Sleep Disorders and Sleep Deprivation An Unmet Public Health Problem (2006) / Chapter Skim
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From page 387... ...
, 9, 22, 145, OSA, 72, 74 202 psychological and social pressures, 142 fellowship training programs, 196-197, quality of life, 153 199, 200, 296, 314 research programs, 186 program requirements for residency RLS, 98 training, 191 school start times, 143, 266 restriction of resident work hours, 139, sleep deprivation, 46, 57, 60, 61, 63, 189 142-144, 210 Sleep Medicine Working Group, 196 sleep-disordered breathing, 56, 74 Acute stress disorder, 91 sleep-onset abnormalities, 79 ADHD. See Attention-deficit/hyperactivity sleep patterns, 46-47, 48, 142, 143 disorder sleep requirements, 46, 57, 142 Adolescents Adults academic performance, 82, 108, 142- advanced sleep phase syndrome, 110 144, 266 alcohol use, 63 behavioral problems, 63 cognitive impairment, 146-147 delayed sleep phase syndrome, 108-109, mood disorders, 63 143, 266 parasomnias, 88 diabetes and glucose tolerance, 61 obesity, 59-60, 61 employment, 142 OSA, 61, 66 387
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See Portable Analysis of NIH grants monitoring and therapeutic devices clinical, basic, and circadian rhythm American Academy of Pediatrics, 75, 180 projects, 270, 272 American Academy of Sleep Medicine for device development, 273 (AASM) , 2, 22, 26, 29, 67, 177, 179, protocol, 269, 275-276 187, 188, 218, 219, 221, 224-225, by research strategy, 271, 273 243, 296, 318 review panel composition, 274-275 accredited fellowship training programs, RFAs and PAs, 268-268 192-196, 314 sleep disorders, 270, 272-273 Medical Education Committee, 189 by species, 271, 274 membership, 235 temporal trends, 269-272 mentoring program, 249 Antiarrhythmics, 104, 105 Pfizer Scholars Grant Program in Sleep Anxiety and anxiety disorders, 59, 63, 79, Medicine, 244 81, 82 standards for sleep centers, 312-313 Appetite, 60-61, 72, 267 Taskforce 2000, 188 Arousal from sleep.
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See B also Professional training advances since 2003 research plan, 267 Back to Sleep campaign, 180-181 barriers to, 237-238 Bacterial infections, and sleep, 102 career training (K) awards, 238-242, BEARS pediatric screening tool, 190, 336 248, 250, 251, 275-276, 339, 360Behavior 367 aggressive, 91 K12 Multidisciplinary Clinical research obstructive sleep apnea and, 22, 1 Training Program, 241, 247, 248 45-146 mentors and mentoring, 6, 234, 237, oppositional, 100 238, 242, 246, 248-250, 296, 361, REM sleep behavior disorder, 90 363, 364, 365, 366, 367 risk taking, 142 midcareer, 238, 248, 250, 364, 366 sleep loss and, 63, 142 model support programs, 244-245 violent, 88 NIH support, 5-6, 25, 234, 238, 238Behavioral Risk Factor Surveillance System, 246, 339, 360-367 152, 203, 208-209 opportunities to accelerate, 247-251 Blood pressure, 38, 63, 68, 69, 70.
