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Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

SLEEP DISORDERS AND SLEEP DEPRIVATION

AN UNMET PUBLIC HEALTH PROBLEM

Committee on Sleep Medicine and Research

Board on Health Sciences Policy

Harvey R. Colten and Bruce M. Altevogt, Editors

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

THE NATIONAL ACADEMIES PRESS

500 Fifth Street, N.W. Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by contracts between the National Academy of Sciences and the American Academy of Sleep Medicine, the Department of Health and Human Services (contract No. N01-OD-4-2139), the National Sleep Foundation, and the Sleep Research Society. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Library of Congress Cataloging-in-Publication Data

Sleep disorders and sleep deprivation : an unmet public health problem / Committee on Sleep Medicine and Research, Board on Health Sciences Policy ; Harvey R. Colten and Bruce M. Altevogt, editors.

p. ; cm.

Includes bibliographical references and index.

Supported by contracts between the National Academy of Sciences and the American Academy of Sleep Medicine, the Department of Health and Human Services, the National Sleep Foundation, and the Sleep Research Society Contract no. N01-OD-4-2139

ISBN 0-309-10111-5 (hardback)

1. Sleep disorders—Social aspects. 2. Sleep deprivation—Social aspects. 3. Sleep—Social aspects. 4. Public health. I. Colten, Harvey R. II. Altevogt, Bruce M. III. Institute of Medicine (U.S.). Committee on Sleep Medicine and Research.

[DNLM: 1. Sleep Disorders—United States. 2. Health Policy—United States. 3. Sleep Deprivation—United States. WM 188 S63178 2006]

RC547.S554 2006

362.196′8498—dc22

2006014107

Additional copies of this report are available from the

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Copyright 2006 by the National Academy of Sciences. All rights reserved.

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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

“Knowing is not enough; we must apply.

Willing is not enough; we must do.”

—Goethe

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine


The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.


The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering.


The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.


The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council.


www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

COMMITTEE ON SLEEP MEDICINE AND RESEARCH

HARVEY R. COLTEN (Chair),

Columbia University, Health Sciences and College of Physicians and Surgeons, New York

FRANCOIS M. ABBOUD,

University of Iowa

GENE D. BLOCK,

University of Virginia

THOMAS F. BOAT,

University of Cincinnati, Ohio

IRIS F. LITT,

Stanford University School of Medicine, California

EMMANUEL MIGNOT,

Stanford University, California

ROBERT H. MILLER,

American Board of Otolaryngology, Texas

F. JAVIER NIETO,

University of Wisconsin School of Medicine and Public Health

ALLAN I. PACK,

University of Pennsylvania Medical Center

KATHY P. PARKER,

Emory University, Georgia

SAMUEL J. POTOLICCHIO,

The George Washington University Medical Center, Washington, DC

SUSAN REDLINE,

Case Western Reserve University School of Medicine, Ohio

CHARLES F. REYNOLDS III,

University of Pittsburgh, Pennsylvania

CLIFFORD B. SAPER,

Harvard Medical School, Massachusetts

Study Staff

BRUCE M. ALTEVOGT, Study Director

SARAH L. HANSON, Research Associate

DAVID CODREA, Financial Associate

AMY HAAS, Administrative Assistant

ELEANORE EDSON, Research Fellow

CATHARYN T. LIVERMAN, Senior Program Officer

ANDREW M. POPE, Board Director

LORA K. TAYLOR, Senior Project Assistant

Consultant

MIRIAM DAVIS,

School of Public Health and Health Services, George Washington University, Washington, DC

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

BOARD ON HEALTH SCIENCES POLICY

FRED H. GAGE (Chair),

The Salk Institute for Biological Studies, La Jolla, California

GAIL H. CASSELL,

Eli Lilly and Company, Indianapolis, Indiana

JAMES F. CHILDRESS,

University of Virginia, Charlottesville

ELLEN WRIGHT CLAYTON,

Vanderbilt University Medical School, Nashville, Tennessee

DAVID R. COX,

Perlegen Sciences, Mountain View, California

LYNN R. GOLDMAN,

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

BERNARD D. GOLDSTEIN,

University of Pittsburgh, Pittsburgh, Pennsylvania

MARTHA N. HILL,

Johns Hopkins University School of Nursing, Baltimore, Maryland

ALAN LESHNER,

American Association for the Advancement of Science, Washington, D.C.

