International Conference on Respiratory Pathophysiology, Sleep and Breathing

Rome - June 15-17, 2016

FINAL PROGRAMME FINALPROGRAMME

RAZIONALE Sleep Medicine is considered as a multidisciplinary discipline involving numerous specialists. Sleep related breathing disorders constitute a subset of the broad group of sleep disorders that include many other disorders such as insomnia, hypersomnias, parasomnias, and sleep related movement disorders. Sleep disorders cause continuous arousals, excessive daytime sleepiness with all related effects on the capacity of concentration and attention; they can worsen cognitive function, and represent a risk factor for cardiovascular and cerebrovascular events, arrhythmias and metabolic disorders. Such disorders affect a huge percentage of the general population and often result in exacerbation of underlying pathologies that tend to worsen considerably during sleep. Individuals with chronic lung disease often have disturbed sleep associated with oxygen desaturations, coughing, or dyspnoea. Patients with certains medical disorders, such as asthma, may suffer their symptoms most severely during sleep. Both obstructive and restrictive lung diseases are associated with poor quality of sleep. Chronic obstructive pulmonary disease (COPD) is a high and increasingly prevalent disease; during wakefulness, abnormalities of respiratory function are demonstrated by standard pulmonary function tests: among them, spirometry and arterial blood gas analysis are the most generally used to define the degree of severity of COPD. A more complete evaluation of patients with this disease includes the assessment of sleep gas exchanges, which worsen to a variable extent with respect to wakefulness. Our ability to predict the prognosis of affected patients is improving, but is still imperfect. A better knowledge of respiratory function during sleep could probably improve our approach to the disease. A similar approach can be suggested for asthma considering the high relevance of its nocturnal exacerbation. Sleep-disordered breathing (SDB) is a very common medical sleep problem; SDB is a group of disorders that affect our breathing while we are asleep, and are characterized by disruptions of normal breathing pattern. A short description of the physiological basis, main principles of treatment and the major acute and chronic impact of treatment will be addressed. The most common sleep related breathing disorders are snoring and sleep apnea. Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial interruption of ventilation during sleep caused by a collapse of the upper airway. Obstructive apneas are associated with ongoing increasing respiratory efforts, and cause intermittent arterial oxygen desaturation, systemic and pulmonary arterial blood pressure fluctuations and sleep disruption. The objective of this meeting is to review Respiratory Pathophysiology with a look at Pulmonary Rehabilitation and the use of tele-health to increase access and capacity, dyspnea, exercise limitation and nutrition; SLEEP DISORDERS going through sleep physiology and cognitive function, respiratory disorders during sleep dealing with excessive daytime sleepiness and road safety and the diagnostic and therapeutic approach; BREATHING DISORDERS with a look at control of breathing and neuromuscular disorders; overlap syndrome and congestive heart failure and central sleep apnea and their treatment. Prof. Francesco de Blasio Prof. Giuseppe Insalaco Prof. Mario Polverino

Scientific Committee Francesco de Blasio, MD, FCCP Giuseppe Insalaco, MD, FCCP Barbara A. Phillips, MD, FCCP Mario Polverino, MD, FCCP

Invited Faculty P. Agostoni (Milano - Italy) F. Andò, FCCP (Messina - Italy) R. Antonelli Incalzi (Roma - Italy) P. Banfi (Milano - Italy) V. Bernhardt (Dallas, TX - USA) A. Braghiroli (Veruno, NO - Italy) M. Bruyneel (Bruxelles - Belgium) C. Cajochen (Basel - Switzerland) S. Carlone (Roma - Italy) P. Carratù (Bari - Italy) R. Casaburi, FCCP (Rancho Palos Verdes, CA - USA) V. Castronovo (Milano - Italy) A. Chetta (Parma - Italy) F. Cirignotta (Bologna - Italy) E.M. Clini, FCCP (Modena - Italy) M. Contini (Milano - Italy) U. Corrà (Veruno, NO - Italy) D. Currow (Adelaide - Australia) R. Cutrera (Roma - Italy) R. Dahl (Brentford Middlesex - United Kingdom) N. Dardes (Roma - Italy) F. de Blasio, FCCP (Napoli - Italy) F. Fanfulla (Pavia - Italy) B. Fauroux (Paris - France) L. Ferini Strambi (Milano - Italy) F. Franssen (Horn - The Netherlands) R. Goldstein, FCCP (Toronto - Canada) G. Insalaco, FCCP (Palermo - Italy) P. Laveneziana (Paris - France)