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tonsillar hypertrophy, 70, 71, 74, 146 therapy, 68, 70, 71, 72, 75, 96, 147, utilization of health care, 156 151, 153, 154, 156-157, 161, 177, CHQ-PF50, 153, 336 218, 228, 264, 295, 298, 299, 314 Circadian phase advance, 80 Coronary artery disease, 65, 69, 70 Circadian rhythm Corticosteroids, 43, 106, 337 age and, 44-45, 46, 47, 49, 261 Cortisol, 45, 47, 71, 76, 104 defined, 41, 336 Council of Graduate Schools, 246 development, 44-45, 46 Council on Education for Public Health, 9, function, 41 202 gender differences, 47-48 CPAP. See Continuous positive airway grants for research, 270, 272, 275 pressure and metabolism, 61-62 Cystic Fibrosis Foundation, 244, 245 molecular mechanisms, 41-42, 261 Cytokines, 71, 105, 106 and motor vehicle accidents, 148 neurobiology research advances, 260 261 D and obesity, 261 shift work and, 58, 109, 261 Dartmouth Sleep Knowledge and Attitude Survey, 190
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INDEX 391 Delayed sleep phase syndrome costs, 157, 160-161, 219, 307 etiology and risk factors, 109, 266 demand for, 9, 218 genetic factors, 260 evaluating daytime sleepiness, 226-227 interventions, 143 future directions, 228-229 manifestations and prevalence, 83, 107, genetic and biochemical tests, 227 108-109 hypersomnia, 84, 86, 226 treatment, 109-110, 143 imaging technologies, 227 Dementias, 91-93 insomnia, criteria for, 75-76 Dental and orofacial pain, 101 International Classification of Sleep Dental appliances, 75 Disorders, 56, 86, 104, 107-108, 262 Department of Commerce, 5, 277, 347 microstructural cyclic alternating Department of Defense, 5, 257, 276, 277, patterns analysis, 227 347 MSLT, 82, 83, 84, 85, 86, 226-227 Department of Education, 5, 179, 277, 347 MWT, 227 Department of Energy, 355 narcolepsy, 83, 84, 86, 226, 262 Department of Health and Human Services, OSA, 65, 67, 83, 160-161 204, 258 polysomnography, 9, 26, 68, 70, 71, 83, Department of Labor, 5, 179, 257, 276, 157, 218, 219, 223, 227 277, 347 portable tools, 26, 218-223 Department of Transportation, 5, 179, 257, reimbursement for, 28 276, 277, 347 revenues from, 310 Department of Veterans Affairs, 208, 219, RLS, 227 257, 258 scoring and processing of sleep studies, Depression 224-225, 309-310 adolescents, 63, 79, 143 sleep logs, 82, 83, 227 cancer and, 103, 105 spectral analysis, 227 dementias and, 91 survey of trends, 208 and hypersomnia, 85, 87, 296 telemonitoring from sleep centers, 228 insomnia and, 23, 77, 79, 80, 81-82, video technologies, 227 103, 265 waiting time for patients, 26, 218, 303, older adults, 48 307 periodic limb movement and, 100 Disasters, fatigue-related, 20, 138 and quality of life, 152 Disease mortality, 63-64 REM sleep characteristics, 79 Dissociative disorders, 89, 342 sleep loss and, 2, 28, 56, 57, 59, 63, Dopamine, 40, 41, 87, 98-99, 261, 262 143, 175, 184 agonists, 90, 99, 100 Diabetes antagonists, 99 OSA and, 65, 71-72, 74 Dreams/dreaming and quality of life, 153 and muscle atonia, 38, 90 sleep loss and, 2, 21, 25, 28, 56, 59, 61- nightmares, 46, 90, 104 62, 267 sleep stage and, 21 type 2 defined, 344 vivid, 38, 104 Diagnosis of sleep disorders Drug abuse, 23, 81, 91, 97, 184, 270 access to, 9, 218 accreditation criteria, 28 actigraphy, 82, 83, 221, 227 E apnea-hypopnea index, 66, 67, 223, 335 circadian rhythm disorder, criteria for, Eating disorders, 23, 84, 89, 342 107-108 Economic impacts direct costs, 2, 157, 159-161 comorbid psychiatric disorders and, 80 81 indirect costs, 108, 158, 160, 161 insomnia, 156, 159-160
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See National 36, 40, 43, 69, 103, 186, 337 Institutes of Health Electromyography, 69 Growth hormone, 39, 104 End-stage renal disease, 98, 99, 105-106, 296 Endocrine function, 39 Endothelial dysfunction, 68 H Entertainment Industry Foundation, 178 Harvard University, 187, 236, 239, 298, Enuresis, 89 Epilepsy, 93-95, 337, 340 376-377 Epworth Sleepiness Scale, 154, 155, 337 Harvard Work Hours Health and Safety Study, 139 Exploding head syndrome, 89, 337 Exploratory Center award, 281 Head trauma, 85, 87 Health care professionals. See also Professional training F attraction to sleep field, 183 awareness about sleep disorders, 182Falls, 150, 160 183 Familial/genetic factors, 73, 74, 77, 79, 85, board certification in sleep medicine, 87, 90, 94, 97, 98, 109, 110, 260, 197-201, 298, 314-315 261, 262, 263, 265-266 Health insurance coverage, 28, 209, 219, Fatigue, 20, 79, 95, 100, 104, 105, 149, 353 315 Fellowship (F)