DANIEL MASYS,

Vanderbilt University Medical Center, Nashville, Tennessee

JONATHAN D. MORENO,

University of Virginia, Charlottesville

E. ALBERT REECE,

University of Arkansas, Little Rock

MYRL WEINBERG,

National Health Council, Washington, D.C.

MICHAEL J. WELCH,

Washington University School of Medicine, St. Louis, Missouri

OWEN N. WITTE,

University of California, Los Angeles

MARY WOOLLEY,

Research!America, Alexandria, Virginia

IOM Staff

ANDREW M. POPE, Director

AMY HAAS, Board Assistant

DAVID CODREA, Financial Associate

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

Independent Report Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Ruth Benca, Department of Psychiatry, University of Wisconsin, Madison

Mary A. Carskadon, Sleep Research Laboratory, Brown University

Norman H. Edelman, Health Sciences Center, SUNY Stony Brook University

Stephen L. Hauser, Department of Neurology, University of California, San Francisco

Meir H. Kryger, Sleep Disorders Center, St. Boniface General Hospital Winnipeg, Manitoba, Canada

Lawrence S. Lewin, Executive Consultant, Chevy Chase, Maryland

Thomas Roth, Sleep Center, Henry Ford Hospital, Detroit, Michigan

Joan L. Shaver, College of Nursing, University of Illinois at Chicago

Joseph S. Takahashi, Department of Neurobiology & Physiology, Northwestern University

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
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Terry B. Young, Department of Population Health Sciences, University of Wisconsin

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by David J. Kupfer, University of Pittsburgh School of Medicine, and Floyd E. Bloom, Professor Emeritus Department of Neuropharmacology, The Scripps Research Institute. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

Preface

Sleep has been a subject of intense interest to poets and mystics and is found in folklore since antiquity. Only in the last half a century have scientists and physicians attempted a systematic study of the biology and disorders of sleep. Within the past four decades remarkable advances in the neurophysiology of normal sleep and in circadian biology and the discovery of the genes that regulate these biological rhythms have provided a scientific framework for the elucidation of the etiology, pathogenesis, and potential treatment of sleep disorders. These scientific advances and input from many clinical disciplines such as internal medicine, neurology, nursing, otolaryngology, pediatrics, psychiatry, psychology, and pulmonology have enriched the study and management of sleep pathology. However, the broad intellectual and service requirements for dealing with sleep has created difficulties in coordination and planning of research and clinical services. Recognition of around 90 distinct clinical disorders of sleep has created a platform and need for specialization in the study of sleep (somnology) and sleep pathology. Accordingly, professional societies such as the American Academy of Sleep Medicine, the American Sleep Apnea Association, the National Sleep Foundation, and the Sleep Research Society have been established and the discipline has been recognized by the American Board of Medical Specialties. Moreover, the National Institutes of Health (NIH) formed the National Center on Sleep Disorders Research (NCSDR) to coordinate research in sleep. Although these developments are positive, they do not yet fully address the scope and depth of the public and individual health consequences of sleep deprivation and sleep disorders. For example, more than 50 million Americans suffer a chronic sleep disorder and many others experience dis-

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

ruption of normal daytime activities owing to sleep deprivation. Sadly, the majority of individuals with substantial sleep disorders are not diagnosed and appropriately treated.

In recognition of the limited appreciation of the importance of sleep disorders and sleep deprivation for individuals and the public health, the American Academy of Sleep Medicine, the NCSDR at the NIH, the National Sleep Foundation, and the Sleep Research Society requested that the Institute of Medicine (IOM) do the following:

  1. Review and quantify the public health significance of sleep health, sleep loss, and sleep disorders, including assessments of the contribution of sleep disorders to poor health, reduced quality of life, and early mortality, as well as the economic consequences of sleep loss and sleep disorders.

  2. Identify gaps in the public health system relating to the understanding, management, and treatment of sleep loss and sleep disorders and assess the adequacy of the current resources and infrastructure for addressing the gaps.

