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
20 SLEEP DISORDERS AND SLEEP DEPRIVATION
MAGNITUDE AND COST OF THE PROBLEM
Fitful sleep, restless nights, hitting the alarm clock button for an additional
10 minutes of sleep—all are all too familiar manifestations of
the interactions of life with one of the frontiers of science and clinical
practice—somnology1 and sleep medicine. It is estimated that 50 to 70 million
Americans suffer from a chronic disorder of sleep and wakefulness
(NHLBI, 2003), hindering daily functioning and adversely affecting health.
The current capacity of America’s health system is not sufficient to diagnose
and treat all individuals with sleep disorders. Further, awareness
among health care professionals and the general public is low considering
the size of the problem. Among those individuals with sleep disorders are 3
to 4 million individuals with moderate to severe obstructive sleep apnea
(Young et al., 1993), a disorder characterized by brief periods of recurrent
cessation of breathing caused by airway obstruction with morbid or fatal
consequences. Chronic insomnia, which hampers a person’s ability to fall
asleep, is observed in approximately 10 percent of the American population
(Ford and Kamerow, 1989; Simon and VonKorff, 1997; Roth and Ancoli-
Israel, 1999). Restless legs syndrome and periodic limb movement disorder
are neurological conditions characterized by nocturnal limb movements and
an irresistible urge to move the legs. These conditions affect approximately
5 percent of the general population (Lavigne and Montplaisir, 1994;
Rothdach et al., 2000; NSF, 2000; Montplaisir et al., 2005), making it one
of the most common movement disorders (Montplaisir et al., 2005).
The negative public health consequences of sleep loss and sleep-related
disorders are enormous. Some of the most devastating human and environmental
health disasters have been partially attributed to fatigue-related performance
failures, 2 sleep loss, and night shift work-related performance failures,
including the tragedy at the Union Carbide chemical plant in Bhopal,
India; the nuclear reactor meltdowns at Three Mile Island and Chernobyl;
and the grounding of the Exxon Valdez oil tanker (NCSDR, 1994; Moss
and Sills, 1981; United States Senate Committee on Energy and National
Resources, 1986; USNRC, 1987; Dinges et al., 1989). Each of these incidents
not only cost millions of dollars but also had a disastrous impact on
the environment and the health of local communities.
1Somnology is the branch of science devoted to the study of the physiology of sleep, the
behavioral dimensions of sleep, and the consequences of sleep loss and sleep disorders on an
individual’s and the general population’s health, performance, safety, and quality of life. Sleep
medicine is the branch of clinical medicine devoted to the diagnosis and treatment of individuals
suffering from chronic sleep loss or sleep disorders.
2A significant portion of fatigue, but not all, is caused by chronic sleep loss and/or sleep
disorders.
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