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, 41, 85, 87, 101, 261, 265 262, 338 pain and, 101 Hypolipidemic drugs, 104-105 psychiatric disorders and, 77, 79, 80, 81Hypomania, 106 82, 156, 159 Hypoperfusion, 74 and quality of life, 75, 152-153 Hypothalamic-pituitary-adrenal axis, 71, 76 sleeping sickness and, 103 dysregulation, 80, 82 stroke and, 95 Hypothalamus, 40, 41, 43, 85, 101, 103, treatment, 23, 65, 77-78, 96, 150, 265 261 undiagnosed and untreated cases, 218, Hypoventilation, 38 294-295 Hypoxemia, 71, 72, 145, 147 utilization of health care, 155, 156, 159 Hypoxia, 71, 74, 263-264, 338, 353 and work-related injuries, 149 Hypoxic ventilatory response, 39 Institutional National Research Service Award, 354 Insulin resistance, 71, 72, 264 I Intelligence quotient, 145, 146 Interdisciplinary research, defined, 27, 28, Immune response, 102 298 Immunologic disorders, 106 Interdisciplinary sleep programs, academic. Infants See also Sleep centers and congenital central hypoventilation laboratories syndrome, 265-266 accreditation and certification, 28, 312 low birth weight, 97 315, 318, 321 newborns, 35, 44-45, 261 administrative jurisdictions, 301 premature, 74, 97, 146 approach, 27-28, 296-303 SIDS, 96-97, 180-181, 265 Centers of Excellence, 11-12, 278-282, sleep patterns, 35, 44-45, 47-48 283
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, research component, 304-305 227 Maternal and Child Health Bureau, 180 revenue generation and fiscal independence, 28, 305-310, Median thalamic stroke, 85 311-312 Medical disorders and sleep. See also individual disorders staffing, 298-300, 302-303, 307 transparent policies and procedures, 306, cancer, 103, 105 311 grants for research, 270 infectious diseases, 102-104 Type I clinical program, 13, 15-16, 279, 284, 316, 317, 319-320 pain, 100-101 Type II training and research program, treatment-related effects, 104-106 Medical education in somnology.
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See Maintenance of Wakefulness 206, 209 Test Medical residents Myocardial infarction, 2, 38, 56, 60, 62, 69, medical errors, 138, 139-140, 144-145 70, 95, 153 motor vehicle accidents, 149 Myotonic dystrophy, 85 restriction of work hours, 25, 139, 189 somnology training curricula, 191-192 Medicare Current Beneficiary Survey, 205, N 209-210 MEDSleep, 25, 189 Naps/napping, 64, 83, 84, 87, 151, 226 Narcolepsy Melatonin, 39, 43, 45, 47, 49, 104, 106, 109-111, 159, 340 and academic performance, 82 Memory, 36, 38, 57, 100, 138, 140, 147, and accidents and injuries, 147 with cataplexy, 83, 85, 86, 87, 262, 336 184 Menopause and menopausal symptoms, 74, without cataplexy, 85-87, 272 105 comorbid sleep disorders, 295 defined, 340 Menstruation, 48, 84 Metabolic syndrome, 261, 266, 295, 353 diagnosis, 226, 227, 262 Microsleeps, 138 economic impacts, 155, 162 etiology and risk factors, 85-87, 237 Microstructural cyclic alternating patterns analysis, 227 grants for research, 270, 272 Modafinil, 65, 87, 93, 266 manifestations and prevalence, 34-35, 82-85, 86 Molecular Biology and Genetics of Sleep and Sleep Disorders, 352 and periodic limb movement disorder, Monitoring. See Sleep monitoring 100 and quality of life, 151-152 Mood, sleep loss and, 23, 48, 63, 65.
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, 365, 366, 367 23, 255, 353, 354, 355, 358 National High Blood Pressure Campaign, National Institutes of Health (NIH) , 22 180 career development awards, 240-241 National Hospital Discharge Survey, 207-208 conference on insomnia, 265 National Human Genome Research Institute coordination of sleep research, 2, 254 (NHGRI)
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From page 397... ...
, 2, 22, 29, education campaign, 177, 179 148, 176-177, 179, 355 and hypertension, 66 hypoventilation syndrome, 264-265 Pickwick Club Award, 243, 244 National Sleep Public Education and and OSA, 61, 66, 72, 160-161, 263, 295 Awareness Campaign, 178-182 sleep loss and, 2, 21, 25, 56, 59-61, 267 stigma of, 175 National Sleep Awareness Week, 176-177 National Somnology and Sleep Medicine utilization of health care, 161 Research and Clinical Network, 7, Obstructive sleep apnea (OSA) advances in research, 263, 265, 266 12-13, 14, 179, 279, 282-285, 320 National Survey of Family Growth, 206 age/aging and, 66, 73, 263 National Transportation Safety Board, 149 alcohol use and, 73 Alzheimer's disease and, 91, 262 Native Americans, 97 NCSDR.
