Dr. Patrick Hanly

Dr. Patrick Hanly

Position in Division

Director, Sleep Centre, Foothills Medical Centre Active staff, Division of Respirology, Calgary Health Region

University Title

Professor of Medicine, University of Calgary

Clinical Interests

Graduating School and Year

Postgraduate Training

Recent Publications

  1. Dancey D, Tullis E, Heslegrave R, Thornley K, Hanly P. Sleep quality and daytime function in adults with cystic fibrosis and severe lung disease. Eur Respir J. 19(3): 504-10, 2002.
  2. Hanly P, Gabor J, Chan C, Pierratos A. Daytime Sleepiness in Patients with Chronic Renal Failure: Impact of Nocturnal Hemodialysis. Am J Kidney Dis 41(2): 403-10, 2003.
  3. Gabor J, Cooper A, Crombach S, Lee B, Kadikar N, Bettger H, Hanly P. Contribution of the Intensive Care Unit Environment to Sleep Disruption in Mechanically-Ventilated Patients and Healthy Subjects. Am J Respir Crit Care Med; 167(5): 708-715, 2003.
  4. Dancey D, Hanly P, Soong C, Lee B, Shepard J, Hoffstein V. Gender Differences in Sleep Apnea: The Role of Neck Circumference. Chest; 123(5): 1544-50, 2003.
  5. Miletin M, Hanly P. Measurement Properties of the Epworth Sleepiness Scale. Sleep Medicine; 4:195-9, 2003
  6. Beecroft J, Zanon S, Lukic D, Hanly P. Oral CPAP for Sleep Apnea: Effectiveness, Patient Preference and Adherence. Chest; 124:2200-8, 2003
  7. Chan C, Hanly P, Gabor J, Picton P, Pierratos P, Floras J. Impact of nocturnal hemodialysis on the variability of heart rate and oxygen saturation during sleep. Kidney International; 65:661-5, 2004
  8. Mahamed S, Hanly P, Gabor J, Beecroft J, Duffin J. Overnight changes of chemoreflex control in obstructive sleep apnea patients. Respiration Physiology and Neurobiology, 2005; 146: 279-90
  9. Gabor J, Newman D, Dorian P, Hanly P. Improvement of Cheyne-Stokes Respiration Following Cardiac Resynchronization Therapy. Eur Respir J 2005; 26: 95-100
  10. Bradley D, Logan A, Kimoff J, Series F, Morrison D, Ferguson K, Belenke I, Pfeifer M, Fleetham J, Hanly P, Smilovitch M, Tomlinson G, Floras J. Continuous Positive Airway Pressure for Central Sleep Apnea and Heart Failure. N Engl J Med 353:2025-2033, 2005
  11. Beecroft J, Hanly P. Comparison of the OxyMask and Venturi mask in the delivery of supplemental oxygen: a pilot study in oxygen dependant patients. Can Respir J. 13(5):247-52, 2006
  12. Beecroft J, Duffin J, Pierratos A, Chan C, McFarlane P, Hanly P. Chemo-responsiveness in Patients with Sleep Apnea and End-Stage Renal Disease. Eur Respir J. 28(1):151-8, 2006

Most Significant Contributions

  1. The Pathogensis of Hypoxemia in Acute Bacterial Pneumonia was investigated in an animal model (Lung 165:305-322, 1987) with particular emphasis on the role of vasodilator prostaglandins in maintaining perfusion to non-ventilated, consolidated lung (Am Rev Respir Dis 137:700-706, 1987). Hypoxemia was corrected by cyclo-oxygenase blockade, which restored hypoxic pulmonary vasoconstriction, thereby diverting blood flow from non-ventilated to ventilated alveoli (J Appl Physiol 1987, 63:1829-1836). A clinical study in the ICU demonstrated similar findings in patients with acute bacterial pneumonia (Lancet 1987, 1:351-354). This research formed the body of my MD thesis (National University of Ireland, 1989).
  2. Sleep Apnea and Cardiovascular Disease: Central Sleep Apnea: This clinical research evaluated the prevalence, pathogenesis and treatment of Cheyne-Stokes respiration (CSR) in patients with congestive heart failure. The research highlighted the severity of sleep fragmentation associated with CSR (Chest 1989, 96:480-488), the beneficial effect of supplemental oxygen therapy in correcting both sleep apnea and associated sleep fragmentation (Ann Intern Med 1989, 111:777-782), the critical role of arterial PC02 in the pathogenesis of CSR (Chest 1993,104:1079-1084), the impact of sleep fragmentation on the development of excessive daytime sleepiness (Chest 1995, 107:952-958) and the increased mortality associated with CSR (Am J Respir Crit Care Med 1996, 153:272-276). I have also reported the improvement of CSR following cardiac resynchronization therapy for heart failure (Eur Respir J 2005, 26:1-6). I have collaborated on a multi-centre study on the treatment of CSR with CPAP (N Engl J Med 2005;353:2025-2033). Obstructive Sleep Apnea (OSA): I have evaluated the interaction between OSA and cardiac function. I found that OSA can cause silent myocardial ischemia during sleep which is corrected by treatment with nasal CPAP (Am J Cardiol 71:1341-1345, 1993), and that OSA does not increase left ventricular mass independently of other risk factors (Am J Respir Crit Care Med 163(7):1632-6, 2001). As a co-investigator, I have reported altered regulation of cerebral blood flow in patients with OSA (Am J Respir Crit Care Med 2007;175:720-5).
  3. Sleep Disruption in Critically Ill Patients: This clinical research in the ICU has highlighted the high prevalence of sleep disruption in critically ill patients (Chest 2000, 117:809-818) and evaluated the potential causes (Am J Respir Crit Care Med 167(5):708-715, 2003). I have found that the ICU environment (noise and patient-care activities) accounts for less than 30% of the total sleep disruption experienced by these patients. I have written a major textbook chapter on this topic (Sleep in the Ventilated Patient in The Principles and Practice of Mechanical Ventilation, 2nd edition, M. Tobin (ed), McGraw-Hill 2006, 1173-1184).
  4. Sleep Apnea in Chronic Renal Failure: I have reported the high prevalence of sleep apnea in patients on chronic hemodialysis and its improvement following conversion from conventional hemodialysis to nocturnal hemodialysis (N Engl J Med 2001, 344(2): 102-7). Recent work has examined the pathophysiology of this association (Eur Respir J 28:151-8, 2006). I have also reported the high prevalence of excessive daytime sleepiness in this patient population (Am J Kidney Dis 2003 Feb;41(2):403-10) and the potential impact of sleep apnea on heart rate variability (Kidney International 65:661-5, 2004). These unique findings have highlighted the importance of sleep apnea in patients with end stage renal disease and its potential role in increasing cardiovascular morbidity and mortality.