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Index
A
Academic performance, sleep loss and, 82, 108, 142-144, 145, 184, 266
Academic programs. See Interdisciplinary sleep programs;
Sleep centers and laboratories
Academy of Dental Sleep Medicine, 177
Accreditation, 18, 321
Accreditation Council for Graduate Medical Education (ACGME), 9, 22, 145, 202
fellowship training programs, 196-197, 199, 200, 296, 314
program requirements for residency training, 191
restriction of resident work hours, 139, 189
Sleep Medicine Working Group, 196
Acute stress disorder, 91
ADHD. See Attention-deficit/hyperactivity disorder
Adolescents
academic performance, 82, 108, 142-144, 266
behavioral problems, 63
delayed sleep phase syndrome, 108-109, 143, 266
diabetes and glucose tolerance, 61
employment, 142
grants for research on, 274
health education campaign, 177
hypersomnia, 85, 87
insomnia, 77, 265
medication safety issues, 65, 78, 87, 100
mood disorders, 63, 79, 108, 143
motor vehicle accidents, 148
narcolepsy, 82, 85, 87
nightmares, 91
obesity, 74
OSA, 72, 74
psychological and social pressures, 142
quality of life, 153
research programs, 186
RLS, 98
school start times, 143, 266
sleep deprivation, 46, 57, 60, 61, 63, 142-144, 210
sleep-disordered breathing, 56, 74
sleep-onset abnormalities, 79
sleep patterns, 46-47, 48, 142, 143
sleep requirements, 46, 57, 142
Adults
advanced sleep phase syndrome, 110
alcohol use, 63
cognitive impairment, 146-147
mood disorders, 63
parasomnias, 88
obesity, 59-60, 61
OSA, 61, 66
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periodic limb movement, 100
sleep-disordered breathing, 146-147
sleep loss, 57, 59, 60, 63, 206
sleep patterns, 47, 48
Advanced sleep phase syndrome
etiology and risk factors, 109, 110
genetic factors, 260
manifestations and prevalence, 107, 110
treatment, 110-111
African Americans, 74, 97, 142, 162, 205, 263
Age/aging.
See also Adolescents;
Adults;
Children;
Infants;
Older adults
and impacts of sleep loss, 60
Agency for Healthcare Research and Quality (AHRQ), 10, 209, 225, 229, 285, 366
Alcohol consumption/abuse, 23, 59, 63, 73, 80, 81, 91, 97, 148, 158, 159, 184, 352
Alertness, 48, 65, 142, 151
Alzheimer’s disease, 91-92, 93, 155, 262
Ambulatory technologies. See Portable monitoring and therapeutic devices
American Academy of Pediatrics, 75, 180
American Academy of Sleep Medicine (AASM), 2, 22, 26, 29, 67, 177, 179, 187, 188, 218, 219, 221, 224-225, 243, 296, 318
accredited fellowship training programs, 192-196, 314
Medical Education Committee, 189
membership, 235
mentoring program, 249
Pfizer Scholars Grant Program in Sleep Medicine, 244
standards for sleep centers, 312-313
Taskforce 2000, 188
American Association of Medical Colleges, 319
American Board of Internal Medicine, 198, 199, 297, 315
American Board of Medical Specialties, 9, 22, 191, 198-201, 202, 296, 315
American Board of Otolaryngology, 190, 198, 297, 315
American Board of Pediatrics, 190, 198, 297, 315
American Board of Psychiatry and Neurology, 198, 297, 315
American Board of Sleep Medicine, 9, 196, 314-315
credentialing nonphysicians, 200-201, 202
certification examination, 197-198
establishment of, 198-201
American College Athletic Association, 185
American College of Chest Physicians, 225, 243
American Diabetes Association, 243
American Heart Association, 243
American Lung Association, 243
American Medical Association, 189
American Professional Sleep Societies, 22
American Sleep Apnea Association, 22, 177
American Sleep Disorders Association. See American Academy of Sleep Medicine
American Sleep Medicine Foundation, 244
Faculty Career Advancement Award, 243
American Thoracic Society, 225, 243, 248
Analysis of NIH grants
clinical, basic, and circadian rhythm projects, 270, 272
for device development, 273
protocol, 269, 275-276
by research strategy, 271, 273
review panel composition, 274-275
RFAs and PAs, 268-268
sleep disorders, 270, 272-273
by species, 271, 274
temporal trends, 269-272
Antiarrhythmics, 104, 105
Anxiety and anxiety disorders, 59, 63, 79, 81, 82
Appetite, 60-61, 72, 267
Arousal from sleep.