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See also cost-effectiveness, 157, 221 Work evaluation of effectiveness, 10, 225-226, regulation, 150-151 273 research, 355 feasibility and quality, 220-222, 228 Occupational Safety and Health future directions, 228 Administration, 257 rationale for, 9, 218-220, 228 Older adults validation of, 26, 222-224, 273 advanced sleep phase, 260 Posttraumatic stress disorder, 91, 257 education campaigns, 176 Prader-Willi syndrome, 85, 341 falls, 150 Pregnancy and postpartum period grants for research on, 274 RLS, 48, 98, 296 insomnia, 76, 77, 160 sleep patterns, 48 neurological disorders, 92 substance abuse, 97 OSA, 66, 68, 73, 154, 263 Process C, 39-40 periodic limb movement disorder, 100 Process S, 39-40 portable monitoring equipment for, 220 Professional training. See also Medical quality of life, 154 education in somnology REM sleep disorders, 90 access to, 296 RLS, 98 accreditation, 177, 192-197, 314 sleep patterns, 22-23, 47, 48-49 advances since 2003 research plan, 260, OSA.
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From page 399... ...
INDEX 399 board certification, 197-201, 314-315 CDC activities, 177-178, 257 challenges, 201 celebrity spokespersons, 178 costs, 307-309 for college students, 185 curriculum development, 6, 8-9, 183, coordinating activities, 179, 180, 181 185-187, 202, 238, 240, 241, 296, costs and challenges, 180 362 curriculum supplements for children and fellowship programs, 192-197, 198, 199, adolescents, 176, 177, 234 200, 238, 240, 242, 243, 244, 296, evaluation of effectiveness, 176, 179 314, 337-338, 371-372 focus and role, 178-179 funding, 5, 6, 186, 200, 201-202, 343- grants, 177 344, 362, 369 integrating with other public health graduate research programs, 8-9, 187, campaigns, 179, 185 189, 373 multimedia campaigns, 177, 178-182 improvement strategies, 248-250 National High Blood Pressure Education integration with other programs, 8, 249- Program, 181 250 National Sleep Awareness Week, 176 interdisciplinary approach, 25-26, 183, 177 187, 247, 249-251 National Sleep Public Education and leadership skills, 240, 241 Awareness Campaign, 178-182 limitations of current programs, 27, 160 NCSDR campaigns, 175-176 182-183 private-foundation campaigns, 176-177 next steps, 201-202 rationale for, 179 NIH awards, 25, 238-240 recommendations, 7, 182 pooling funds for, 241 strategies for strengthening, 176, 178 recommendations, 6, 8-9, 202, 250-251 182, 184 remote mentoring programs, 248-249 requirements, 182-187 revenues from, 311 Q tools and products, 25, 202 undergraduate education, 8-9, 183, 184- Quality of care 187, 373 accreditation of sleep centers and, 313 314 workforce shortages, 192, 296 Program (P) awards, 281, 340-341, 352, certification of specialists and, 314-315 355, 370 health insurance reimbursement and, 315 Psychiatric disorders with sleep disturbances database, 208 Quality of life economic costs, 159 bed partners of individuals with sleep disorders, 153-154 etiology and risk factors, 80 grants for research, 270, 272 measuring, 151, 152, 153, 154 insomnia, 77, 78, 81-82, 156, 159, 296 sleep loss and, 48, 75, 147, 151-153, 184 manifestations and prevalence, 78-79, 208, 295 parasomnias, 79 R treatment, 80-81 utilization of health care, 156, 175 Race/ethnicity Psychomotor vigilance task, 142 and OSA, 66, 73, 74, 161-162, 263 Public education and SIDS, 97 absence of sleep content, 175 and sleep patterns, 142 awareness of sleep disorders, 2, 20, 22, Rapid-eye-movement (REM)
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See also Obstructive sleep apnea; Sleep-disordered 341-342, 352, 353, 354, 355, 356 359, 369 breathing Respiratory activity, 38-39 and accidents and injuries, 147, 148, 149, 150 Restless legs syndrome (RLS) and accidents and injuries, 147 AHI for defining, 223 and ADHD, 22 defined, 342 demand for diagnosis and treatment, defined, 342 diagnosis, 227 219 etiology and risk factors, 48, 98-99, 100, diagnostic technologies, 222, 223 economic costs of, 157 105, 262 grants for research, 270, 273 grants for research, 270 and insulin resistance, 264
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From page 401... ...
