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Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem
ing programs have a responsibility to have in place, or alternatively, to identify faculty-level expertise in somnology and sleep medicine, and ensure availability of these individuals for learners in the residency training program. As a result of the multidisciplinary nature of sleep medicine, interdepartmental sharing of expertise for training should be required in many settings. Clinical experience with diagnosis and management of patients with sleep disorders is preferred to didactic experiences. For this reason, the presence of an institutional sleep disorders clinic, laboratory, or center should be a key component of the educational infrastructure. Exposure of residents to the multidisciplinary nature of sleep evaluation and treatment will best prepare them for roles as primary caregivers, particularly for identification, treatment of simple sleep problems, and triage of more complicated patients to appropriate subspecialists.
Residents should become aware of the general health consequences of sleep disorders, such as the relationship between sleep deprivation and obesity, cardiovascular disease, and behavioral disorders. In addition, subspecialists in internal medicine and pediatric prevention, diagnosis, and treatment should be fully familiar with the sleep-related consequences of chronic disease and incorporate this awareness into their practices and subspecialty fellow training. Providing generalists with sleep-related education would enable them to be competent to care for a substantial number of sleep problems and refer individuals to sleep specialists as needed.
In view of the workforce shortage in the field (see Chapter 7) and the small number of both training programs and individuals enrolled in somnology and or sleep medicine training programs (see below), exposure of residents to this area of medicine will enhance awareness of career opportunities in this discipline and improve clinical care. Thus, the goal of embedding somnology and sleep medicine exposure and experiences in core residency training is to prepare a wide range of individuals to participate as frontline caregivers, and also to ensure that somnology and sleep medicine is visible to learners early in their training process and possibly foster their consideration of somnology or sleep medicine as a career focus. Exposure of residents to discovery and translational research related to sleep medicine might also enhance the attractiveness of the field. Therefore, somnology and sleep medicine investigators should participate, wherever possible, in the residency training process.
OVERVIEW OF SLEEP MEDICINE FELLOWSHIP TRAINING
AASM-Accredited Fellowship Training Programs
Until recently fellowship training programs in sleep medicine were rare, with a small number of academic institutions, hospitals, and other facilities