See also Sleep-wake regulation
disorders of, 82, 88-90
forced, 88
and myocardial infarction risk, 38
neurological systems, 76, 82
raphe magnus “off” cells, 101
response to respiratory resistance, 39
sleep-disordered breathing and, 65, 71
thresholds, 35-37, 47
Arrhythmias, 65, 69, 74
Asians, 162
Associated Professional Sleep Societies, 177, 186
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Association of SIDS and Infant Mortality Programs, 180
Asthma, 74, 106, 223-224, 235, 352
Attention-deficit/hyperactivity disorder (ADHD), 22, 98, 100, 145, 146, 221, 335
Attention deficits, 100, 138, 141-142, 145, 147
Attitudes about sleep and sleepiness, 174-175
Automobile accidents. See Motor vehicle accidents
Awareness. See Public awareness of sleep disorders
B
Back to Sleep campaign, 180-181
Bacterial infections, and sleep, 102
BEARS pediatric screening tool, 190, 336
Behavior
aggressive, 91
obstructive sleep apnea and, 22, 145-146
oppositional, 100
REM sleep behavior disorder, 90
risk taking, 142
sleep loss and, 63, 142
violent, 88
Behavioral Risk Factor Surveillance System, 152, 203, 208-209
Blood pressure, 38, 63, 68, 69, 70.
See also Hypertension
Body Mass Index (BMI), 60, 336
Brain.
See also individual structures
activity during sleep, 21, 35, 36, 37, 39
blood flow and metabolism, 39, 80, 142, 227
emotional pathways, 80
imaging of cognitive impairments, 142
iron deficiency, 98-99, 227, 262
metastases, 103
pain circuitry, 101
sleep-wake regulation processes and structures, 40-41, 43, 76-77, 80, 101
suprachiasmatic nucleus, 39, 42-43, 261
Breathing. See Respiratory activity;
Sleep-disordered breathing
C
Caffeine, 65, 106
California Technology Assessment Forum, 226
Cancer, and sleep problems, 101, 103, 105, 106
Cardiovascular activity during sleep, 38
Cardiovascular disease
childhood sleep disorders and, 70, 266
education campaigns, 179, 181
OSA and, 68, 69-71, 72, 74, 263-264, 266
sleep loss and, 21, 25, 28, 59, 62-63
treatment-related sleep problems, 104-105
Career development in sleep research.
See also Professional training
advances since 2003 research plan, 267
barriers to, 237-238
career training (K) awards, 238-242, 248, 250, 251, 275-276, 339, 360-367
K12 Multidisciplinary Clinical research Training Program, 241, 247, 248
mentors and mentoring, 6, 234, 237, 238, 242, 246, 248-250, 296, 361, 363, 364, 365, 366, 367
midcareer, 238, 248, 250, 364, 366
model support programs, 244-245
NIH support, 5-6, 25, 234, 238, 238-246, 339, 360-367
opportunities to accelerate, 247-251
professional organization and
foundation support, 243-245, 247, 248
public awareness/education and, 237
recruiting and retaining trainees, 237, 238, 278-279
Caregivers, 154-155
Cataplexy, 83, 85, 86, 87, 103
Catching up on sleep, 64
Catecholamines, 71, 336
Caucasians, 97, 142, 162
Center of Scientific Review, 275, 276
Centers for Disease Control and Prevention, 5, 347
educational activities, 7, 176, 177-178, 179, 180, 182, 257
sleep-related research, 257, 276, 277
surveillance, 8, 57, 203, 204, 208, 209, 210, 257, 285
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Centers for Medicare and Medicaid Services, 209
Central nervous system tumors, 85
Central sleep apnea, 73, 74, 75, 262, 336
Cerebral blood flow, 39
Cerebrospinal fluid hypocretin-1 (orexin-A), 83, 84, 85, 86, 87, 262
Children
academic performance, 145, 146
ADHD, 22, 98, 100, 145, 146, 221
cardiovascular disease risk in adulthood, 70, 266
cognitive deficits, 145
diagnostic technologies, 220, 221, 227
epilepsy, 94
grants for research on, 274
insomnia, 265
medication safety issues, 65, 78, 87, 100, 265
narcolepsy, 87, 175
nightmares, 91
obesity, 61
OSA, 22, 61, 66, 68, 70, 71, 74, 75, 145-146, 153, 156, 227, 263, 265, 266, 352
parasomnias, 88, 89, 91
periodic limb movement, 100
quality of life, 153
sleep deprivation and sleep disorders, 154-155, 353
sleep patterns, 46, 48
sleepwalking, 89
snoring, 145, 266
tonsillar hypertrophy, 70, 71, 74, 146
utilization of health care, 156
CHQ-PF50, 153, 336
Circadian phase advance, 80
Circadian rhythm
age and, 44-45, 46, 47, 49, 261
defined, 41, 336
development, 44-45, 46
function, 41
gender differences, 47-48
grants for research, 270, 272, 275
and metabolism, 61-62
molecular mechanisms, 41-42, 261
and motor vehicle accidents, 148
neurobiology research advances, 260-261
and obesity, 261
shift work and, 58, 109, 261
sleep disorders, 21, 82, 107-111
sleep-wake regulation, 39-40, 41