See community-based, 219 also individual disorders costs, 219 and academic performance, 142-144 funding, 281 access to care, 201, 294-295 learning experiences in, 188 adolescents, 142-144 lung function laboratories compared, and alcohol use, 63 224 animal studies, 21, 61-62 models for, 278-282 and cardiovascular morbidity, 62-63 in NIH clinical research program, 285- challenges for individuals with, 174-178 286 cognitive effects, 138-142 number in U.S., 218 cumulative effects, 2, 142 quality of care, 313-314 and diabetes, 61-62 recommendation, 10-11, 286 effectiveness of interventions, 150-151 staffing, 219, 224, 307 environmental factors, 143 telemonitoring of hospital etiology and risk factors, 34, 57-59 polysomnograms, 228 family and community effects, 153-155 utilization, 26, 182 fragmentation of sleep, 71, 147 Sleep-disordered breathing, 82. See also and functional status, 151-152, 153-155 Obstructive sleep apnea and glucose tolerance, 61-62 and accidents and injuries, 147 grants for research by type of, 270, 272 and ADHD, 100 273 advances in research, 263-265 health effects, 2, 21, 25, 28, 56, 59-64 apnea-hypopnea index, 67, 95, 263 lifestyle and sociocultural factors, 174 bed partners of individuals with, 154 management and treatment, 64-65 and cognitive impairment, 146-147 manifestations, 56, 57 economic impacts, 155 and medical errors, 138, 139-140, 144 etiology and risk factors, 72-75, 263 145
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From page 402... ...
See Somnology and sleep adolescents, 186 medicine research advances since 2003, 260-267 Sleep monitoring. See Portable monitoring animal studies, 261-262, 271, 274, 352 and therapeutic devices basic, 23, 25, 240, 259, 261-262, 270, Sleep paralysis, 84, 87, 89, 90, 342 272, 279, 282, 354 Sleep patterns Basics of Sleep Research guide, 177 age and, 44-47, 142, 143 bias in studies, 59, 70, 74 circadian rhythm disruption, 21 Centers of Excellence, 278-282, 283 temporal distribution, 108 challenges, 6, 22-26 Sleep Research Society, 2, 22, 25, 29, 177, circadian rhythm, 260-261, 270, 272 235, 237, 249 clinical, 270, 272, 274, 279, 282, 285Sleep Research Society Foundation, 177 286 Sleep restriction therapy, 77, 342 collaborations, 28, 276, 277-278 Sleep, Sleep Disorders, and Biological coordination by NIH, 2, 3-5, 22-24, Rhythms, 176 186, 229, 240, 241, 244, 250, 254Sleep spindles, 36, 186, 342-343 256, 257-258, 267, 268, 275-276, Sleep terrors, 89, 90, 227, 343 277, 357 Sleep-wake regulation defining, 2 n.1, 20, 23, 250, 342, 343 brain processes and structures, 40-41, fellowship training, 192-197, 198, 199, 43, 76-77, 80, 85, 92, 94, 261 200 iatrogenic effects of medical therapies, grants from NIH, 4, 200, 235-236, 254, 104-106 255, 256, 277, 282, 296, 340-342, immune system and, 102 351-359, 368-373, 375-377; see also phylogenetic studies, 261-262 Analysis of NIH grants two-process model, 39-40 growth of field, 4, 22, 25, 234-238, 296 Sleepiness, excessive daytime.
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awards, 238, 239, 250, 251, Stigma of sleep disorders, 174-175 275-276, 343-344, 354, 373 Stimulus control therapy, 78 Trans-NIH Sleep Research Coordinating Stress, 76, 77, 91, 94, 184, 222 Committee, 4, 5, 6, 10, 12, 24, 186, Stroke, 93, 181, 262 229, 240, 241, 244, 250, 254, 255 and sleep architecture, 85, 95-96 256, 257-258, 267, 276, 277, 283, sleep-disordered breathing and, 65, 69, 305, 357 70, 95 Treatment. See also Sleep loss and sleep sleep loss and, 56, 62 disorders; individual disorders Sudden infant death syndrome (SIDS)
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404 INDEX U Weight gain, sleep loss and, 267 Wisconsin Sleep Cohort study, 66, 68, 72 University of Pennsylvania, 236, 239, 298, Work. See also Occupational safety and 307, 376-377 health; Shift work University of Pittsburgh, 236, 239, 376-377 absenteeism, 154, 158, 160 Utilization of health care, 2, 21, 26, 155- accidents and injuries, 147, 149-150, 157, 159, 161 158, 160, 266 hours, 138, 139, 148 performance/productivity losses, 2, 146 V 147, 154, 158, 160 Vigilance deficits, 138, 148 Viral infections, and sleep, 103 Y Youth Risk and Behavior Surveillance W System, 210 Wakefulness, 40-41 medications promoting, 64-65 sympathetic nervous system hyperactivity, 73
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