Public Awareness, Medical Integration, and Innovation in Sleep Medicine

摘要

On behalf of the Board of Directors and the Technology Presidential Committee of the American Academy of Sleep Medicine (AASM), we appreciate the feedback from Solveig Magnusdottir, MD, MBA, in response to the AASM position statement on consumer sleep technology and our previous letter to the editor.13 We agree that although consumer sleep technology has the potential to improve our ability to increase awareness of and track sleep disorders through multi-night testing in the home environment, scientific validation is necessary for consumer sleep technology to have a significant role in clinical practice.We also agree with Dr. Magnusdottir's statement that, AASM has a leadership obligation to facilitate increased public awareness of sleep disorders and to support improved integration of sleep health into medical care in a responsible manner. To establish common ground, AASM needs to embrace innovation in sleep medicine. We will briefly describe how AASM already has taken steps to fulfill this obligation.Regarding the facilitation of increased public awareness of sleep disorders, in 2018 the AASM concluded a 5-year cooperative agreement with the Centers for Disease Control and Prevention (CDC) for the administration of the National Healthy Sleep Awareness Project, involving collaboration with the Sleep Research Society (SRS) and other partners. This initiative produced two consensus statements that sparked, and continue to stoke, media coverage about the importance of a healthy sleep duration.4,5 The project also generated multiple public awareness campaigns on important topics such as drowsy driving, obstructive sleep apnea (OSA), and insufficient sleep among teens. This partnership of the AASM and SRS continues with a group of experts from both societies tasked with the evaluation of recommendations regarding shift work.Currently the AASM continues to invest in an ongoing public relations campaign to raise awareness that healthy sleep is essential for health and well-being, untreated sleep disorders are common and detrimental to health, and patient-centered care is available from board-certified sleep medicine physicians and the sleep team of health care providers at accredited sleep centers. Anyone who has been involved in sleep medicine for more than a few years should recognize that we are living in the golden age of sleep awareness. Using Google search data since 2004 as a gauge, Figure 1 shows that public interest in sleep is currently at its peak. Although the AASM has contributed to this success, this achievement is a credit to everyone in our fieldincluding individual AASM members, accredited sleep facilities, sleep-related patient organizations, sleep therapy manufacturers, and advocates such as Arianna Huffington, who received the 2018 Mark O. Hatfield Public Policy or Advocacy Award from the AASM.Sleep topic, interest over time in the United States: 2004 to 2019.Numbers represent search interest relative to the highest point on the chart for the given region and time. A value of 100 is the peak popularity for the term. A value of 50 means that the term is half as popular. Source: Google Trends. Accessed Feb. 16, 2019. Available from: https://trends.google.com.Figure 1Sleep topic, interest over time in the United States: 2004 to 2019.(more ...)The AASM also is committed to the integration of sleep health into medical care, and we recognize that primary care providers play an important role in detecting and managing sleep disorders. However, we face two considerable challenges. First, education on normal sleep and sleep disorders is severely lacking in most medical school curricula.6 For decades, the AASM and other stakeholders have sought to improve sleep education in medical schools through a variety of task forces, workshops, and other strategies.711 However, increasing the amount of time committed to sleep instruction requires decreasing time from other topics of study, and medical educators have been and continue to be reluctant to make this trade. Second, primary care physicians are being stretched to their limits by large patient panels, complex chronic diseases, and administrative requirements such as prior authorization and electronic health records (EHRs) management.12 Many simply do not have the bandwidth to take on significant responsibility for identifying and managing sleep disorders.These were some of the topics that we discussed during the Sleep-Disordered Breathing Collaboration Summit, which the AASM hosted in November 2018. Thirty-five representatives from 14 medical societies, nurse practitioner associations, and patient advocacy groups met to discuss strategies to improve the diagnosis and treatment of OSA. The goal of the summit was to discuss how the sleep field could expand access to care by involving primary care physicians, advanced practice providers, and other medical specialists in a team-based approach to address the sleep apnea crisis. Although attendees express