sleeping sickness and, 104
suprachiasmatic nucleus and, 42-43, 261
and thermoregulation, 43, 45, 47, 106
Clinical Fellowship Program, 245
Clock genes, 41, 42-43, 101, 109, 110, 237, 261
Cognitive deficits
brain imaging studies, 142
disasters, fatigue-related, 20, 138
measuring, 137, 141-142
and medical errors, 138, 139-140, 144-145
OSA and, 145-146, 263, 266
sleep-disordered breathing, 65, 146-147
sleep loss and, 138-142, 145
Cognitive therapy, 78, 336
College students
premed, 185, 187
recruitment for sleep research, 185
sleep disturbances, 176, 184
sleep education programs, 184-185
Colorectal cancer screening campaign, 177-178, 180
Commission on Collegiate Nursing Education, 9, 202
Confusional arousals, 88-89, 336
Congenital central hypoventilation
syndrome, 265-266
Congestive heart failure, 65, 69, 74, 95, 152
Continuous positive airway pressure (CPAP) therapy, 68, 70, 71, 72, 75, 96, 147, 151, 153, 154, 156-157, 161, 177, 218, 228, 264, 295, 298, 299, 314
Coronary artery disease, 65, 69, 70
Corticosteroids, 43, 106, 337
Cortisol, 45, 47, 71, 76, 104
Council of Graduate Schools, 246
Council on Education for Public Health, 9, 202
CPAP. See Continuous positive airway pressure
Cystic Fibrosis Foundation, 244, 245
Cytokines, 71, 105, 106
D
Dartmouth Sleep Knowledge and Attitude Survey, 190
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Delayed sleep phase syndrome
etiology and risk factors, 109, 266
genetic factors, 260
interventions, 143
manifestations and prevalence, 83, 107, 108-109
treatment, 109-110, 143
Dementias, 91-93
Dental and orofacial pain, 101
Dental appliances, 75
Department of Commerce, 5, 277, 347
Department of Defense, 5, 257, 276, 277, 347
Department of Education, 5, 179, 277, 347
Department of Energy, 355
Department of Health and Human Services, 204, 258
Department of Labor, 5, 179, 257, 276, 277, 347
Department of Transportation, 5, 179, 257, 276, 277, 347
Department of Veterans Affairs, 208, 219, 257, 258
Depression
adolescents, 63, 79, 143
cancer and, 103, 105
dementias and, 91
and hypersomnia, 85, 87, 296
insomnia and, 23, 77, 79, 80, 81-82, 103, 265
older adults, 48
periodic limb movement and, 100
and quality of life, 152
REM sleep characteristics, 79
sleep loss and, 2, 28, 56, 57, 59, 63, 143, 175, 184
Diabetes
OSA and, 65, 71-72, 74
and quality of life, 153
sleep loss and, 2, 21, 25, 28, 56, 59, 61-62, 267
type 2 defined, 344
Diagnosis of sleep disorders
access to, 9, 218
accreditation criteria, 28
actigraphy, 82, 83, 221, 227
apnea-hypopnea index, 66, 67, 223, 335
circadian rhythm disorder, criteria for, 107-108
comorbid psychiatric disorders and, 80-81
costs, 157, 160-161, 219, 307
demand for, 9, 218
evaluating daytime sleepiness, 226-227
future directions, 228-229
genetic and biochemical tests, 227
hypersomnia, 84, 86, 226
imaging technologies, 227
insomnia, criteria for, 75-76
International Classification of Sleep Disorders, 56, 86, 104, 107-108, 262
microstructural cyclic alternating patterns analysis, 227
MSLT, 82, 83, 84, 85, 86, 226-227
MWT, 227
narcolepsy, 83, 84, 86, 226, 262
OSA, 65, 67, 83, 160-161
polysomnography, 9, 26, 68, 70, 71, 83, 157, 218, 219, 223, 227
portable tools, 26, 218-223
reimbursement for, 28
revenues from, 310
RLS, 227
scoring and processing of sleep studies, 224-225, 309-310
sleep logs, 82, 83, 227
spectral analysis, 227
survey of trends, 208
telemonitoring from sleep centers, 228
video technologies, 227
waiting time for patients, 26, 218, 303, 307
Disasters, fatigue-related, 20, 138
Disease mortality, 63-64
Dissociative disorders, 89, 342
Dopamine, 40, 41, 87, 98-99, 261, 262
agonists, 90, 99, 100
antagonists, 99
Dreams/dreaming
and muscle atonia, 38, 90
nightmares, 46, 90, 104
sleep stage and, 21
vivid, 38, 104
Drug abuse, 23, 81, 91, 97, 184, 270
E
Eating disorders, 23, 84, 89, 342
Economic impacts
direct costs, 2, 157, 159-161
indirect costs, 108, 158, 160, 161
insomnia, 156, 159-160
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motor vehicle accidents, 158
narcolepsy, 162
obstructive sleep apnea, 156-157, 160-162
productivity losses, 21, 108, 158
utilization of health care, 2, 21, 155-157
Education on sleep disorders. See Medical education in somnology;
Professional training;
Public education
Elderly people. See Older adults
Electrocardiography, 69
Electrooculography, 69, 139, 337
Electroencephalography (EEG), 21, 34, 35, 36, 40, 43, 69, 103, 186, 337
Electromyography, 69
