nosis and management of sleep problems are nurses—the largest number of health care providers in the United States. Nurses are in a unique position to contribute to new knowledge about sleep and health promotion, provide primary care, as well as monitor sleep habits and disseminate information to patients, and enhance patient compliance with treatment (Lee et al., 2004). Unfortunately, nursing education faces many of the same challenges as other health care provider educational programs regarding the incorporation of sufficient sleep content in its programs. Recently, curriculum recommendations for somnology and chronobiology education for nursing at the undergraduate and graduate level programs have been developed (Lee et al., 2004). These guidelines have been integrated into a limited number of nursing programs; however, greater integration of sleep-related material is required in nursing education programs.


To ensure a high degree of recognition and the most effective clinical care, it is important that more training programs educate residents about the need for early detection and, whenever possible, the prevention of chronic sleep loss and sleep disorders. Primary care providers are largely responsible for this surveillance in the medical system. Therefore, it is imperative that internists, family medicine doctors, and pediatricians are sufficiently trained to assume the surveillance role. As many individuals are referred to pulmonologists, neurologists, psychiatrists, and otolaryngologists for disorders that are related to sleep problems, extensive training in sleep medicine also should be integrated into those program curricula.

The current ACGME program requirements for residency training in internal medicine, family medicine, pediatrics, and psychiatry do not mention chronic sleep loss or sleep disorders. Program requirements for residency in neurology list sleep disorders as one of 22 subjects to be addressed in seminars and conferences. However, except for residency programs in otolaryngology, none of the other four residency program requirements address clinical experiences in sleep medicine (ACGME, 2005a).

Curricula should be designed to ensure that knowledge and skills required to detect the broad range of sleep disorders and to manage those that are not complex should be a component of general competency in each of the five relevant specialty areas of medicine. General competency in somnology and sleep medicine should be certified and recertified by the respective boards of the American Board of Medical Specialties (ABMS). With guidance from the residency review committee of the ACGME, each training program in these five specialty areas must develop curriculum content for somnology and sleep medicine. Departments sponsoring these train-

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