Professor Walter McNicholas

The Irish Thoracic Society Award for Outstanding Contribution to Respiratory Medicine recognises members of the ITS who have greatly contributed to Respiratory Medicine and healthcare in Ireland and/or the development of the ITS. It is the highest award the Society can bestow to a person, and the 8 previous recipients of this award are all true giants of Irish Respiratory Medicine (3 of whom are graduates of University College Galway): the 8 prior recipients are Muiris FitzGerald, Cathal Bredin, Pat Finnegan, Luke Clancy, JJ Gilmartin, Shane O’Neill, Tim McDonnell and Lorcan McGarvey – all of whom I know personally and greatly respect, all of whom have inspired not only me, but also many people in this room throughout their respiratory careers, and all have been very worthy recipients of this award, and all have hugely contributed to the development of respiratory medicine in this country.

I am truly honoured to be asked to do the citation for tonight’s recipient, who I consider a good friend and colleague for over 30 years. I was his Registrar 30 years ago, and if that makes me old, well I guess it makes him even older! He is a true giant of Irish respiratory medicine, who genuinely deserves to join this ITS elite group for outstanding contribution to Respiratory Medicine on the island of Ireland, and he is one of only a handful of Irish Respiratory Physicians who has a true international profile and recognition. Without his leadership and guidance, sleep medicine would not exist as a recognised and impactful subspecialty of respiratory medicine in Ireland, as it is today.

Without his leadership and guidance, sleep medicine would not exist as a recognised and impactful subspecialty of respiratory medicine in Ireland.

Walter McNicholas is a medical graduate of University College Dublin in 1974, and undertook his postgraduate training in Respiratory and Sleep Medicine at the University of Toronto, where he also undertook a research fellowship in Respiratory Sleep Disorders. He received a postgraduate research doctoral degree by thesis from UCD in 1982 on the pathophysiology of obstructive sleep apnoea.

Walter was appointed as Consultant Respiratory Physician to St Vincent’s University Hospital Dublin in 1985, where he established Ireland’s first Sleep Laboratory, which he developed to the best international standards. Walter established a multidisciplinary research group based in St Vincent’s and the Conway Institute in UCD, which collaborated with other groups within UCD and throughout Europe. Walter is an international authority in translational research on the mechanisms and consequences of sleep-related breathing disorders, particularly sleep apnoea. His research interests range from human clinical to basic cell and molecular biology, and include the pathophysiology, treatment and outcomes of obstructive sleep apnoea syndrome, the cardiovascular and metabolic consequences of the disorder, basic cell and molecular mechanisms and consequences of intermittent hypoxia, in addition to sleep disturbances in COPD and other chronic respiratory disorders.

For this body of work, Walter was awarded a Newman Clinical Research Professorship from the School of Medicine UCD in 2001. He has published over 300 papers to date in international peer-reviewed journals, with a very impressive h-index of 86 in 2024. Walter is an Associate Editor of the ERJ Open Research Journal, is the current Joint Chief Editor of the ESRS Sleep Medicine Textbook, now in preparation for its Third Edition, and is a past Associate Editor of the European Respiratory Journal. Walter has supervised and inspired many PhD and other doctoral research students over a 40-year career in his research laboratory at UCD and St Vincent’s, many of whom are here tonight to celebrate with him.

Walter was President of the Irish Thoracic Society from 1994 to 1996. During his time as President, Walter recalls cross-border Annual Scientific Meetings in Dublin and Belfast, with abstracts of research presentations published in the Irish Journal of Medical Science for the first time in the Society’s history. During Walter’s Presidency of the ITS there were also discussions within the Executive Committee regarding the establishment of a permanent secretariat; however, progress was curtailed due to lack of funding. It would be a further 10 years from that time before we got our first CEO, Suzanne McCormack, who was with us for 17 years, who was an excellent CEO, and we have been very fortunate in the last 2 years to have Orla Veale as our new CEO, and Orla is also an excellent CEO. During Walter’s Presidency of the Irish Thoracic Society it was also agreed that Respiratory Nurse Specialists and Respiratory Function Technicians could become Associate Members for the first time, and I know there are many Nurse Specialists and Physiologists in Ireland today who are most grateful to Walter for encouraging and promoting their careers. Indeed, Geraldine Nolan has been the Chief Respiratory Physiologist at St Vincent’s Hospital throughout most of Walter’s working career.

