasks. I have been truly humbled to be your first 'sleep representative' President of SASM, and believe this unique blend of anesthesia and sleep medicine thought leaders has been an honor and a very rewarding experience as President of the SASM. I am very grateful for the hard work of the Board Members, the Committee Chairs and Committee Members who contribute to the immense success of the SASM. 

Nonetheless, the SASM needs more help from its members. If you would like to serve in any capacity, please submit your request on the SASM website (www.sasmhq.org) with your CV. 

Peter C. Gay, MD
President