End-stage renal disease, 98, 99, 105-106, 296
Endocrine function, 39
Endothelial dysfunction, 68
Entertainment Industry Foundation, 178
Enuresis, 89
Epilepsy, 93-95, 337, 340
Epworth Sleepiness Scale, 154, 155, 337
Exploding head syndrome, 89, 337
Exploratory Center award, 281
F
Falls, 150, 160
Familial/genetic factors, 73, 74, 77, 79, 85, 87, 90, 94, 97, 98, 109, 110, 260, 261, 262, 263, 265-266
Fatigue, 20, 79, 95, 100, 104, 105, 149, 353
Fellowship (F) awards, 238, 239, 250, 275-276, 337-338, 371-372
Fogarty International Center, 255, 355, 359
Folate deficiency, 98
Francis Fellowship Program, 244
G
Garfield Star Sleeper Campaign, 176
Gastric bypass surgery, 72, 98
Gender differences
insomnia, 76, 77
OSA, 66
REM sleep disorders, 90
RLS, 98
SIDS, 97
sleep patterns, 47-48, 142
thermoregulation, 48-49
Generalized anxiety disorder, 79, 338
Genetic disorders, 85
Genetic factors. See Familial/genetic factors
Ghrelin, 60, 267
Grants for sleep research. See National Institutes of Health
Glucose metabolism
and AHI threshold, 223
circadian rhythm and, 42
CPAP and, 71
OSA and, 65, 71-72
sleep loss and, 59, 61-62, 63
Grants for sleep research. See National Institutes of Health
Growth hormone, 39, 104
H
Harvard University, 187, 236, 239, 298, 376-377
Harvard Work Hours Health and Safety Study, 139
Head trauma, 85, 87
Health care professionals.
See also Professional training
attraction to sleep field, 183
awareness about sleep disorders, 182-183
board certification in sleep medicine, 197-201, 298, 314-315
Health insurance coverage, 28, 209, 219, 315
Healthy Sleep Handbook, 176
Heart attack. See Myocardial infarction
Hemodialysis, 105
Hispanics, 205
HIV/AIDS, 103, 353
Homeostatic sleep pressure, 47, 49
Hormone replacement therapy, 74
Human Brain Project, 355
Huntington’s chorea, 91, 262
Hyperactivity, 106
Hyperarousal, 265
Hypercapnia, 72
Hypersexuality, 84
Hypersomnia
defined, 83, 338
diagnosis, 226
etiology and risk factors, 85, 87
grants for research, 270, 272-273
idiopathic, 82, 84, 86, 87, 272-273
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labeling and stigmatization of individuals, 175
manifestations and prevalence, 82, 84-85, 86, 87
and mortality risk, 74
neurological disorders and, 92, 296
with normal sleep length, 84, 86, 87
OSA and, 65, 66, 68
periodic, 84, 86, 87
and periodic limb movement disorder, 100
with prolonged sleep time, 84, 86, 87
and psychiatric disorders, 78-79, 80-81, 85, 87, 296
secondary, 85, 86, 88, 100, 105
sleep attacks, 93
treatment, 80-81, 87, 94-95
and work-related injuries, 150
Hypertension, 2, 21, 25, 56, 59, 62, 65, 66-69, 70, 74, 95, 180, 181, 223, 338
Hypnagogic/hypnopompic hallucinations, 84, 87, 89, 338
Hypnotic drugs, 77-78, 96, 150, 158, 160, 265, 338
Hypocretin (orexin), 41, 85, 87, 101, 261, 262, 338
Hypolipidemic drugs, 104-105
Hypomania, 106
Hypoperfusion, 74
Hypothalamic-pituitary-adrenal axis, 71, 76
dysregulation, 80, 82
Hypothalamus, 40, 41, 43, 85, 101, 103, 261
Hypoventilation, 38
Hypoxemia, 71, 72, 145, 147
Hypoxia, 71, 74, 263-264, 338, 353
Hypoxic ventilatory response, 39
I
Immune response, 102
Immunologic disorders, 106
Infants
congenital central hypoventilation syndrome, 265-266
low birth weight, 97
newborns, 35, 44-45, 261
premature, 74, 97, 146
SIDS, 96-97, 180-181, 265
sleep patterns, 35, 44-45, 47-48
Infectious diseases, and sleep, 102-104
Inflammatory disorders, 85
Insomnia
brain imaging studies, 265
circadian rhythm disruptions and, 108
comorbid sleep disorders, 295
defined, 338
and depression, 23, 77, 79, 80, 81-82, 103, 265, 296
deterrents to seeking help, 175
economic impacts, 155, 156, 157, 159-160
etiology and risk factors, 23, 40, 76-77, 100
and fall risk in older people, 150, 160
grants for research, 270
human leukocyte antigen DQB1*0602, 83, 85, 86
manifestations and prevalence, 2, 20, 58, 75-76, 159
medications and, 99, 103, 104-105, 106, 150, 159
narcolepsy and, 84
NIH State-of-the-Science Conference, 265
pain and, 101
psychiatric disorders and, 77, 79, 80, 81-82, 156, 159
and quality of life, 75, 152-153
sleeping sickness and, 103
stroke and, 95
treatment, 23, 65, 77-78, 96, 150, 265
undiagnosed and untreated cases, 218, 294-295
utilization of health care, 155, 156, 159
and work-related injuries, 149
Institutional National Research Service Award, 354
Insulin resistance, 71, 72, 264
Intelligence quotient, 145, 146
Interdisciplinary research, defined, 27, 28, 298
Interdisciplinary sleep programs, academic.
