IOM: It's Time to Wake Up to Sleep Disorders
Brunk, Doug, Clinical Psychiatry News
It's time for physicians and the public alike to wake up to the staggering impact of sleep disorders, a new report from the Institute of Medicine charges.
An estimated 50-70 million Americans suffer from chronic sleep disorders such as insomnia, sleep apnea, and restless legs syndrome, yet the vast majority "go unrecognized because nobody's asking patients about them," Dr. Harvey R. Colten, who chaired the committee that assembled the report, said in an interview. "Even when they do [ask], they're not following up on the problem and dealing with it either directly or by referral. That's a major issue for the practitioner as well as for the medical educator."
Titled "Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem," the wide-ranging report noted that fatigue alone costs an estimated $150 billion a year in lost productivity and mishaps, and another $48 billion in medical costs related to motor vehicle accidents that involve drowsy drivers.
Data from the 1990s suggest that sleep disorders themselves cost an estimated $15.8 billion in medical costs, a figure the committee believes is conservative.
"What we found was that sleep disorders are extremely common," said Dr. Allan I. Pack, one of the report's committee members. "They obviously have an impact not only on sleep and behavior, but in cardiovascular disease and metabolic effects," said Dr. Pack, who directs the University of Pennsylvania's Center for Sleep and Respiratory Neurobiology.
The report was commissioned by the American Academy of Sleep Medicine (AASM), the National Center on Sleep Disorders Research of the National Institutes of Health, the National Sleep Foundation, and the Sleep Research Society.
The document comes "at a time when they perceived ... that the field has developed rather dramatically in the last decade-and-a-half, with lots of new scientific findings, but with some evidence that neither the public nor even the relevant professional people are appreciating the full magnitude of the problem of sleep disorders," noted Dr. Colten, a pediatrician and former vice president and senior associate dean for academic affairs at Columbia University Medical Center, New York. "It happens to come at a time when research funding is tight, but we emphasize the importance of developing a sufficient workforce, too--both clinical and research workforces--to deal with this underappreciated problem."
Chock full of statistics and strategies to advance the sleep medicine field, the report is "an important next step in the evolution of sleep medicine from its beginnings to its teenage years, and into its adulthood," said Dr. Charles W. Atwood Jr., of the division of pulmonary, allergy, and critical care medicine at the University of Pittsburgh.
Sleep medicine "has been growing steadily as a clinical activity, but what has not kept up with it is the realization that it's becoming a full-fledged academic activity," he observed. …