Interview with the President of the Italian Association of Sleep Medicine (AIMS), Dr. Raffaele Ferri

Dear Dr. Ferri, what is the status of the accreditation procedures for sleep medicine experts? Can you explain how the procedure works?

Since 1997, AIMS has appointed the accreditation of “Sleep Medicine Expert” to doctors that pass a careful exam, held annually the day before the beginning of the annual Congress, and consisting of three parts: 1) a questionnaire composed by 50 questions on basic Sleep sciences, cardiorespiratory Sleep medicine, hypersomnias, insomnia and circadian rhythm disorders, sleep-related movement disorders and parasomnias; 2) a practical test on reading and scoring PSG for staging, phasic event detection and quantification, analysis of cardio-respiratory signals and analysis of other PSG features, such as neurovegetative and motor events; and 3) the discussion of a clinical case proposed by the candidate and by the examiners.

The candidates must pass the questionnaire by correctly answering at least 37/50 questions in order to sustain the following step.

Such an accreditation procedure is planned only for physicians or also for other professional figures like psychologists, technicians etc.?

We also admit psychologists to the exam.

Do you also have an accreditation procedure for sleep centers?

We first established an accreditation procedure for Sleep Centers in 1995, which have been regularly updated over the years and include criteria for the first accreditation and the subsequent maintenance of the status. In particular, we verify and certify the clinical competence of the staff of the Center and the appropriateness of the clinical procedures and of the equipment available for a correct diagnostic and therapeutic management of patients with sleep disorders.

Do you have accreditation procedures for centers with different characteristics (multidisciplinary, respiratory specific, pediatrics etc)?

We have two main types of Centers:

1)    “Centro di Medicina del Sonno (CMS)” that can manage and follow-up patients with all types of sleep disorders, also by collaborating, when needed, with other specialists and centers, with established and validated protocols for diagnosis/therapy. The Director of a CSM must be a neurologist with a demonstrated experience within the field of Sleep Medicine and at least one of the staff must have the AIMS Sleep Medicine Expert accreditation.

2)    “Centro per i Disturbi Respiratori in Sonno (CDRS)” )” that can manage and follow-up patients with sleep disordered breathing, also by collaborating, when needed, with other specialists and centers, with established and validated protocols for diagnosis/therapy. At least one of the staff must have the AIMS Sleep Medicine Expert accreditation.

Both types of Centers may be dedicated specifically to the pediatric age range.

Is sleep medicine officially included in academic programs?

No. In Italy, Sleep Medicine is not a discipline officially recognized as an academic one; however, there was a PhD program dedicated to Sleep Medicine at the University of Bologna (no longer active), which also organizes a University Master’s Degree in Sleep Medicine every year, in collaboration with AIMS, with 15 colleagues getting this degree every year.

Do you organize accredited sleep medicine courses?

AIMS organizes an accredited Sleep Medicine residential course every year in Bertinoro, and this year we will have our 20th edition. It consists of lessons and practical sessions, including hands-on computer scoring of different PSG recordings and video sessions. Basic and advanced courses are organized, depending on the perceived needs, which last usually for 4-5 days and are highly attended.

Are you working toward achieving the recognition of sleep medicine as a medical sub-specialty?

This is a very difficult target, especially in the current particular global socio-economic period, and the specific academic and health system reorganization needs for the public spending review process which are taking place. These do not allow for an increase in the number of official specialties/sub-specialties. However, AIMS is continuously promoting the importance and the need of Sleep Medicine Experts, and its efforts have recently received some support from an official document of the Italian Ministry of Health about the application of the E.U. directive on driving licenses for drivers with obstructive sleep apnea, in which a specific mention of “experts in sleep disorders” has been repeatedly made.

Is basic research in the sleep field represented in the Italian Association of Sleep Medicine activities?

AIMS has an important and strong group of basic researchers that represent a fundamental component of the association. This importance is reflected by the presence of a specific commission dedicated to basic sleep research, and its Coordinator is, through by-laws, a component of the Society Board of Directors. Basic researchers are a very active part of AIMS who are fully embedded in the association’s activities with dedicated symposia at the annual congress and specific courses and activities.

Thank you, Dr. Ferri, for participating in this interview.

Lino Nobili