Sleep Disorders and Sleep Deprivation An Unmet Public Health Problem (2006) / Chapter Skim
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7 Opportunities to Improve Career Development in Somnology
7 Opportunities to Improve Career Development in Somnology
Pages 233-252
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From page 233... ...
Further, only 54 doctorates were awarded with a focus on somnology or sleep medicine. This workforce is insufficient, given the burden of sleep loss and sleep disorders.
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. Attracting, training, and supporting investigators in sleep-related research is critical for fueling the scientific efforts needed to make important discoveries into the etiology, pathogenesis, prevention, and treatment of chronic sleep loss and sleep disorders.
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The limited number of researchers is clustered at a limited number of institutions. Of the 253 funded primary investigators in 2004, 33 percent of all investigators were at the top 10 academic sleep programs (ranking by the total number of somnology and/or sleep disorders grants)
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In 2004, Harvard University, the University of Pennsylvania, and the University of Pittsburgh received 46 percent of sleep-related career development awards. Further, although many sleep disorders disproportionately affect minorities (Rosen et al., 2003)
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Therefore, although there have been some remarkable successes in scientific investigation aimed at elucidating fundamental sleep physiology and biology (e.g., discovery of a mammalian Clock gene (Antoch et al., 1997; King et al., 1997; Tei et al., 1997) and the cause of narcolepsy (Lin et al., 1999; Chemelli et al., 1999; Mignot et al., 1999; Thannickal et al., 2000; Peyron et al., 2000)
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Data from the CRISP database were used to assess the number of awards that were classified under the following thesaurus terms: insomnia, periodic limb movement disorder, restless legs syndrome, circadian rhythm, sudden infant death syndrome, sleep disorder, narcolepsy, sleep apnea, sleep, hibernation, and dream. To limit the number of grants that were not relevant to somnology or sleep disorders, the committee included only grants in which the key words appeared in both the thesaurus terms and the abstract and not the abstract alone.
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OPPORTUNITIES TO IMPROVE CAREER DEVELOPMENT 239 applications that were submitted and not funded; therefore, it is not possible to conclusively determine if changes in investment are the result of NIH policy, the number and/or quality of submissions in each area, composition of grant review committees, or combination of these factors. Temporal Analysis of Sleep Training Awards Although there is a statistically significant increase in the total number of K awards from 1996 to 1998 (Appendix H)
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240 SLEEP DISORDERS AND SLEEP DEPRIVATION Support of training grants may also diminish. The NIH reported that in response to rising tuitions and steady budgets that if the current formula used to determine the number of awards is not altered there would be an overall loss of 4,000 training grant slots by 2015 (Bhattacharjee, 2005a)
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OPPORTUNITIES TO IMPROVE CAREER DEVELOPMENT 241 NHLBI-sponsored training grants were K07 awards devoted to the Sleep Academic Award program, which were designed to support the development of curricula and educational leadership, not research training. The vast majority of the Trans-NIH Sleep Research Coordinating Committee member institutes -- many of whom have a large portion of the sleep-related research project grant portfolio (Appendix G)
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There are many existing training grants or large research programs in disciplines related to somnology or sleep medicine (e.g., internal medicine, neurology, psychiatry, psychology, otolaryngology, nursing, epidemiology, neuroscience, and health services research)
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It is worth noting that investment in sleep-related research is low for all professional organizations profiled below; for example, despite the significant association of sleep disorders and cardiovascular disease, only 2 of the 845 awards given by the American Heart Association's career training program portfolio supported sleep-related research. One impediment leading to the limited support from these organizations is that they might not recognize the important role they have in fostering interdisciplinary research, as they are focused on more traditional organ-based research.
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Funds for these programs have been derived from endowments and well-organized, targeted fund-raising efforts. This analysis identifies the potential availability of funding for sleep training from multiand interdisciplinary initiatives available through professional organizations with secondary interests related to sleep loss and/or sleep disorders, in addition to the need for organizations with primary sleep-related agendas to invest more heavily in developing the next generations of investigators.
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To gether, these programs provide support for the full spectrum of trainees: combined clinical/research fellowship training, early research career de velopment (enrolling fellows within the first 4 years of training) , and junior faculty development.
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246 SLEEP DISORDERS AND SLEEP DEPRIVATION The Role of Mentoring and Availability of Sleep Mentors Numerous studies have documented the pivotal role of mentoring in career development (Chilcott and Shapiro, 1996; Palepu et al., 1998; Young et al., 2002; Lieff et al., 2003)
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committed to promoting sleep health and somnology and sleep disorders professionals is a largely untapped resource for support for trainees.
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Remote Mentoring Programs Successful career development awards require the identification of a strong mentor. However, if such mentors may only be located at the candidate's home institution, there would be little growth of somnology and/or sleep disorders research expertise in institutions other than the few large academic programs.
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Integration of Somnology and Sleep Medicine with Other Training Programs Another strategy to be considered is providing additional training positions to already established training grants in relevant disciplines, such as neuroscience and clinical epidemiology. This, when combined with the remote mentorship model, would have considerable benefit.
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to get retrained in sleep research. They would do so in collaboration with one of the comprehensive sleep centers described elsewhere in this report.
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2003. National Sleep Disorders Research Plan, 2003.
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American Journal of Respiratory and Critical Care Medicine 165(9)
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