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News from the National Academies
Date: April 4, 2006
Contacts: Christine Stencel, Media Relations Officer
Megan Petty, Media Relations Assistant
Office of News and Public Information
202-334-2138; e-mail <news@nas.edu>

FOR IMMEDIATE RELEASE

U.S. Lacks Adequate Capacity to Treat People With Sleep Disorders;
Efforts Needed to Boost Sleep Research, Treatment, and Public Awareness

WASHINGTON -- Currently too few scientists study sleep disorders and too few health care professionals are trained to diagnose and treat sleep problems to meet the needs created by this underappreciated health problem, says a new report from the Institute of Medicine of the National Academies. Between 50 million and 70 million Americans struggle with chronic sleep disorders, which cost the nation hundreds of billions of dollars every year in medical expenses, lost productivity, accidents, and other costs.

The report recommends boosting the training of all health care providers in sleep medicine to improve diagnosis and care for people experiencing sleep problems. It urges increased research into the causes of sleep disorders and sleep loss as well as new, more effective ways to diagnose and treat these conditions. The report also calls for a national public awareness campaign to increase Americans' understanding of the importance of sleep and the consequences of sleep deprivation.

"Although sleep research and care for individuals with sleep disorders have expanded over the past several years, we currently don't have the capacity to adequately diagnose and treat all who suffer from these problems," said Harvey Colten, chair of the committee that wrote the report and former vice president and senior associate dean for academic affairs, Columbia University Medical Center, New York City. "There is much we don't yet understand about the causes and processes that underlie sleep disorders, which is why we need a boost in research. And what we do know about the importance of sleep and how to treat sleep loss needs to be better applied."

Sleep disorders include conditions such as chronic insomnia, sleep apnea, and restless legs syndrome. Millions more Americans suffer from occasional or frequent fatigue, which can be brought on by involuntary factors, such as anxiety and illness, or voluntary choices such as staying up late and forgoing exercise. Sleep loss has increased in the United States over the past several decades due in part to longer workdays and more time spent using computers and watching television, among other factors, the committee found. Studies have shown that sleep deprivation increases the risk of a range of health problems, including diabetes, cardiovascular disease, and heart attacks, and raises the chances of injury or death due to accidents.

Estimates generated in the 1990s put the cost of medical care for sleep disorders at $15.9 billion, which is probably a conservative figure, the committee said. Fatigue is estimated to cost businesses roughly $150 billion a year in lost productivity and mishaps, and motor vehicle accidents involving tired drivers amount to at least $48 billion a year.

The number of health care practitioners and scientists trained for and committed to careers in sleep research and medicine is inadequate given the number of Americans who experience these disorders, the committee found. Only 54 individuals entered the biomedical research arena with doctoral degrees focused on somnology or sleep medicine in 2004. In contrast, 158 people earned degrees focused on pain research and 630 on cancer research that year. Medical students generally receive only four hours of instruction in sleep medicine, and the majority never perform a clinical evaluation of a patient with a sleep disorder during their training.

To develop a larger, more interdisciplinary work force with skills in and knowledge of sleep medicine, instruction in sleep loss and sleep disorders should be part of undergraduate and postgraduate training for those pursuing health care careers, particularly those specializing in psychiatry, pulmonology, neurology, nursing, psychology, and other specialties involved in the diagnosis and treatment of sleep disorders, the report recommends. The National Institutes of Health should invest in mentoring and support programs to attract more researchers to the field of somnology and sleep medicine. And accredited interdisciplinary sleep programs should be created to close the gap between research and clinical care that exists in most academic institutions.

Too few Americans understand and appreciate the harms linked to lack of sufficient sleep, the committee said. Millions do not recognize fatigue or more serious problems, or they just accept them. Evidence indicates that the majority of people who have a sleep disorder go undiagnosed and untreated. For example, at least 75 percent of those who suffer from sleep apnea – severe obstruction of breathing during sleep -- remain undiagnosed.

