Position:
Professor
Division:
Respiratory
Research Sumary:

Since my initial appointment at UBC, the majority of my research has been involved in different aspects of respiratory sleep and neuromuscular disorders, with a special focus on obstructive sleep apnea.  Over the last ten years, I have been the primary investigator in a collaborative research program with the Faculty of Dentistry, which has examined upper airway structure using a variety of imaging techniques.  In other studies, I have evaluated the influence of obstructive sleep apnea on upper airway muscle function, respiratory muscle function, systemic blood pressure, hypothalamic pituitary function, and psychological status.  I have helped develop and evaluate a variety of case selection techniques for patients with suspected obstructive sleep apnea.  I have been involved in a variety of clinical trials to evaluate the long-term efficacy, compliance and side-effects of different treatments for sleep disordered breathing.  I have also been involved in studies to predict the long term morbidity and mortality of untreated sleep disordered breathing. I am a practicing respiratory physician and as such have been involved in a variety of clinical studies (eg. asthma) and have published on selected topics in clinical respiratory medicine (eg. drug induced pleural disease).

Education:
MB BS, University of London, London, U.K.
Fellow, Queens University, Respiratory Medicine
Recent Publications:
  • •Ayas NT, FitzGerald JM, Fleetham JA, White DP, Schulzer M, Ryan CF, Ghaeli R, Mercer GW, Cooper P, Tan M, Marra CA.  Cost-effectiveness of continuous positive airway pressure therapy for moderate to severe obstructive sleep apnea/hypopnea.  Arch Intern Med 166:977-984, 2006.
  • •Ayas NT, Mancini GBJ, Fleetham JA.  Does CPAP delay the development of cardiovascular disease in patients with obstructive sleep apnoea hypopnoea? Thorax 61:459-460, 2006.
  • •Fleetham J, Ayas N, Bradley D, Ferguson K, Fitzpatrick M, George C, Hanley P, Hill F, Kimoff J, Kryger M, Morrison D, Series F, Tsai W.  Canadian Thoracic Society Guidelines:  Diagnosis and treatment of sleep disordered breathing in adults.  Can Respir J 2006;13(7):38l7-392.
  • •Lim J, Lasserson TJ, Fleetham J, Wright J.  Oral appliances for obstructive sleep apnea.  Cochrane Database Syst. Rev. 1:CD004435, 2006.
  • •Mulgrew A, Fleetham JA. How best to determine optimal nasal CPAP in patients with OSAH?  Thorax 61:186-187, 2006.
  • •Alajmi M, Mulgrew AT, Fox J, Davidson W. Schulzer M, Mak E, Ryan CF, Fleetham J, Choi P, Ayas NT.  The impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea:  A meta-analysis of randomized controlled trials.  Lung, 185:67-72, 2007.
  • •Arzt M, Floras JS, Logan AG, Kimoff RJ, Series F, Morrison D, Ferguson K, Belenkie I. Pfeifer M, Fleetham J, Hanly P, Smilovitch M, Ryan C, Tomlinson G, Bradley TG.  Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure.  Circulation 115:3173-3180, 2007.
  • •Chen, H., Lowe, A.A., Almeida, F.A., Wong, M., Fleetham, J.A. and Wang, B. 3D Computer Assisted Study Model Analysis of Long Term Oral Appliance Wear – Part I: Methodology.  Am J Orthod Dentofacial Orthop 134:393-407, 2008.
  • •Fleetham J, Ayas N, Bradley D, Ferguson K, et al.  Directives de la Société canadienne de thoracologie:  Diagnostic et traitement des troubles respiratoires du sommeil de l’adulte.  Can Resp J 14(1):31-36, 2007.
  • •Fleetham JA.  Oral appliance treatment for snoring and obstructive sleep apnoea/hypopnoea.  Minerva Pneumologica.  2007; 46:223-8.
