Education

  1. Fellow - Thoracic Diseases and Critical Care Medicine Mayo Graduate School of Medicine, Mayo Clinic College of Medicine
  2. Resident - Internal Medicine Mayo Graduate School of Medicine, Mayo Clinic College of Medicine
  3. Internship - General Surgery Naval Hospital, San Diego, CA
  4. MD Dartmouth Medical School
  5. BS - Chemical engineering Massachusetts Institute of Technology

Certifications

  1. Internal Medicine, American Board of Internal Medicine
  2. Critical Care Medicine, American Board of Internal Medicine
  3. Pulmonary Medicine, American Board of Internal Medicine
  4. Sleep Medicine, American Board of Internal Medicine
  5. American Board of Medical Quality

Academic rank

  1. Professor of Medicine

Professional Highlights

  • President, American Academy of Sleep Medicine 2014-2015
  • Chief Patient Safety Officer of Mayo Clinic, 2011-present
  • Director, Minnesota Alliance for Patient Safety, 2013-present
  • Secretary Treasurer, American Academy of Sleep Medicine, 2012-2014
  • Director, American Academy of Sleep Medicine, 2009-present
  • Director, American Sleep Medicine Foundation, 2009-2015
  • Director, American Board of Sleep Medicine, 2009-present

Interests

Main clinical interests

Sleep-disordered breathing.

Sleep medicine research

I have two main areas of research and academic interest: sleep-disordered breathing and patient safety. In sleep medicine, I have concentrated on special kinds of sleep-disordered breathing. Most sleep clinicians are familiar with the Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) and two syndromes with cyclic non-obstructive breathing patterns — the Central Sleep Apnea-Hypopnea Syndrome and the Cheyne-Stokes Breathing Syndrome (CSBS). A primary interest of my group has been a complex-pattern breathing abnormality that has been noted for many years but not previously described in terms of clinical behavior and implications, cause, and treatment. Patients exhibiting this disorder appear at first to have purely obstructive sleep apnea, but after the application of CPAP, they develop problematic central sleep apnea or Cheyne-Stokes breathing pattern. Little is known about this unclassified group of patients; they lack a common syndromic definition, clinical or pathophysiologic description. For our purposes, we term this type of sleep-disordered breathing "Complex Sleep Apnea Syndrome" (CompSAS). We have published a description of the clinical characteristics of this group of patients. Ongoing work includes studies to determine the underlying pathophysiology, the long term clinical sequellae, and the study of novel breathing assistance devices such as Adaptive Servo Ventilation that appear to show promise to treat this complex breathing pattern. Since the pattern resembles central sleep apnea syndrome (CSA) once the patient is treated with CPAP, we also have been adapting what we learn about treating CompSAS to our substantial population of patients who have CSA.

Patient safety research

I have been interested in the development of data analytics that help inform a practice on priority areas for improvement and that obtain an ability to be both predictive and prescriptive. Intrinsic in this work is developing the capability to measure important components of patient safety, such as preventable harm, aggregated near-miss analysis, and relationship between risk conditions and serious harm events.

Publications

See my publications

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