Sleep Disorders and Sleep Deprivation: An Unmet Public

Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem
http://www.nap.edu/catalog/11617.html
BOLSTERING SOMNOLOGY RESEARCH 267
These findings are leading to rapid changes in the on-call requirements for
physicians in training (Cavallo et al., 2004).
The impact of chronic sleep restriction on human health and endocrinological
status is also increasingly recognized. Associations among short
sleep, obesity, diabetes, and mortality have been reported (Alvarez and Ayas,
2004; Gottlieb et al., 2005). A large number of studies have shown crosssectional
association between short sleep and obesity (Cizza et al., 2005). A
trend for a longitudinal association between shortening sleep and gaining
weight is also typically found. The biological mediation of these changes
may be through alterations in leptin and ghrelin, two major appetite regulatory
hormones (Taheri et al., 2004; Spiegel et al., 2004). The levels of these
hormones are altered in health subjects if sleep is restricted for a few nights.
Sleep Education and Training
Although a top priority of the 2003 research plan, the NIH has not
established any new large-scale programs in training or career development.
In fact, as has been described in Chapter 7, there has been a decrease in the
number of career development grants pertaining to sleep. Further, although
a few private foundations and professional societies have invested some in
professional development, as discussed in Chapter 5, increased efforts are
required to fully embrace the need to increase education and training programs.
Thus, progress in this critical area has been quite limited.
ANALYSIS OF NIH-SPONSORED RESEARCH PROJECT GRANTS
Currently, assessment of the success of the sleep research effort at NIH
seems to be based largely on the total dollars being committed by various
institutes to the field (for more information see the 2001 to 2004 annual
reports of the Trans-NIH Sleep Research Coordinating Committee). NIH
funding for somnology research has increased by more than 150 percent
since the NCSDR became fully operational in 1996, reaching a total of
$196.2 million (0.07 percent of the NIH budget) in fiscal year 2004
(NHLBI, 2003). However, this growth occurred during the same period
that the overall budget to the NIH doubled.
At the same time that the science and magnitude of the problem
requires greater investment, over the last few years NIH funding to sleeprelated
activities has plateaued. This has partially overlapped the period
when the overall NIH budget has plateaued. Consequently, the future outlook
for somnology and sleep medicine is unclear. In 2004, for the first
time since the NCSDR was established, there was a decrease of $846,000
in annual expenditures for sleep-related projects. This decrease raises even
greater concern because it occurred in the same year that the NCSDR in-
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