See also Sleep centers and laboratories
accreditation and certification, 28, 312-315, 318, 321
administrative jurisdictions, 301
approach, 27-28, 296-303
Centers of Excellence, 11-12, 278-282, 283
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chronic disease management model, 28, 304, 321
consortia, 185, 187
constraints on, 26-28, 300-303
diagnosis-treatment linkages, 28, 303-305
direct costs, 307-309
education and training, 304
examples of approaches, 299
grants, 318, 370
guiding principles, 11, 14-16, 305-306
health insurance coverage, 315
institutional reward system and, 301
key components, 303-306
knowledge base, 26, 296
leadership, 305
macrostructure, 310-311
microstructure, 311
network participation, 12-13, 282, 284, 305, 320
next steps, 315-321
obstacles, 27, 301-302
organizational structures, 13-14, 27-28, 310-311, 312, 316-320
and quality of care, 27
rationale for, 26-28, 294-300
recommendations, 14, 319, 321
research component, 304-305
revenue generation and fiscal independence, 28, 305-310, 311-312
staffing, 298-300, 302-303, 307
transparent policies and procedures, 306, 311
Type I clinical program, 13, 15-16, 279, 284, 316, 317, 319-320
Type II training and research program, 13, 15-16, 200, 284, 316, 317, 318, 320
Type III regional program, 13-14, 15-16, 200, 284, 316, 317, 318, 320
International Classification of Sleep Disorders, 56, 86, 104, 107, 262
Internet, 21, 58
Interventions.
See also Treatment effectiveness of, 150-151
Iron deficiency, 98, 262, 295-296
Irregular sleep schedules, 58
Irregular sleep-wake disorder, 107
Irritability, 79, 108, 184
J
Jet lag, 58, 107
K
K awards. See Career development in sleep research
K complexes, 36, 38
Kleine-Levin syndrome, 84, 86, 87, 273, 340
L
Learning and vocabulary, sleep loss and, 140, 145, 146, 184, 264
Leptin, 60, 72, 267, 340
Lewy body disease, 92, 262, 296
Light-dark cycle, 39, 40, 43
Light exposure, 47, 76, 109, 110, 143
M
Magnetic resonance imaging, 186, 227, 340
Maintenance of Wakefulness Test (MWT), 227
Maternal and Child Health Bureau, 180
Median thalamic stroke, 85
Medical disorders and sleep.
See also individual disorders
cancer, 103, 105
grants for research, 270
infectious diseases, 102-104
pain, 100-101
treatment-related effects, 104-106
Medical education in somnology.
See also Professional training
accreditation and certification, 189, 190, 191-192, 196, 197-201, 202
barriers to curriculum implementation, 25, 188
evaluation of effectiveness of, 188, 189-190
inadequacy of, 187-188
multidisciplinary learning environment, 189, 192, 193, 202
nurses as care managers, 190-191
overview, 187-191
residency training curricula, 191-192
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Sleep Academic Award program, 189-190, 240, 241, 352
undergraduate education, 185, 187
workforce shortages, 192
Medical errors, sleep loss and, 138, 139-140, 144-145, 266
Medical Expenditure Panel Survey, 203, 206, 209
Medical residents
medical errors, 138, 139-140, 144-145
motor vehicle accidents, 149
restriction of work hours, 25, 139, 189
somnology training curricula, 191-192
Medicare Current Beneficiary Survey, 205, 209-210
MEDSleep, 25, 189
Melatonin, 39, 43, 45, 47, 49, 104, 106, 109-111, 159, 340
Memory, 36, 38, 57, 100, 138, 140, 147, 184
Menopause and menopausal symptoms, 74, 105
Menstruation, 48, 84
Metabolic syndrome, 261, 266, 295, 353
Microsleeps, 138
Microstructural cyclic alternating patterns analysis, 227
Modafinil, 65, 87, 93, 266
Molecular Biology and Genetics of Sleep and Sleep Disorders, 352
Monitoring. See Sleep monitoring
Mood, sleep loss and, 23, 48, 63, 65.
