Editorial: Sleep Medicine-In the Wake of a New Medical Subspecialty
Lavie, Peretz, The Israel Journal of Psychiatry and Related Sciences
The present issue of The Israel Journal of Psychiatry and Related Sciences includes 5 articles all related to different aspects of sleep disorders and their treatment. Given the fact that the scientific study of sleep started in the middle of the 20th century with the seminal discovery of Rapid Eye Movement (REM) sleep by Aserinsky and Kleitman in 1953 (1), the progress and development in sleep medicine is enormous. Suffice to mention that there are 5 international journals dedicated solely to sleep and its disorders, in addition to several locally based journals, and that there is not a single issue of the first line journals (e.g., Chest and American Journal of Respiratory and Critical Care Medicine) without 2 or 3 papers related to sleep. Likewise, the number of participants in the Annual Meeting of the American Academy of Sleep Medicine and the American Sleep Research Society has grown steadily over the years, reaching over 4,000 in the 2001 meeting. Israel does not fall far behind! Over 200 participants took part in the 2001 meeting of the Israeli Society of Sleep Research that took place in Haifa. Since the first diagnostic recording was carried out in 1975, in the former 2-bed laboratory located on the Technion campus, more than 50,000 patients have been diagnosed in the Technion Sleep Disorders Center's laboratories in Haifa, Jerusalem, Tel Aviv, Holon and Hadera. Several thousands more have been examined in Tel Hashomer, Bet Loewenstein and Soroka Hospitals' sleep laboratories.
There is no doubt that the force behind the impressive development in sleep medicine was the growing awareness of breathing disorders in sleep and their significant impact on patients' health and life quality. It is estimated now that sleep apnea syndrome affects as much as 4% of middle-aged men and 2% of the women (2). Thus, it is more prevalent than asthma or Parkinson disease. There is a vast literature on this syndrome and its clinical significance, mostly published in the last decade. For this reason, we decided to focus in this special issue on sleep disturbances other than sleep apnea syndrome. We particularly selected sleep disturbances in which the objective documentation of sleep usually sheds a new light on patients' subjective complaints. Thus, Klein et al. convincingly demonstrate that in spite of the fact that post-traumatic stress disorder patients (PTSD) complain about their sleep, objective sleep laboratory recordings fail to demonstrate any major alterations in their sleep pattern. This finding, which has been reported also for war-related PTSD patients, has major clinical significance with respect to the treatment of such patients, a subject addressed just recently in a special paper in the New England Journal of Medicine (3). …