Sleep Disorders and Sleep Deprivation An Unmet Public Health Problem (2006) / Chapter Skim
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From page 1... ...
, academic health centers, private foundations, and professional societies are essential to ensure appropriate public and professional awareness, education and training, basic and clinical research, and patient care. Finally, the fragmentation of research and clinical care currently present in most academic institutions requires the creation of accredited interdisciplinary sleep programs in academic institutions.
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However, recognizing that continued scientific and clinical advances will require a new coordinated strategy to improve public awareness and strengthen the field of Somnology and Sleep Medicine, the American Academy of Sleep Medicine, the NCSDR at the NIH, the National Sleep Foundation, and the Sleep Research Society requested that the IOM conduct a study that would examine: (1) the public health significance of sleep, sleep loss, and sleep disorders, (2)
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· Increase the investment in interdisciplinary sleep programs in academic health centers that emphasize long-term clinical care, training, and research. THE NATIONAL INSTITUTES OF HEALTH LEADERSHIP IN RESEARCH AND TRAINING To a greater extent than most scientific and medical disciplines, the field of somnology and sleep medicine cuts across many clinical and basic research disciplines, including but not limited to cardiology, dentistry, endocrinology, epidemiology, geriatrics, molecular biology, neurology,
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should have adequate staff and resources to ensure its ability to fulfill its mission of coordinating and stimulating training, research, and health information dissemination relevant to somnology and sleep disorders. All relevant institutes with significant sleep portfo lios should become members of the Trans-NIH Sleep Research Coordinating Committee.
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Further, of the top academic institutions that received the greatest number of grants from the NIH, less then half had career development or training grants in somnology or sleep medicine. Only 54 doctorates were awarded with a focus on somnology or sleep medicine in 2004.
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of medical students, graduate students, postdoctoral fellows, clini cal fellows, and junior faculty. To implement this recommendation the following should be considered: · The Trans-NIH Sleep Research Coordinating Committee should establish a somnology and sleep medicine career development program.
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The National Center on Sleep Disorders Research -- working with the Centers for Disease Control and Prevention, the proposed Na tional Somnology and Sleep Medicine Research Network, private organizations and foundations, entertainment and news media, and private industry -- should develop, implement, and evaluate a long term national multimedia and public awareness campaign directed to targeted segments of the population (e.g., children, their parents, and teachers in preschool and elementary school; adolescents; col lege students and young adults; middle-aged adults; and elderly people) and specific high-risk populations (e.g., minorities)
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Recommendation 5.2: Academic health centers should integrate the teaching of somnology and sleep medicine into baccalaureate and doctoral health sciences programs, as well as residency and fellow ship training and continuing professional development programs. The subjects of sleep loss and sleep disorders should be included in the curricula of relevant baccalaureate and graduate educational
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The curriculum should expose students in the fields of medicine and allied health fields to the etiology, pathophysiology, diagnosis, treatment, prevention, and public health burden of sleep loss and sleep disorders. Relevant accrediting bodies and licensing boards ought to define sleep-related curriculum requirements and expectations for knowledge and competency (e.g., Liaison Com mittee on Medical Education, Accreditation Council for Graduate Medical Education, American Board of Medical Specialties, the National League for Nursing, the Commission on Collegiate Nurs ing Education, and the Council on Education for Public Health)
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However, because appropriateness of sleep patterns is one of the basic tenets of health, the committee strongly urges the NIH intramural clinical research program to ascertain the need for establishing a sleep study laboratory so that evaluation of sleep may be integrated into ongoing relevant clinical research protocols at NIH. Recommendation 8.3: The National Institutes of Health should ascertain the need for a transdisciplinary sleep laboratory that would serve as a core resource in its intramural clinical research program.
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INTERDISCIPLINARY SLEEP PROGRAMS IN ACADEMIC HEALTH CENTERS Accelerating Scientific Advances A coordinated and integrated strategy requires bolstering clinical and basic research efforts, catalyzing collaborative research efforts, and attracting the breadth of talented researchers who can provide leadership to advance research and clinical care in sleep loss and sleep disorders. Key to accelerating progress in the treatment of chronic sleep loss and sleep disorders is the development of a coordinated, focused, and centralized network that connects individual investigators, research programs, and research centers; facilitates collaborative projects; encompasses relevant research from diverse fields; and builds on the unique strengths of each research effort to move toward effective therapy, prevention, and treatment.
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The National Center on Sleep Disorders Research in collaboration with the Trans-NIH Sleep Research Coordination Committee should establish a National Somnology and Sleep Medicine Re search Network. Type III regional interdisciplinary sleep programs designated by the National Institutes of Health would act as re gional centers working with basic research laboratories and sleep cores at NIH-designated clinical translational research centers.
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Criteria for Interdisciplinary Sleep Programs in Academic Health Centers Somnology and sleep medicine is an emerging interdisciplinary field that is being forged from several disciplines and clinical specialties. However, the limited investment and organization of sleep programs in academic health centers do not favor interdisciplinary research efforts and continued advances in clinical care.
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Research-intensive medical centers should aspire to become Type III regional interdisciplinary sleep pro grams and coordinators of the National Somnology and Sleep Medi cine Research Network. The American Academy of Sleep Medicine should develop accreditation criteria for sleep programs specific to academic health centers.
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The network would benefit greatly from cultural, ethnic, and environmental diversity. Therefore, a long-range goal should be to have 8 to 10 geographically distributed Type III regional interdisciplinary sleep programs.
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centers) Training Program Training program for health care x x x professionals and/or researchers Medical school training and education x x x Education for residents in primary care x x x Residents in neurology, psychiatry, x x otolaryngology, and fellows in pulmonary medicine rotate through sleep program Accredited fellowship program for physicians x x Research training for clinical fellows x x NIH-sponsored training grants for graduate x x and postgraduate researchers Research Program Research areas of emphasis:c Neuroscience x x Epidemiology/public health x x Pharmacology x Basic or clinical research program x Basic and clinical research program x Member of proposed national somnology xd x x and sleep medicine research and clinical network Regional coordinator for: Core facilities for basic research x Multisite clinical trials x Core facilities for clinical research x Mentoring of sleep fellows x Public education x Data coordinating site x aThis list is not meant to be exclusive or exhaustive and should be modified as relevant specialties and training programs emerge.
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Academic health centers should integrate the teaching of som nology and sleep medicine into baccalaureate and doctoral health sciences programs, as well as residency and fellowship training and continuing professional development programs. (Recommendation 5.2)
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Type I clinical interdisciplinary sleep program Type II clinical, research, and training interdisciplinary sleep program Type III regional comprehensive sleep program It is recommended that the National Institutes of Health establish a national somnology and sleep medicine research network. (Recommendation 8.2)
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