See also Anxiety and anxiety disorders;
Depression
Mortality
falls in older people, 150
RLS and, 99
SIDS, 181
sleep-disordered breathing and, 74-75, 264
survey, 206
work-related fatalities, 150
Motor vehicle accidents, 2, 21, 56, 147-149, 158, 160, 161, 266
Movement disorders.
See also Periodic limb movement disorder;
Restless legs syndrome
neurological disorders and, 92
Multidisciplinary research, defined, 27, 28, 298
Multiple sclerosis, 85
Multiple Sleep Latency Test (MSLT), 82, 197, 199, 226-227, 340
Multiple systems atrophy, 90, 93
Muscular Dystrophy Cooperative Research Centers, 283
Musculoskeletal disorders, 101
MWT. See Maintenance of Wakefulness Test
Myocardial infarction, 2, 38, 56, 60, 62, 69, 70, 95, 153
Myotonic dystrophy, 85
N
Naps/napping, 64, 83, 84, 87, 151, 226
Narcolepsy
and academic performance, 82
and accidents and injuries, 147
with cataplexy, 83, 85, 86, 87, 262, 336
without cataplexy, 85-87, 272
comorbid sleep disorders, 295
defined, 340
diagnosis, 226, 227, 262
economic impacts, 155, 162
etiology and risk factors, 85-87, 237
grants for research, 270, 272
manifestations and prevalence, 34-35, 82-85, 86
and periodic limb movement disorder, 100
and quality of life, 151-152
secondary, 85, 86
and stigma, 175
treatment, 23, 87
undiagnosed and untreated cases, 218, 294-295
National Aeronautics and Space Administration (NASA), 355
National Ambulatory Medical Care Survey, 207
National Association of Student Personnel Administrators, 185
National Cancer Institute (NCI), 255, 278-280, 283, 352, 354, 355, 359, 366
National Center for Complementary and Alternative Medicine (NCCAM), 255, 355, 359, 365
National Center for Health Statistics (NCHS), 57, 203, 204, 206
National Center for Medical Rehabilitation Research, 268, 283
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National Center for Research Resources (NCRR), 354, 365, 366
National Center on Sleep Disorders Research (NCSDR), 22, 256-258
advisory board to, 3, 5, 257, 258-259, 276-277, 345-350
budget, 257
educational materials, 176
establishment, 24, 175, 254, 256, 345
funding, 24, 355
information collection and dissemination, 347
leadership, 3
mission, 24, 256-257, 345
public education campaigns, 7, 175-176, 179, 180, 182, 347
recommended role, 4-5, 7, 8, 10, 277
research plans, 2, 29, 259-267, 347
RFA, PA, 239, 256, 268-269, 274, 275-276
Sleep Academic Award, 189
strengthening, 4-5, 276-277
technology evaluation and validation, 229
National Colorectal Cancer Research Alliance, 178
National Death Index, 206
National Eye Institute (NEI), 24, 255, 354, 357, 358, 366
National Health and Nutrition Examination Survey (NHANES), 203, 204, 205, 211, 257
National Health Care Survey, 203, 206-208
National Health Interview Survey, 57, 203, 204-206, 211
National Heart, Lung, and Blood Institute (NHLBI), 12, 22, 23, 24, 25, 175, 180, 181, 189, 204, 211, 240, 241, 255, 256, 257, 258, 273, 274, 275, 283, 352, 353, 354, 355, 358, 364, 365, 366, 367
National High Blood Pressure Campaign, 180
National Hospital Discharge Survey, 207-208
National Human Genome Research Institute (NHGRI), 23, 354
National Immunization Survey, 203
National Institute for Occupational Safety and Health (NIOSH), 352, 355, 359
National Institute of Allergy and Infectious Diseases (NIAID), 23, 255, 354, 355, 359
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 255, 283, 353, 354, 355, 359
National Institute of Child Health and Human Development (NICHD), 22, 180, 255, 258, 268-269, 273, 283, 352, 353, 354, 355, 359, 365, 366
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 23, 255, 353, 359, 365, 366
National Institute of Dental and Craniofacial Research (NIDCR), 23, 352, 353, 355, 359
National Institute of Environmental Health Sciences (NIEHS), 23, 352, 355
National Institute of General Medical Sciences (NIGMS), 255, 357, 358, 366
National Institute of Mental Health (NIMH), 22, 23, 24, 186, 240, 255, 258, 273, 274, 352, 353, 354, 355, 358, 365, 366
National Institute of Neurological Disorders and Stroke (NINDS), 22, 23-24, 255, 258, 274, 283, 352, 354, 355, 358, 365, 366
National Institute of Nursing Research (NINR), 23, 255, 353, 354, 355, 358, 365
National Institute on Aging (NIA), 22-23, 255, 258, 274, 352, 353, 354, 355, 358, 365, 366
