Fitful sleep, restless nights, and hitting the alarm clock button for an additional 10 minutes of sleep are all too familiar manifestations of the interactions of life with one of the frontiers of science and clinical practice—somnology1 and sleep medicine. It is estimated that 50 to 70 million Americans suffer from a chronic disorder of sleep and wakefulness, hindering daily functioning and adversely affecting health. Hundreds of billions of dollars a year are spent on direct medical costs associated with doctor visits, hospital services, prescriptions, and over-the-counter medications. Almost 20 percent of all serious car crash injuries in the general population are associated with driver sleepiness, independent of alcohol effects. However, given this burden, awareness among the general public and health care professionals is low. In addition, the current clinical and scientific workforce is not sufficient to diagnose and treat individuals with sleep disorders.

Six million individuals suffer moderate to severe obstructive sleep apnea, a disorder characterized by brief periods of recurrent cessation of breathing caused by airway obstruction. Chronic insomnia, which hampers a person’s ability to fall or stay asleep, occurs in approximately 30 million Americans. Restless legs syndrome and periodic limb movement disorder are neurological conditions characterized by an irresistible urge to move the legs and nocturnal limb movements; they affect approximately 6 million individuals, making it one of the most common movement disorders.

The cumulative effects of sleep loss and sleep disorders have been associated with a wide range of deleterious health consequences including an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke. At the same time, the majority of people with sleep disorders are yet to be diagnosed. Compared to healthy individuals, those suffering from sleep loss and sleep disorders are less productive, have an increased health care utilization, and have an increased likelihood of injury.

In 2003 the NIH National Center on Sleep Disorders Research (NCSDR) published a research plan, which contained a set of research priorities for the field. However, recognizing that continued scientific and clinical advances will require a new coordinated strategy to improve public awareness and strengthen the field of Somnology and Sleep Medicine, the American Academy of Sleep Medicine, the NCSDR at the NIH, the National Sleep Foundation, and the Sleep Research Society requested that the IOM conduct a study that would examine: (1) the public health significance of sleep, sleep loss, and sleep disorders, (2) gaps in the public health system and adequacy

1

Somnology is the branch of science devoted to the study of the physiology of sleep, the behavioral dimensions of sleep, and the consequences of sleep loss and sleep disorders on an individual’s and the general population’s health, performance, safety, and quality of life. Sleep medicine is the branch of clinical medicine devoted to the diagnosis and treatment of individuals suffering from chronic sleep loss or sleep disorders.



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