D.A. Mahler, FCCP (Hanover, NH - USA) M. Manconi (Lugano - Switzerland) D.M. Mannino, FCCP ((Lexington, KY - USA) E. Muscianisi (Origgio, VA - Italy) N. Netzer (Bad Aibling - Germany) D.E. O’Donnell, FCCP (Kingston, ON - Canada) O. Oldenburg (Bochum - Germany) P. Paggiaro (Pisa - Italy) P. Palange (Roma - Italy) F. Pasqua (Roma - Italy) J.L. Pepin (Grenoble - France) P. Philip (Bordeaux - France) B.A. Phillips, FCCP (Lexington, KY - USA) S. Picciolo, FCCP (Messina - Italy) F. Pizza (Bologna - Italy) M. Polverino, FCCP (Scafati, SA - Italy) W.J. Randerath, FCCP (Zurich - Germany) S. Redolfi (Paris - France) A. Rizzi (Verona - Italy) P. Rogliani (Roma - Italy) I. Rosenzweig (London - United Kingdom) C.M. Sanguinetti, FCCP (Roma - Italy) L. Scalfi (Napoli - Italy) A. Schols (Maastricht - The Netherlands) M. Steiner (Leicester - United Kingdom) C. Tantucci (Brescia - Italy) M.P. Villa (Roma - Italy) M. Vitacca (Lumezzane, BS - Italy)

PROGRAMME

Wednesday, June 15th 2016 09.00-10.00 Participants registration RESPIRATORY PATHOPHYSIOLOGY 10.00-11.30 Pulmonary rehabilitation Chairmen: R. Goldstein - F. Pasqua 10.00-10.20 Using tele-health to increase access and capacity M. Vitacca 10.20-10.40 Consequences and therapies of inactivity R. Casaburi 10.40-11.00 Milestones in pulmonary rehabilitation R. Goldstein 11.00-11.30 Discussion 11.30-13.00 Dyspnea Chairmen: D.A. Mahler - C.M. Sanguinetti 11.30-11.50 Dyspnea domains and descriptors D.A. Mahler 11.50-12.10 Mechanisms of dyspnea in chronic interstitial and obstructive lung diseases: final common pathways D.E. O’Donnell 12.10-12.30 Opioids and anxiolytics for refractory dyspnea D. Currow 12.30-13.00 Discussion 13.00-13.30 Industry sponsored lecture Right treatment to right patient: GSK commitment to the respiratory research R. Dahl - A. Rizzi Chairman: F. de Blasio 13.30-14.00 Lunch

PROGRAMME

14.00-14.30 Opening remarks F. de Blasio - B.A. Phillips 14.30-16.00 Exercise limitation Chairmen: E.M. Clini - P. Rogliani 14.30-14.50 Cardiovascular response to exercise in COPD A. Chetta 14.50-15.10 Performance of obese patients during exercise V. Bernhardt 15.10-15.30 Respiratory mechanics and symptoms in pulmonary hypertension P. Laveneziana 15.30-16.00 Discussion 16.00-17.30 Nutrition Chairmen: F. Franssen - L. Scalfi 16.00-16.20 Assessment of body composition in COPD M. Steiner 16.20-16.40 Metabolic phenotypes in COPD A. Schols 16.40-17.00 Obesity in COPD F. Franssen 17.00-17.30 Discussion

PROGRAMME

Thursday, June 16th 2016 SLEEP DISORDERS 09.00-10.30 Sleep physiology and cognitive function Chairmen: R. Antonelli Incalzi - L. Ferini Strambi 09.00-09.20 Cognition and sleep loss C. Cajochen 09.20-09.40 Sleep apnea and the brain: a complex relationship I. Rosenzweig 09.40-10.00 Neurocognitive function and sleep apnea: the effects of therapy V. Castronovo 10.00-10.30 Discussion 10.30-12.00 Respiratory disorders during sleep: diagnostic approach Chairmen: G. Insalaco - M.P. Villa 10.30-10.50 When must we think to RDS B.A. Phillips 10.50-11.10 Laboratoratory and ambulatory management for obstructive sleep apnea: where and when M. Bruyneel 11.10-11.30 Pediatric approach to sleep apnea R. Cutrera 11.30-12.00 Discussion 12.00-12.30 Industry sponsored lecture A new paradigm in the treatment of COPD: results of the Flame Study E. Muscianisi Chairman: M. Polverino 12.30-13.00 Industry sponsored lecture From the symptoms to the therapy. Customized options for patients with COPD C. Tantucci Chairman: F. de Blasio 13.00-14.00 Lunch

PROGRAMME

14.00-15.30 Excessive daytime sleepiness Chairmen: F. Cirignotta - P. Palange 14.00-14.20 How to measure sleepiness - A critical review F. Pizza 14.20-14.40 Sleepiness at the weel P. Philip 14.40-15.00 Determinants of sleepiness in OSAS M. Manconi 15.00-15.30 Discussion 15.30-17.00 RDS: which therapeutic approach Chairmen: G. Insalaco - S. Picciolo 15.30-15.50 RDS and CPAP therapy: just a pressure? N. Netzer 15.50-16.10 Sleep apnea phenotypes and therapies choice for obstructive sleep apnea W.J. Randerath 16.10-16.30 Adaptive servo-ventilation for the treatment of CSR: what’s going on A. Braghiroli 16.30-17.00 Discussion

