Sleep Medicine Fellowship

Since this is only a one-year fellowship, the research component expectation is limited and will be individually tailored to you. You will be expected to do a scholarly project for the year. That will consist of any of the following:

• case report/abstract with submission to APSS meeting and review article submitted for publication.
• original research project which would entail IRB submission and could include a chart review
• prospective clinical study
• basic science/translational project.

Currently, the sleep division’s research interests include the study of sleep in the intensive care unit, sleep quality on noninvasive ventilation, screening for sleep apnea in the preoperative period, screening for sleep apnea in the pulmonary hypertension patient population, and the interaction between sleep disordered breathing and pulmonary hypertension in general, as far as pathophysiologic mechanisms and effects of therapies.

In addition to individual research mentoring and support from the sleep faculty, Tufts Clinical and Transitional Institute (CTSI), www.tuftsctsi.org, accelerates translation of laboratory research into clinical use, medical practice and health policy. The center works on connecting people to research resources, consultation, and education, and fostering collaboration with scholars of all disciplines and with community members and with the ultimate goal of improving the health of the public.

Tufts Medical Center, the primary teaching hospital for Tufts University School of Medicine, is an academic medical center providing comprehensive inpatient and outpatient care in the heart of downtown Boston. The 359-bed medical center is one of only two full-service university hospitals in Boston. It has a nationally recognized staff that is committed to providing an integrated, interdisciplinary approach to the diagnosis and management of patients with complicated diseases. Tufts MC has a large and diverse research program with over $50 million of extramural funding. It is ranked among the top academic medical centers receiving National Institutes of Health (NIH) funding.

Tufts Medical Center has a 6-bed Sleep lab that provides the whole gamete of sleep studies for both adults and pediatrics. On average, the lab performs more than 1200 overnight studies annually in addition to portable home testing. The Sleep Laboratory Rotation for fellowship trainees aims to provide an extensive exposure to sleep medicine polysomnograpy and related techniques via didactic teaching, polysomnogram recording and interpretation and direct patient contact. These include standard polysomnography, multiple sleep latency testing, maintenance of wakefulness testing, portable polysomnography testing and actigraphy. Sleep study interpretations are completed by the fellow throughout the academic year and are fully reviewed using all available information including patient sleep medicine history questionnaires, technical notes during the study, pre and post study patient questionnaires and direct review of scored data recordings. After an introductory period, fellows will provide the initial interpretation independently of the attending, which will then be reviewed in detail with the attending.

The Sleep Medicine Inpatient Consult Service aims to provide excellent patient care, strong teaching, and a broad clinical exposure to consultative inpatient sleep medicine.This includes exposure via direct patient contact through a consult service staffed by the sleep medicine fellow and sleep medicine attending. The fellow will be expected to provide the initial assessment of the consult patient, including performing a complete general and targeted sleep medicine history and physical exam. The consult will then be reviewed with the attending and a full note generated with recommendations to the requesting service.

During the Dental Sleep Medicine Rotation Fellows will rotate through the dental sleep medicine service of the Dental School of Tufts University, under the direct supervision of Dr. Leopoldo Correa, who is board certified in dental sleep medicine, providing exposure to aspects of the dental clinical examination relevant to sleep medicine, the principles of oral appliance fitting and adjustment, and familiarity with the advantages and disadvantages of the different types of appliances.

The outpatient Behavioral Sleep Medicine Rotation will provide direct patient contact in the outpatient setting, and aims to provide strong teaching and broad clinical exposure in cognitive behavior therapy, under the direct supervision of a certified Behavioral Sleep Medicine psychologist. This rotation allows the fellow to witness first-hand the complex management of patients with insomnia, PTSD, anxiety and depression, as they relate to the development of abnormal sleep. The Sleep Psychologist will also be visiting our sleep lab for formal lecture/training on cognitive behavioral therapy.

The Neurology Sleep Medicine rotation for fellowship trainees in sleep medicine aims to provide an emphasis on neurology and the neurological aspects of sleep medicine. Fellows will be involved in the management of patients with Narcolepsy, Restless Leg Syndrome, and other movement disorders under the direct supervision of dual board certified Neurology and Sleep attending, Dr. Joel Oster. In addition, the sleep fellow will participate in a set of introductory sessions on basics of EEG, conducted by the neurology department at Tufts Medical Center.

The Otolaryngology Sleep Medicine rotation provides a broad clinical exposure to sleep medicine with an emphasis on the otolaryngology assessment and management of sleep medicine disorders as it pertains to the adult as well as pediatric population. This rotation will occur at Tufts Medical Center within the Division of Otolaryngology which is a leading center for the diagnosis and management of complete spectrum of otolaryngology disorders including sleep apnea. Dr. Mark Vecchiotti (pediatrics) will provide supervision in this clinic.

The Pediatric Sleep Medicine rotation aims to provide a broad clinical exposure to all aspects of pediatric sleep medicine which includes behavioral disorders as well as disorders of breathing like obstructive and central sleep apnea in addition to hypoventilation syndromes. The fellow will gain experience in pediatric polysomnograpy and related techniques via didactic teaching, polysomnogram recording and interpretation and direct patient contact in both the inpatient and outpatient settings.