The National Center on Sleep Disorders Research should partner with the Centers for Disease Control and Prevention and other appropriate organizations to launch a national public education campaign to promote better sleep habits and improved health, the committee said. Similar efforts demonstrate how effective such campaigns can be. For example, the rate of Sudden Infant Death Syndrome has dropped 50 percent since the launch of the Back to Sleep initiative, which encourages parents to put infants to sleep on their backs to reduce the risk of SIDS.

The report was sponsored by the American Academy of Sleep Medicine, the National Institutes of Health, the National Sleep Foundation, and the Sleep Research Society. The Institute of Medicine is a private, nonprofit institution that provides health policy advice under a congressional charter granted to the National Academy of Sciences. A committee roster follows.


Pre-publication copies of Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).


[ This news release and report are available at http://national-academies.org ]

INSTITUTE OF MEDICINE
Board on Health Sciences Policy

Committee on Sleep Medicine and Research

Harvey R. Colten, M.D. (chair)
Former Vice President and Senior Associate Dean for Academic Affairs
Columbia University Medical Center
New York City

Francois M. Abboud, M.D.
Edith King Pearson Chair in Cardiovascular Research;
Professor of Medicine, Physiology, and Biophysics;
Director, Cardiovascular Research Center; and
Associate Vice President for Research
University of Iowa
Iowa City

Gene D. Block, Ph.D.
Vice President and Provost, and
Thomas Jefferson Professor of Biology
University of Virginia
Charlottesville

Thomas F. Boat, M.D.
Director
Children's Hospital Research Foundation, and
Professor and Chair
Department of Pediatrics
University of Cincinnati
Cincinnati

Iris F. Litt, M.D.
Marron and Mary Elizabeth Kendrick Professor of Pediatrics, and
National Director
Robert Wood Johnson Clinical Scholars Program
Stanford University School of Medicine
Stanford, Calif.

Emmanuel Mignot, M.D., Ph.D.
Investigator
Howard Hughes Medical Institute;
Professor of Psychiatry and Behavioral Sciences; and
Director, Center for Narcolepsy
Stanford University
Stanford, Calif.

Robert H. Miller, M.D., M.B.A.
Executive Director
American Board of Otolaryngology
Houston

F. Javier Nieto, M.D., Ph.D.
Professor and Chair
Department of Population Health Sciences
University of Wisconsin School of Medicine and Public Health
Madison

Allan I. Pack, M.D., Ph.D.
Professor of Medicine;
Director, Center for Sleep and Respiratory Neurobiology; and
Chief, Division of Sleep Medicine
University of Pennsylvania
Philadelphia

Kathy P. Parker, Ph.D., R.N., A.P.R.N., F.A.A.N.
Edith F. Honeycutt Professor
Neil Hodgson Woodruff School of Nursing, and
Professor of Neurology
Emory University
Atlanta

Samuel J. Potolicchio, M.D.
Professor of Neurology
George Washington University Medical Center
Washington, D.C.

Susan Redline, M.D., M.P.H.
Professor of Pediatrics, Medicine, Epidemiology, and Biostatistics
Case Western Reserve School of Medicine, and
Chief, Division of Clinical Epidemiology
Department of Pediatrics
Rainbow Babies & Children's Hospital
Cleveland

Charles F. Reynolds III, M.D.
Professor of Psychiatry, Neurology, and Neurosciences, and Senior Associate Dean
University of Pittsburgh School of Medicine; and
Director, Mental Health Intervention Research Center for the Study of Late-Life Mood Disorders
Western Psychiatric Institute and Clinic
Pittsburgh

Clifford B. Saper, M.D., Ph.D.
James Jackson Putnam Professor of Neurology and Neuroscience
Harvard Medical School, and
Chair
Department of Neurology
Beth Israel Deaconess Medical Center
Boston

INSTITUTE STAFF

Bruce M. Altevogt, Ph.D.
Study Director