Sleep Disorders and Sleep Deprivation: An Unmet Public

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Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem http://www.nap.edu/catalog/11617.html 5 Improving Awareness, Diagnosis, and Treatment of Sleep Disorders CHAPTER SUMMARY The public health burden of chronic sleep loss and sleep disorders coupled with the low awareness among the general population, health care professionals, and policy makers requires a well-coordinated strategy to improve sleep-related health care. Increasing the awareness and improving the diagnosis and treatment of sleep disorders necessitates a multipronged effort that includes three key components: public education, training for health professionals, and surveillance and monitoring. First, a public health campaign is required to increase awareness among the general population. Second, specific education and training strategies are needed to increase awareness among health care professionals, including improved curriculum content and certification requirements. There are a number of surveillance and monitoring tools, but very few examine issues pertaining to sleep loss and sleep disorders. Thus, third, improved surveillance and monitoring of the general population is needed. The preeminent goal of this strategy is to create and sustain a broad societal commitment to engaging in proper sleep habits as a primary tenet of health. Such a commitment will involve participation by those individuals and organizations in a position to educate the public at national, state, local, and community levels—including K–12 education, colleges and universities, medical schools and other health profession education programs, hospitals, community clinics, local health departments, private industry (e.g., transportation, manufacturing facilities, nursing homes), and entertainment media. It will also require simultaneous investment in public education cam- 173 Copyright © National Academy of Sciences. All rights reserved.
Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem http://www.nap.edu/catalog/11617.html 174 SLEEP DISORDERS AND SLEEP DEPRIVATION paigns for all age groups as well as a sustained effort to integrate sleep-related content into curricula of undergraduate health science programs all the way through continuing education programs for health professionals. CHALLENGES FACING INDIVIDUALS WITH SLEEP DISORDERS Sleep is often viewed by the general public as a “perceptual hole in time”—during which nothing productive occurs (Dement and Vaughn, 1999). One only has to examine common colloquialisms such as “don’t get caught napping,” “if you snooze you loose,” or “time is money” to gain a sense of the prevailing attitude that sleep is either optional, a luxury, or unimportant. In fact, being able to “get by on 4 hours of sleep” (and thus being able to increase productivity) is often considered an enviable trait. Daily sleeping and waking patterns are no longer driven by the light and dark cycle but, rather, by work schedules, economic interests, and increasing globalization. Unfortunately, the resulting “24/7” schedules are typically not optimal in terms of filling physiological requirements for sleep. Thus, daytime sleepiness and its consequences are becoming increasingly common problems affecting up to 15 percent of the population (Punjabi et al., 2003). For some, sleep disruption and constant sleepiness are often deemed an inevitable part of their social roles as spouses, workers, caregivers, and so on. Although improving diet and exercise as a part of a healthy lifestyle program is acceptable, sleep continues to be considered an expendable luxury (Dzaja et al., 2005). Thus, performance and social responsibilities may often take precedence over sleep, largely because of multiple role demands and expectations. Stigma is a problem that often complicates chronic illness. Acceptable standards for roles and activities are socially determined, and individuals who deviate from these expectations because of chronic illness are often labeled as “different” and are thus stigmatized (Falvo, 2005). Similarly, individuals with certain sleep disorders, which are often chronic in nature, may also be stigmatized because of the inability to fulfill role expectations. An additional factor that may underlie this stigma is that sleep is typically misperceived as an “asocial” activity. However, sleep is actually a very important type of social interaction—an activity that is negotiated with self, family, friends, employers, lawmakers, fellow drivers on the road, and so on (Meadows, 2005). When, where, and how sleep occurs is an extremely important sociocultural matter (Taylor, 1993; Williams, 2002), and there can be considerable negative sociocultural consequences when the sleep behavior, either intentionally or unintentionally, is unacceptable (Mehlman, Copyright © National Academy of Sciences. All rights reserved.
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