National Institute on Alcohol Abuse and Alcoholism (NIAAA), 23, 255, 352, 354, 355, 358, 366
National Institute on Deafness and Other Communication Disorders (NIDCD), 24, 255, 352, 354, 355, 359
National Institute on Drug Abuse (NIDA), 23, 255, 353, 354, 355, 358
National Institutes of Health (NIH), 22
career development awards, 240-241
conference on insomnia, 265
coordination of sleep research, 2, 254-259;
see also National Center on Sleep Disorders Research;
Trans-NIH Sleep Research Coordinating Committee
Exploratory Center award, 281
grants for sleep research, 24, 25, 222, 235-236, 254, 267-276, 351-355
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Institutional Clinical and Translational Science Award, 282
leadership in somnology research and training, 3-5, 17
loan repayment policies, 247
new career award support, 241-242
Office of Behavioral and Social Science Research, 23
Office of Research on Women’s Health, 355
roadmap initiatives, 14, 241, 242, 247, 285
Science Conference on the Manifestations and Management of Chronic Insomnia, 77
technology development grants, 222, 229
training awards, 200, 238-240
National League for Nursing, 9, 202
National Library of Medicine (NLM), 354, 355
National Occupational Research Agenda, 352
National Research Service Award Institutional Training Grants, 238
National Safety Council, 161
National Sleep Foundation (NSF), 2, 22, 29, 148, 176-177, 179, 355
Pickwick Club Award, 243, 244
National Sleep Public Education and Awareness Campaign, 178-182
National Sleep Awareness Week, 176-177
National Somnology and Sleep Medicine Research and Clinical Network, 7, 12-13, 14, 179, 279, 282-285, 320
National Survey of Family Growth, 206
National Transportation Safety Board, 149
Native Americans, 97
NCSDR. See National Center on Sleep Disorders Research
Neurological disorders with sleep abnormalities
Alzheimer’s disease, 91-92, 262
epilepsy, 93-95
grants for research, 270
multiple system atrophy, 90
Parkinson’s disease, 85, 90, 92-93, 262
spinal cord damage, 101
stroke, 95-96
Nicotine dependence, 81, 97
Nightmare disorder, 89, 90-91, 340
NIH. See National Institutes of Health
Nocturnal frontal lobe epilepsy, 94
Non-rapid-eye-movement (NREM) sleep
arousal disorders, 88-90
brain activity, 21, 35, 36, 40
continuous spike wave epilepsy, 94
cycles, 35
defined, 340
disorders of, 34-35
physiological changes, 37, 38
stages, 21, 34, 35-37, 343;
see also Slow-wave sleep
Nonentrained sleep-wake syndrome, 107
Nonsteroidal anti-inflammatory drugs, 106
Nurses and nurse practitioners
medical errors, 145
role in interdisciplinary programs, 298-300
somnology education, 183, 185, 187, 190-191
Nurses Health Study, 61, 62, 71
O
Obesity
education campaign, 177, 179
and hypertension, 66
hypoventilation syndrome, 264-265
and OSA, 61, 66, 72, 160-161, 263, 295
sleep loss and, 2, 21, 25, 56, 59-61, 267
stigma of, 175
utilization of health care, 161
Obstructive sleep apnea (OSA)
advances in research, 263, 265, 266
age/aging and, 66, 73, 263
alcohol use and, 73
Alzheimer’s disease and, 91, 262
apnea-hypopnea index, 65, 66, 67, 69, 71, 148, 220
and cardiovascular disease and stroke, 69-71, 72, 74, 263-264
in children, 22, 61, 66, 68, 70, 71, 74, 75, 145-146, 153, 156, 263, 265, 266, 352
comorbid sleep disorders, 295
defined, 340
developmental, behavioral, and cognitive effects, 145-146
and diabetes and glucose tolerance, 70, 71-72, 74
diagnosis, 65, 67, 83, 160-161, 225
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economic impacts, 156-157, 160-162
etiology, 72-73
familial/genetic factors, 73, 74, 97
gender differences, 66, 73-74
grants for research, 268
and hypertension, 66-69, 74
manifestations and prevalence, 2, 20, 66, 178, 263
and motor vehicle accidents, 148, 161, 219, 263
obesity and, 61, 66, 72, 73-74, 160-161
and periodic limb movement disorder, 100
portable monitoring equipment for, 220, 225
and quality of life, 153
race and, 66, 73, 74, 161-162, 263
research, 23
risk factors, 73-74, 91
and SIDS risk, 97
socioeconomic status and, 161-162
training requirements for health professionals, 183
treatment, 23, 26, 68, 75, 151, 153, 156-157, 264
and sudden death, 74
undiagnosed and untreated cases, 218
utilization of health care, 156-157, 161
Occupational safety and health.