Walter was the first Irish President of the European Respiratory Society from 2003 to 2004, and it must give Walter great pride to see another of his trainees, Silke Ryan, subsequently receive the honour of becoming only the second Irish person to be ERS President; Silke is the immediate Past-President of the ERS.

In 2005, Walter was the founding Member of the Irish Sleep Society, and served as its first President until 2012, where his overarching aim was to improve the standards of care of patients with sleep disorders in Ireland by promoting awareness of sleep disorders and patients’ needs amongst the public and relevant health authorities, and supporting education and research into sleep disorders. During this time Walter was also President of the European Board of Accreditation in Pneumonology from 2010 to 2014. Walter was awarded Fellowship of the European Respiratory Society in 2016, a truly prestigious honour given by the Society to recognise outstanding achievements in research and leadership.

The Irish Sleep Society is a Member of the Association of National Sleep Societies, a formal body of the European Sleep Research Society, and Walter was President of the European Sleep Research Society from 2016 to 2020. When I was President of the Irish Sleep Society I had the great pleasure of travelling with Walter, as President of the European Sleep Research Society, to the Association of National Sleep Societies in Parma, Italy in 2018, and in St Petersburg, Russia in 2019, and I had dinner in both places with Walter and Nuala.

Walter chaired an EU-sponsored COST action on Obstructive Sleep Apnoea from 2005 to 2010, which led to the establishment of the European Sleep Apnoea Database Cohort Study (the ESADA Network), now the largest cohort study of its kind in the world with over 40,000 patients in its registry, with the objective of studying the clinical manifestations, management and co-morbidities of obstructive sleep apnoea.

Moreover, the ESADA Network is a strong partner, with 24 participating centres, in the EU-funded project SLEEP REVOLUTION, of which Walter is an Executive Committee Member. Sleep Revolution is a €15 million EU Horizon 2020 funded research consortium, with the principal objective of developing novel approaches based on machine learning through a set of wearables and a digital management platform. The project aims to bring together researchers, patients and healthcare professionals to provide a state-of-the-art method of accurate OSA diagnosis and optimal treatment.

Importantly, from a public health perspective, Walter also chaired a working group established by the Transport and Mobility Directorate of the European Commission on Sleep Apnoea and Driving between 2012 and 2013, which led to an official European Union Directive on this topic, issued in June 2014, that is now mandatory throughout all EU Member States.

During Walter’s career he has seen huge changes in the practice of Sleep Medicine. We have an estimated 1 billion people on the planet with sleep-disordered breathing, many of whom are undiagnosed. To try to meet this demand for diagnosis, we have gone from gold-standard overnight hospital diagnosis, to home sleep studies, to, pretty soon, wearable smartwatches giving an accurate diagnosis of sleep apnoea. We will have patients turning up to our clinics soon saying, look at my watch data showing I have sleep apnoea, what treatments do you recommend for me? Treatment options have also evolved during Walter’s career, from just CPAP therapy to other choices such as mandibular advancement therapy, neurostimulation, and combined GLP-1/GIP agonist weight-loss therapy.

In recognition of his lifetime’s work, Walter was awarded, in 2022, a European Respiratory Society Lifetime Achievement Award in recognition of a lifetime of excellence in the field of sleep-disordered breathing. Well, tonight Walter, we would like to recognise you with the Irish Thoracic Society Award for an Outstanding Lifetime Contribution to Respiratory Medicine.