Overview

When staffing a laboratory, the medical, other health care staff, and technical staff involved with sleep medicine must meet the qualifications outlined in this chapter.

Medical Staff

Each sleep laboratory has a physician who has expertise in assessing and managing patients with sleep disorders. Appropriate documentation is provided by the physician reflected by one of the following criteria.

Each physician must meet the criteria established for physicians practicing sleep medicine:

* on or before October 1, 1996

or

* after October 1, 1996.

Physicians entering the practice of sleep medicine on or before October 1, 1996 have clinical experience in sleep medicine and interpreting polysomnography for the previous 12 months.

Physicians Practicing
Sleep Medicine
after October 1, 1996

Physicians entering the practice of sleep medicine after October 1, 1996 have:

* a minimum of 12 months clinical training in the assessment, management
and polysomnographic evaluation of patients with sleep disorders in a recognized postgraduate training center

or
* certification by the American Board of Sleep Medicine

or
* previous clinical research (minimum three years) in sleep medicine in an academic setting which demonstrates appropriate knowledge of the clinical management of these patients

or
* experience obtained from:
- the clinical management of patients with sleep disorders

- performing and interpreting polysomnograms under the supervision of a physician in a laboratory which meets the criteria in this document. A minimum of 2,000 hours experience and training must be obtained and can occur in a time frame of between 12 and 36 months.

Note: Prescribing and administering nasal CPAP, spontaneous BI-level positive pressure and/or supplemental oxygen during sleep is routine practice for qualified sleep physicians. However, the use of mechanical ventilation during sleep and/or wakefulness for patients with respiratory failure requires additional training in mechanical ventilation such as respirology.

In laboratories performing non-level I OHIP studies (nocturnal recording of respiratory variables only) physician training requirements are consistent with the ATS/ASDA accreditation document. During a fellowship year, six months clinical training is required.

Technical staff in a sleep laboratory must meet the following criteria:

* are registered as a polysomnography technologist by the American Board of Registered Polysomnographic Technologists (RPSGT) or equivalent

or

* have expertise in a relevant discipline (e.g., BSc in life sciences, registered respiratory therapist, registered EEG technologist, registered nurse, registered pulmonary function technologist)

* receive training in polysomnography in a laboratory which meets the criteria listed in this document.

Note: The duration of training is at least six weeks (240 hours) under the supervision of a registered or registry eligible polysomnographic technologist. Appropriate documentation of training is required.

Non-registered technologists are expected to obtain RPSGT certification within three years (6,000 hours) of full-time employment. The 6,000 hours may be extended over five years to allow for part-time employment, leave of absence, maternity leave, etc.

Each laboratory has a minimum of one RPSGT and new laboratories have one RPSGT at the outset.

All staff has up-to-date certification in cardiopulmonary resuscitation.

Technical staff has the opportunity for ongoing professional development.

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