ATS Core Curriculum 2017: Part I. Adult Sleep Medicine

摘要

The American Thoracic Society (ATS) Core Curriculum updates clinicians annually in adult and pediatric pulmonary disease, medical critical care, and sleep medicine on a 3- or 4-year recurring cycle of topics. The 2017 course was presented in May during the annual International Conference and is published in four parts. This year, Part I covers topics in adult sleep medicine. A Continuing Medical Education (CME) exercise covering the contents of the Core Curriculum can be accessed online at www.thoracic.org until Aueust 2020. Insomnia is the most common sleep disorder, affecting approximately 33% of the general population (1) and with approximately 12-20 million U.S. adults reporting the use of prescription sleep aids (2). Insomnia is characterized by difficulty falling asleep, maintaining sleep, and/or waking too early, resulting in insufficient sleep duration and/or quality. Insomnia may exist as a singular condition or comorbid with medical (e.g., cancer, chronic pain) and psychiatric (e.g., depression, anxiety) disorders. Insomnia alone has been associated with reduced quality of life and functional impairment as well as increased risk for new onset of both psychiatric and medical conditions (3). As such, insomnia is associated with substantial burden in terms of healthcare use (4) and workplace costs, with an estimated 8 days of individual lost work performance annually (5). Although cognitive behavioral therapy for insomnia (CBT-I) is the mainstay of chronic insomnia treatment, medications can play an important role in initial management.