  3. Identify barriers to and opportunities for improving and stimulating multi- and interdisciplinary research and education in sleep medicine and biology. Delineate organizational models that will promote and facilitate sleep research in the basic sciences, collaborative research between basic scientists, clinicians, and population scientists in relevant specialties, and education of practitioners and scientists in sleep health, sleep disorders, and sleep research.

  4. Develop a comprehensive plan for enhancing sleep medicine and sleep research for improving the public’s health.

In response, the IOM appointed a 14-member committee with expertise in pulmonology, cardiology, nursing, neurology, pediatrics, adolescent medicine, psychiatry, epidemiology, public health, otolaryngology, academic and medical administration, and health sciences research. The committee met five times during the course of its work and held two workshops. In addition, the committee received input from relevant federal, private, and non-profit organizations.

Our findings confirmed the enormous public health burden of sleep disorders and sleep deprivation and the strikingly limited capacity of the health care enterprise to identify and treat the majority of individuals suffering sleep problems.

The direct effects of sleep disorders as well as the comorbidity with other substantial public health problems such as obesity, diabetes, stroke, and depression have a profound economic and social impact. Only minimal estimates of the economic impact of sleep disorders and their derivative consequences are possible because of underrecognition and underreporting.

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

At a minimum, however, the total direct and indirect cost of sleep disorders and sleep deprivation in the United States is hundreds of billions of dollars. The magnitude of the effect of sleep pathology is shocking even to experts in the field of somnology and sleep medicine. We found that there are too few professionals dedicated to sleep problems to meet the size and importance of the problem and there are too few educational programs that have the potential to increase the workforce of health care practitioners and scientists to meet even current demands. In addition, research that will advance our understanding of sleep pathology and its treatment has been underfunded. We therefore have outlined recommendations to address these shortcomings, in the hope that the burden of sleep disorders and sleep deprivation can be minimized. These recommendations fall into four broad categories: education (public, professional); technology; coordination of research initiatives at the NIH; and organization of research, clinical care, and education in academic health centers.

EDUCATION

The lack of public awareness should prompt a multimedia public education campaign that also targets elementary, middle, and high school students as well as undergraduate college health education programs about the impact of inadequate sleep.

Professional education will be enhanced by integrating the teaching of sleep medicine and biology into medical, nursing, and pharmacology curricula and into residency and specialty fellowships. Strategies to facilitate careers in somnology will be needed to meet the demand for sound science and expert clinical capacity to take care of the health problems related to sleep disorders.

TECHNOLOGY

The cumbersome nature and cost of diagnosis and treatment of sleep disorders and sleep loss will require research to develop and validate the efficacy of advances in diagnostic technologies, including ambulatory monitoring and imaging as well as the development of new therapeutic options for specific sleep disorders.

NATIONAL INSTITUTES OF HEALTH

The NCSDR at the NIH should take a more proactive role in promoting integration of research disciplines pertinent to somnology and sleep disorders, and it should promote training programs that increase the pipeline of highly qualified investigators. Together with other federal agencies, the

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

NCSDR can support increased public awareness and generation of more reliable prevalence data.

ORGANIZATION OF ACADEMIC HEALTH CENTERS

Within academic health centers new and existing sleep programs should be organized as Interdisciplinary Sleep Programs that encompass the relevant basic and clinical disciplines. The complexity of these programs will vary in accord with the capacity and goals of each center; therefore, we have proposed several different models. Networking among the most complex of these programs will facilitate research progress and accelerate implementation of new clinical strategies with help from the NCSDR.

The committee has been fortunate in having superb support from IOM staff and willing consultants in related fields. Without their help this report could not have been completed. We are most grateful.