PROGRAMME

Friday, June 17th 2016 BREATHING DISORDERS 09.00-10.30 Control of breathing and neuromuscular disorders Chairmen: F. Andò - P. Banfi 09.00-09.20 Controversies in the control of breathing R. Casaburi 09.20-09.40 Sleep-disordered breathing in adult with neuromuscular disease J.L. Pepin 09.40-10.00 Sleep-disordered breathing in children with neuromuscular disease B. Fauroux 10.00-10.30 Discussion 10.30-12.00 Overlap syndrome Chairmen: B.A. Phillips - N. Dardes 10.30-10.50 Overview, definitions and epidemiology B.A. Phillips 10.50-11.10 OSAS and overlap syndrome affect both left and right heart P. Carratù 11.10-11.30 Effect of treatment on COPD outcomes D.M. Mannino 11.30-12.00 Discussion 12.00-13.00 Industry sponsored lecture Drugs and patients: strategies for effective asthma therapy M. Polverino Chairman: G. Insalaco 12.30-13.00 Industry sponsored lecture COPD double association therapy: which patients and when? P. Paggiaro Chairman: G. Insalaco 13.00-14.00 Lunch

PROGRAMME

14.00-15.30 Congestive heart failure Chairmen: P. Agostoni - S. Carlone 14.00-14.20 Ventilation during exercise in heart failure, COPD and in patients with both COPD and heart failure P. Agostoni 14.20-14.40 Day-time, night-time and exercise periodic breathing in heart failure U. Corrà 14.40-15.00 Gas exchange in heart failure M. Contini 15.00-15.30 Discussion 15.30-17.00 Central sleep apnea Chairmen: A. Braghiroli - F. Fanfulla 15.30-15.50 Central apneas: how to differentiate physiology from disease C. Tantucci 15.50-16.10 Central sleep apnea and fluid dynamics S. Redolfi 16.10-16.30 Treatment of central sleep apnea O. Oldenburg 16.30-17.00 Discussion

INDUSTRY SPONSORED LECTURES

Wednesday, June 15th 2016 13.00-13.30 Right treatment to right patient: GSK commitment to the respiratory research Supported by GlaxoSmithKline*

Thursday, June 16th 2016 12.00-12.30 A new paradigm in the treatment of COPD: results of the Flame Study Supported by Biofutura-Novartis Farma*

Thursday, June 16th 2016 12.30-13.00 From the symptoms to the therapy. Customized options for patients with COPD Supported by Laboratori Guidotti-Malesci*

Friday, June 17th 2016 12.30-13.00 COPD double association therapy: which patients and when? Supported by AstraZeneca*

Friday, June 17th 2016 12.00-12.30 Drugs and patients: strategies for effective asthma therapy Supported by an unrestricted educational grant by A. Menarini**

* Italian Ministry of Heath CME accreditation was not applied for ** Italian Ministry of Heath CME accreditation was applied for

REGISTRATION INFORMATION Registration fee All fees are requested in Euro. Daily registration is not provided. REGISTRATION FEE (VAT 22% included) CHEST Member Physician Non CHEST Member Physician Physician younger than 35 Nurses, Physiotherapists

Euro 400,00 Euro 500,00 Euro 100,00 Euro 70,00

The registration fee includes: • access to the scientific sessions • access to the exhibition area • congress kit • coffee and lunch • certificate of attendance Payment The registration fee payment should be made through: • Cash • Check non transferable made payable to Devital Service S.p.A. • Credit card (Visa / Diners Club, Mastercard)

GENERAL INFORMATION Organizing Secretariat and CME Provider

Devital Service SpA Piazza Wagner 5 - 20145 Milan (Italy) Tel. 0039 02 43319223 - Fax 02 48513353 E-mail: [email protected] Congress Venue Roma Eventi Fontana di Trevi P.zza della Pilotta, 4 - 00187 Roma Secretariat Opening Hours Wednesday June 15 2016: 08.30-17.30 Thursday June 16 2016: 08.30-17.30 Friday June 17 2016: 08.30-17.30 Official Language The official language of the Conference is English. Simultaneaus translation is not provided. Badge Participants are kindly requested to wear their name badge during all the Conference activities. The badge will admit to the scientific sessions, exhibition area, lunch and coffee break. Lost badges are replaced against the payment of a handling fee of Euro 30,00 (local VAT included) and upon proof of original registration. Attendance Certificates Attendance Certificates will be delivered on request to all regularly registered participants at the end of the Conference. WEB SITE www.chest.it CME The conference has been accredited by the national agency for regional health services (AGE.Na.S) for the professional figure of Medical Surgeon. Topic areas: Allergy and Clinical Immunology, Cardiology, Geriatrics, Internal Medicine, Pediatrics, Respiratory Diseases, General Practitioners (family doctors), Anesthesia and Resuscitation, Neurology, Otolaryngology, Physical Medicine and Rehabilitation CME Reference number: 159359 Ed. 1 Number CME credits obtained: 3,6 For acquisition of credits requires 80% presence of the actual duration of the meeting and compilation of the CME requested documentation.

Organizing Secretariat and CME Provider

Devital Service SpA Piazza Wagner 5 - 20145 Milan (Italy) Tel. 0039 02 43319223 - Fax 02 48513353 E-mail: [email protected]