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Pulmonary/Critical Care

ACGME Sleep Fellowship

Overview

Alejandra Lastra, MD

The University of Chicago’s Department of Medicine, under the Section of Pulmonary and Critical Care, offers three ACGME-approved positions per year for its one-year clinical fellowship training program in Sleep Medicine. The Sleep Fellowship Program, under the direction of Dr. Alejandra Lastra, Assistant Professor of Medicine, draws upon the enormous resources and diversity of our University. We take pride in our multidisciplinary approach to Sleep Medicine with faculty members with expertise in pulmonary, neurology, pediatrics, endocrinology, cardiology, otolaryngology, plastic surgery and dentistry.

The fellowship program offers unique clinical and research experiences to meet our goal of training the next generation of leaders in sleep medicine. The sleep training experience follows the guidelines established by ACGME.

Program Perks:
• High level clinical sleep medicine education and research experience in a collegial, supportive, friendly and
knowledgeable team of faculty and staff.
• Structured in-lab and home sleep study reading time with faculty.
• General, Pediatrics, and Behavioral Sleep Medicine clinics (for adults and children).
• Inpatient Sleep Consult Service.
• Full capacity sleep laboratory (advanced titrations, CO2 monitoring, MSLTs, actigraphy, HNS titrations, diaphragmatic
pacing PSGs) and home sleep testing.
• Neuromuscular disorders clinic (pulmonary sleep and neurology) and advanced PAP modalities.
• Hypoglossal Nerve Stimulator (HNS) / Upper Airway Surgery Program.
• Diaphragmatic Pacing Program (for CSA).

Brief History of Sleep Medicine at the University of Chicago

The University of Chicago has a most distinguished history in this field. Sleep research began at the University of Chicago when Professor Nathaniel Kleitman established the world’s first sleep laboratory in the late 1920s. He was the first scientist to concentrate entirely on sleep. In 1939, he published the first major textbook on sleep, Sleep and Wakefulness, which rapidly became the gold standard of sleep researchers everywhere. Dr. Kleitman and doctoral student Eugene Aserinsky revolutionized sleep research in 1953 when they announced the discovery of rapid eye movement (REM) sleep and its association with dreaming. This finding is usually considered the birth of modern scientific interest in sleep. Later in the decade, Kleitman and one of his students, Dr. William Dement, developed the techniques of all-night sleep recording, using measurements of eye motion and EEGs of brain activity. They used these measurements to chart the sequence of sleep patterns over the course of a night. This changed the established notion that sleep was a single state. The further discovery in 1955 that Narcolepsy had a neurophysiologic abnormality demonstrated by unusual premature REM onset sleep as opposed to the 90 minute delay encountered in normal individuals was a major step in the characterization of this condition. University of Chicago researchers Dr. Allan Rechtschaffen and Gerry Vogel, working with colleagues (including Dr. William Dement), described narcolepsy–the first true sleep disorder–in a landmark paper in 1963. Over the years, Dr. Rechtshaffen went on to become one of the single most respected basic and animal sleep investigators of this field performing experiments in rats that demonstrated the lethal consequences of long-term (two weeks or more) sleep deprivation. In 1968 Rechtshaffen together with Dr. Anthony Kales of UCLA standardized the scoring system for human sleep stages which is currently used today. The cutting edge research in sleep continues today.

The University of Chicago has also been nationally and internationally recognized as a leading institution for sleep research in adverse health consequences of insufficient sleep and sleep disorders. The leading researchers published seminal studies showing that sleep is not important just to the brain (cognitive function, memory), but for the rest of the body, and that sleep loss plays a role in the current epidemics of obesity and diabetes. In summary, the work by University of Chicago researchers has help to firmly establish sleep as one of the pillars of health.