Harvey R. Colten, M.D., Chair

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Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

Acknowledgments

The committee acknowledges with appreciation the individuals who provided information to the committee. These individuals include Richard Allen, Johns Hopkins University School of Medicine; Sonia Ancoli-Israel, University of California, San Diego School of Medicine; Bonnie Austin, AcademyHealth; Donald Bliwise, Emory University; Martha Brewer, American Heart Association; Debra J. Brody, National Center for Health Statistics; Kathleen C. Buckwalter, University of Iowa Center on Aging; Roger Bulger, Association of Academic Health Centers; Daniel Buysse, University of Pittsburgh School of Medicine; Andrea Califano, Columbia University; Sue Ciezadlo, American College of Chest Physicians; Charles A. Czeisler, Harvard University School of Medicine; William Dement, Stanford University School of Medicine; David Dinges, University of Pennsylvania School of Medicine; Darrel Drobnich, National Sleep Foundation; Paul Eggers, National Institute of Diabetes and Digestive and Kidney Diseases; Lawrence Epstein, Sleep HealthCenters; Gary Ewart, American Thoracic Society; David Lewis, SleepMed, Inc; Magda Galindo, American Diabetes Association; Lee Goldman, University of California, San Francisco Medical School; Allan Gordon, American Thoracic Society; Daniel Gottlieb, Boston University School of Medicine; David Gozal, University of Louisville; Meir Kryger, University of Manitoba; James Kiley, National Heart, Lung, and Blood Institute; David J. Kupfer, University of Pittsburgh School of Medicine; Story Landis, National Institute of Neurological Disorders and Stroke; Kathy Lee, University of California, San Francisco; Eugene J. Lengerich, Pennsylvania Cancer Control Consortium; Carole Marcus, The Children’s Hospital of Pennsylvania; Jennifer Markkanen, American Academy of Sleep

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×

Medicine; Michael Martin, Center for Scientific Review, National Institutes of Health; William McLeod, Institute of Medicine; John McGrath, National Institute of Child Health & Human Development; Merrill Mitler, National Institute of Neurological Disorders and Stroke; Rosanne Money, American Academy of Sleep Medicine; Hal Moses, Vanderbilt-Ingram Cancer Center; Judith Owens, Brown University Medical School; Barbara Phillips, University of Kentucky College of Medicine; Stuart Quan, University of Arizona; Roger Rosa, National Institute for Occupational Safety and Health; Thomas Roth, Henry Ford Health System of Detroit; Michael Sateia, Dartmouth University; Jerome Siegel, University of California, Los Angeles; John Slater, American Academy of Sleep Medicine; Margaret Snyder, National Institutes of Health; Ed Sondik, The National Center for Health Statistics; Ray Vento, American Lung Association; James Walsh, St. Luke’s Hospital; David White, Brigham and Women’s Hospital; Steven Wolinsky, Northwestern University; Terry Young, University of Wisconsin.

This study was sponsored by the American Academy of Sleep Medicine, the National Center on Sleep Disorders Research of the National Institutes of Health, the National Sleep Foundation, and the Sleep Research Society. We appreciate their support and especially thank Jerry Barrett, Richard Gelula, Al Golden, Carl Hunt, and Michael Twery for their efforts on behalf of this study.

We appreciate the work of John Fontanesi, University of California, San Diego for his commissioned paper. We also thank Andrew Pope for his guidance and Judy Estep for her expertise in formatting the report for production. Finally, we especially thank Cathy Liverman for all of her thoughtful guidance throughout the project.

Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
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Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
×
   

  

 

 

   

 Parasomnias,

 

88

   

 Sleep and Neurological Disorders,

 

91

   

 Sudden Infant Death Syndrome,

 

96

   

 Sleep and Movement Disorders,

 

97

   

 Sleep and Medical Disorders,

 

101

   

 Circadian Rhythm Sleep Disorders,

 

107

   

 References,

 

111

4

 

FUNCTIONAL AND ECONOMIC IMPACT OF SLEEP LOSS AND SLEEP-RELATED DISORDERS

 

137

   

 Performance and Cognition Deficits,

 

138

   

 Motor Vehicle Crashes and Other Injuries,

 

147

   

 Impact on Functioning and Quality of Life,

 

151

   

 Economic Impact of Sleep Loss and Sleep Disorders,

 

155

   

 References,

 

163

5

 

IMPROVING AWARENESS, DIAGNOSIS, AND TREATMENT OF SLEEP DISORDERS

 

173

   

 Challenges Facing Individuals with Sleep Disorders,

 

174

   

 Public Education,

 

178

   

 Professional Training and Awareness Is Required,

 