  • •Mulgrew A, Cheema R, Fleetham J, Ryan CF, Ayas NT.  Efficacy and patient satisfaction with auto-adjusting CPAP with variable expiratory pressure versus standard CPAP: A two-night randomized crossover trial.  Sleep Breath. 2007 Mar;11(1):31-7.
  • •AlGhanim N, Comondore VR, Fleetham J, Ayas NT.  The economic impact of obstructive sleep apnea. Lung. 186(1):7-12, 2008.
  • •Chen H, Lowe AA, Bai Y, Hamilton P, Fleetham JA, Almeida FR..Evaluation of a portable recording device (ApneaLinktrade mark) for case selection of obstructive sleep apnea.Sleep Breath, Dec 4 2008, epub ahead of print.
  • •Chen, H., Lowe, A.A., Almeida, F.A., Fleetham, J.A. and Wang, B. 3D Computer-Assisted Study Model Analysis of Long Term Oral appliance Wear – Part II: Side Effects of Oral Appliances in Sleep Apnea Patients.  Am. J. Orthod. Dentofacial Orthop., 134:408-17, 2008.
  • •Chen, H., Lowe, A.A., Strauss, A.M., de Almeida, F.A., Ueda, H., Fleetham, J.F. and Wang, B. “Dental Changes Evaluated with a 3D Computer-Assisted Model Analysis After Long Term Tongue Retaining Device Wear in OSA Patients”, Sleep Breath 12(7):169-78, 2008.
  • •Fleetham JA.  Canadian Thoracic Society guidelines for sleep disordered breathing.  Can. Respir J. November/December, 15:25-26, 2008.
  • •Fleetham JA.  Obstructive sleep apnea across the life span:  Adult perspective.  Can. Respir J. November/December, 15:30-31, 2008.
  • •Froese CL, Butt A, Mulgrew A, Cheema R, Speirs MA, Gosnell C, Fleming J, Fleetham J, Ryan CF, Ayas NT.  Depression and sleep-related symptoms in an adult, indigenous, North American population.  J Clin Sleep Med 4:356-61, 2008.
  • •MCY Tan, NT Ayas, AT Mulgrew,  L Cortes, JM Fitzgerald, JA Fleetham, M Schulzer, CF Ryan, R Ghaeli, P Cooper, CA Marra.  Cost-Effectiveness of CPAP Therapy for Obstructive Sleep Apnea Hypopnea in British Columbia. Can. Resp. J. 15, 159-165, 2008.
  • •Mulgrew AT, Nasvadi G, Butt A, Cheema R, Fox N, Jung D, Fleetham J, Ryan CF, Cooper P, Ayas NT.  Risk and severity of motor vehicle crashes in patients with obstructive sleep apnea hypopnea. Thorax, 63(6):536-41, 2008.
  • •Mulgrew, AT, Ryan CF, Fleetham JA, Cheema R, Fox N, Keohoorn M, Fitzgerald JM, Marra C, Ayas NT.  The impact of obstructive sleep apnea hypopnea and daytime sleepiness on work limitation.  Sleep Med 9(1):42-53, 2008.
  • •Comondore VR, Cheema R, Fox J, Butt A, Mancini JGB, Fleetham JA, Ryan CF, Chan S, Ayas NT.  The impact of CPAP on cardiovascular biomarkers in minimally symptomatic patients with obstructive sleep apnea:  A pilot feasibility randomized crossover trial.  Lung. 2009 Jan-Feb;187(1):17-22. Epub 2008 Sep 16.
  • •Al Lawati N, Mulgrew A, Cheema R, VanEeden S, Butt A, Fleetham J, Ryan F, Ayas N.  Pro-atherogenic cytokine profile of patients with suspected obstructive sleep apnea.  Sleep & Breathing. 13(4):391-5, 2009.
  • •Chen H, Lowe AA, Bai Y, Hamilton P, Fleetham JA, Almeida FR..Evaluation of a portable recording device (ApneaLinktrade mark) for case selection of obstructive sleep apnea. Sleep Breath, 13(3):213-9, 2009.
