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 INTRODUCTION 27 or those that could be created (Ehrenberg and Epifantseva, 2001; Thursby and Thursby, 2002). Somnology and Sleep Medicine Is an Interdisciplinary Field The field of Somnology and Sleep Medicine is an emerging interdisciplinary field that is being forged from several existing sciences and medical specialties. However, the current organization of academic health centers houses clinicians and scientists in discrete departments that do not favor interdisciplinary research efforts. Although the scientific enterprise of the field requires interdisciplinary strategies, the clinical service of patients is multidisciplinary and requires linkages to other medical specialties. As described in the National Academy of Sciences (2004) report Facilitating Interdisciplinary Research: Interdisciplinary research is a mode of research performed by teams or individuals that integrates information, data, techniques, tools, perspectives, concepts, and/or theories from two or more disciplines or bodies of specialized knowledge to advance fundamental understanding or to solve problems whose solutions are beyond the scope of a single discipline or field of research practice (Figure 1-1A). Multidisciplinary research is taken to mean research that involves more than a single discipline in which each discipline makes a separate contribution. Investigators may share facilities and research approaches while working separately on distinct aspects of a problem (Figure 1-1B) (NAS, 2004). There are a wide range of programs in Somnology and Sleep Medicine. Some are solely clinical in nature; others are clinical programs that include training of physicians and some research. There are also a limited number of comprehensive programs that emphasize clinical care education and training, as well as basic and clinical research. With few exceptions most programs continue to be not integrated and embedded in medical departments. This organization has many adverse implications for the field; including: • Clinical training in sleep loss and sleep disorders is often limited to those in the department where the program is housed to the exclusion of others. • The absence of interdisciplinary clinical teams hinders patient care. • A limited sense of identity with, or focus on the field, and an absence of an established career path for faculty makes it difficult to attract new students, researchers, and clinicians into the field. 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 28 SLEEP DISORDERS AND SLEEP DEPRIVATION A) Interdisciplinary A B B) Multidisciplinary A B C A′ B′ Joined together to work on a common question or problem. Interaction may forge a new research field or discipline. Disciplines joined together to work on a common question or problem, split apart when work is complete, having likely gained new knowledge, insight, strategies from other disciplines. FIGURE 1-1 Interdisciplinary and multidisciplinary research. SOURCE: National Academy of Sciences, 2004. • Research or clinical funds generated from sleep-related activities are not generally reinvested to enhance sleep programs. • Collaboration can be more difficult because researchers and clinicians are geographically dispersed. Sleep Loss and Sleep Disorders Require Long-Term Patient Care and Chronic Disease Management Sleep disorders are chronic conditions necessitating complex treatments. They are frequently comorbid with other sleep disorders and other conditions (e.g., cardiovascular disease, depression, or diabetes), which, by themselves, are complex to treat. Despite the importance of early recognition and treatment, the primary focus of most existing sleep centers is on diagnosis, rather than on comprehensive care of sleep loss and sleep disorders as chronic conditions. The narrow focus of sleep centers may largely be the unintended result of accreditation criteria, which emphasize diagnostic standards and reimbursement for the diagnostic testing (see Chapter 9). Copyright © National Academy of Sciences. All rights reserved.
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Sleep Disorders and Sleep Deprivation: An Unmet Public

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