182

   

 Graduate Research Training in Somnology and Sleep Disorders,

 

187

   

 Overview of Medical School Somnology Education,

 

187

   

 Overview of Somnology in Medical Residency Training Curricula,

 

191

   

 Overview of Sleep Medicine Fellowship Training,

 

192

   

 Demonstration of Knowledge: Board Certification,

 

197

   

 Next Steps,

 

201

   

 Data Systems for Surveying Sleep and Sleep Disorders,

 

203

   

 References,

 

212

6

 

ENSURING ADEQUATE DIAGNOSIS AND TREATMENT: ACCESS, CAPACITY, AND TECHNOLOGY DEVELOPMENT

 

217

   

 Developing Portable Diagnostic Tools,

 

218

   

 Challenges to Developing Ambulatory Technologies,

 

222

   

 Future Directions,

 

228

   

 References,

 

229

Page xvii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
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7

 

OPPORTUNITIES TO IMPROVE CAREER DEVELOPMENT IN SOMNOLOGY

 

233

   

 Growth of the Somnology and Sleep Medicine Field,

 

234

   

 NIH Training and Career Development Programs,

 

238

   

 Opportunities to Accelerate Somnology and Sleep Medicine Career Development,

 

247

   

 References,

 

251

8

 

BOLSTERING SOMNOLOGY AND SLEEP DISORDERS RESEARCH PROGRAMS

 

253

   

 NIH Coordination of Sleep-Related Activities,

 

254

   

 National Sleep Disorders Research Plan,

 

259

   

 Analysis of NIH-Sponsored Research Project Grants,

 

267

   

 Next Steps in Accelerating Progress,

 

276

   

 References,

 

286

9

 

BUILDING SLEEP PROGRAMS IN ACADEMIC HEALTH CENTERS

 

293

   

 Rationale for Sleep Programs in Academic Health Centers,

 

294

   

 Constraints Facing Interdisciplinary Sleep Programs,

 

300

   

 Key Components and Guiding Principles for Building Sleep Programs,

 

303

   

 Organizational and Fiscal Structures for Sustaining or Expanding a Sleep Program,

 

306

   

 Accreditation and Certification Are Essential to Quality Care,

 

312

   

 Next Steps,

 

315

   

 References,

 

321

 

 

APPENDIXES

 

 

A

 

Study Process

 

325

B

 

Acronyms

 

332

C

 

Glossary of Major Terms

 

335

D

 

Congressional Language Establishing the National Center on Sleep Disorders Research, § 285b–7

 

345

E

 

Sleep Disorders Research Advisory Board Membership

 

348

F

 

National Institutes of Health Sleep-Related Initiatives: 1994–2004

 

351

G

 

National Institutes of Health Support of Sleep-Related R01 Grants

 

356

H

 

Summary of NIH Support of Sleep-Related Career Development Awards

 

360

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Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
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SLEEP DISORDERS AND SLEEP DEPRIVATION

AN UNMET PUBLIC HEALTH PROBLEM

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Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
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Suggested Citation:"Front Matter." Institute of Medicine. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press. doi: 10.17226/11617.
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Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem Get This Book
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Clinical practice related to sleep problems and sleep disorders has been expanding rapidly in the last few years, but scientific research is not keeping pace. Sleep apnea, insomnia, and restless legs syndrome are three examples of very common disorders for which we have little biological information. This new book cuts across a variety of medical disciplines such as neurology, pulmonology, pediatrics, internal medicine, psychiatry, psychology, otolaryngology, and nursing, as well as other medical practices with an interest in the management of sleep pathology. This area of research is not limited to very young and old patients—sleep disorders reach across all ages and ethnicities. Sleep Disorders and Sleep Deprivation presents a structured analysis that explores the following:

  • Improving awareness among the general public and health care professionals.
  • Increasing investment in interdisciplinary somnology and sleep medicine research training and mentoring activities.
  • Validating and developing new and existing technologies for diagnosis and treatment. This book will be of interest to those looking to learn more about the enormous public health burden of sleep disorders and sleep deprivation and the strikingly limited capacity of the health care enterprise to identify and treat the majority of individuals suffering from sleep problems.
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