  • •Comondore VR, Cheema R, Fox J, Butt A, Mancini JGB, Fleetham JA, Ryan CF, Chan S, Ayas NT.  The impact of CPAP on cardiovascular biomarkers in minimally symptomatic patients with obstructive sleep apnea:  A pilot feasibility randomized crossover trial.  Lung. 2009 Jan-Feb;187(1):17-22. Epub 2008 Sep 16.
  • •Lim J, Lasserson T, Fleetham J, Wright JJ.  Oral appliances for obstructive sleep apnoea.  The Cochrane Database of Systematic Reviews.  Volume 3, 2009.
  • •S. Fels, I. Stavness, A.G. Hannam, J. E. Lloyd, P. Anderson, C. Batty, H. Chen, C. Combe, T. Pang, T. Mandal, B. Teixeira, S. Green, R. Bridson, A. Lowe, F. Almeida, J. Fleetham and R. Abugharbieh. Advanced Tools for Biomechanical Modeling of the Oral, Pharyngeal, and Laryngeal Complex. In International Symposium on Biomechanics Healthcare and Information Science, electronic proceedings, Feb. 2009. (invited).
  • •Sadatsafavi,M Marra C,Ayas N,Stradling J,Fleetham J Cost-effectiveness of oral appliances in the treatment of obstructive sleep apnea-hypopnea.  Accepted Sleep and Breathing, 2009.
  • •Sadatsafavi,M Marra C,Ayas N,Stradling J,Fleetham J Cost-effectiveness of oral appliances in the treatment of obstructive sleep apnea-hypopnea.  Sleep Breath.  Aug;13(3):241-52, 2009. Epub 2009 Feb 20.
  • •Ayas N, Fox J, Epstein L, Ryan F, J. Fleetham. Initial use of portable monitoring versus polysomnography to confirm obstructive sleep apnea in symptomatic patients:  An economic decision model. Sleep Med. 2010 Mar;11(3):320-4. Epub 2010 Feb 4.
  • •Blackman A, McGregor C, Dales, R, Driver H, Dumov I, Fleming J, Fraser K, George C, Khullar A, Mink J, Moffat, M. Sullivan GE, Fleetham JA (Chair), Ayas N, Bradley T, Fitzpatrick M, Kimoff J, Morrison D, Ryan F, Skomro R, Series F, Tsai W. Canadian Sleep Society/Canadian Thoracic Society position opaper on the use of portable monitoring for the diagnosis of obstructive sleep apnea/hypopnea in adults. Can Respir J, 17(5):229-232, 2010.
  • •Fleetham JA. Postal code diagnosis and treatment of sleep apnea.  Editorial. Can Resp J, 17(4):169, 2010.
  • •Fleetham JA. Waking up to sleep disordered breathing. Thorax. 65(9):762-763, 2010.
  • •Fleetham, J and Almeida FR. Oral Appliances. Eur Respir 50:267-285, 2010.
  • •Ryan CM, Floras JS, Logan AG, Kimoff RJ, Series F, Morrison D, Ferguson KA, Belenkie I, Pfeifer M, Fleetham J, Hanly PJ, Smilovitch M, Arzt M, Bradley TD. Shift in sleep apnea type in heart failure patients in the CANPAP trial. Eur Respir J. Mar;35(3):592-7, 2010.
  • •Fleetham J, Ayas N, Bradley D, Fitzpatrick M, Oliver T, Morrison D, Ryan F, Series F, Skomro R, Tsai W. Canadian Thoracic Society 2011 guideline update:  Diagnosis and treatment of sleep disordered breathing. Can Respir J 18(1):xx-xx, In press 2011.
  • •Van Tongeren L, Shaipanich T, Fleetham J. Co-infection with Cryptococcus gatti and Mycobacterium tuberculosis in an otherwise health 18-year-old woman. Can Resp J.  Accepted 2011.