See also Work
regulation, 150-151
research, 355
Occupational Safety and Health Administration, 257
Older adults
advanced sleep phase, 260
education campaigns, 176
falls, 150
grants for research on, 274
insomnia, 76, 77, 160
neurological disorders, 92
OSA, 66, 68, 73, 154, 263
periodic limb movement disorder, 100
portable monitoring equipment for, 220
quality of life, 154
REM sleep disorders, 90
RLS, 98
sleep patterns, 22-23, 47, 48-49
OSA. See Obstructive sleep apnea
Oxidative stress, 68, 263-264
P
Pain, and sleep problems, 100-101, 105
Parasomnias
defined, 341
grants for research, 270, 272
manifestations and prevalence, 88
NREM sleep arousal disorders, 88-90
psychiatric disorders and, 79
and quality of life, 152
REM sleep disorders, 90-91
treatment, 96
Parker B. Francis Fellowship Program, 244
Parkinson’s disease, 85, 90, 92-93, 262, 296
Pathway to Independence Award program, 242
Performance problems, 2, 82, 108, 142-144, 145, 146-147, 154, 158, 160, 184, 266.
See also Cognitive deficits
Periodic limb movement disorder, 2, 20, 92, 98, 100, 220, 223, 273, 295, 355
Periodic limb movement index, 223
Physical activity education campaign, 177
Physicians. See Health care professionals
Polysomnography, 26, 68, 70, 71, 83, 139, 146, 157, 341
Portable monitoring and therapeutic devices
challenges to developing, 222-228
cost-effectiveness, 157, 221
evaluation of effectiveness, 10, 225-226, 273
feasibility and quality, 220-222, 228
future directions, 228
rationale for, 9, 218-220, 228
validation of, 26, 222-224, 273
Posttraumatic stress disorder, 91, 257
Prader-Willi syndrome, 85, 341
Pregnancy and postpartum period
RLS, 48, 98, 296
sleep patterns, 48
substance abuse, 97
Process C, 39-40
Process S, 39-40
Professional training.
See also Medical education in somnology
access to, 296
accreditation, 177, 192-197, 314
advances since 2003 research plan, 260, 267
awareness programs, 184-185
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board certification, 197-201, 314-315
challenges, 201
costs, 307-309
curriculum development, 6, 8-9, 183, 185-187, 202, 238, 240, 241, 296, 362
fellowship programs, 192-197, 198, 199, 200, 238, 240, 242, 243, 244, 296, 314, 337-338, 371-372
funding, 5, 6, 186, 200, 201-202, 343- 344, 362, 369
graduate research programs, 8-9, 187, 189, 373
improvement strategies, 248-250
integration with other programs, 8, 249-250
interdisciplinary approach, 25-26, 183, 187, 247, 249-251
leadership skills, 240, 241
limitations of current programs, 27, 160 182-183
next steps, 201-202
NIH awards, 25, 238-240
pooling funds for, 241
recommendations, 6, 8-9, 202, 250-251
remote mentoring programs, 248-249
requirements, 182-187
revenues from, 311
tools and products, 25, 202
undergraduate education, 8-9, 183, 184-187, 373
workforce shortages, 192, 296
Program (P) awards, 281, 340-341, 352, 355, 370
Psychiatric disorders with sleep disturbances
database, 208
economic costs, 159
etiology and risk factors, 80
grants for research, 270, 272
insomnia, 77, 78, 81-82, 156, 159, 296
manifestations and prevalence, 78-79, 208, 295
parasomnias, 79
treatment, 80-81
utilization of health care, 156, 175
Psychomotor vigilance task, 142
Public education
absence of sleep content, 175
awareness of sleep disorders, 2, 20, 22, 26, 29, 175, 234
Back to Sleep program, 97, 180-181
CDC activities, 177-178, 257
celebrity spokespersons, 178
for college students, 185
coordinating activities, 179, 180, 181
costs and challenges, 180
curriculum supplements for children and adolescents, 176, 177, 234
evaluation of effectiveness, 176, 179
focus and role, 178-179
grants, 177
integrating with other public health campaigns, 179, 185
multimedia campaigns, 177, 178-182
National High Blood Pressure Education Program, 181
National Sleep Awareness Week, 176-177
National Sleep Public Education and Awareness Campaign, 178-182
NCSDR campaigns, 175-176
private-foundation campaigns, 176-177
rationale for, 179
recommendations, 7, 182
strategies for strengthening, 176, 178-182, 184
Q
Quality of care
accreditation of sleep centers and, 313-314
certification of specialists and, 314-315
health insurance reimbursement and, 315
Quality of life
bed partners of individuals with sleep disorders, 153-154
measuring, 151, 152, 153, 154
sleep loss and, 48, 75, 147, 151-153, 184
R
Race/ethnicity
and OSA, 66, 73, 74, 161-162, 263
and SIDS, 97
and sleep patterns, 142
Rapid-eye-movement (REM) sleep behavior disorder, 84, 89, 90, 92, 93, 100, 262, 296, 342
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brain wave activity, 37, 40
characteristics, 37-38
cycles, 35
defined, 342
depression and, 79
discovery, 21
infections and, 102
and muscle atonia, 37, 38, 40, 45, 84, 335
nightmare disorder, 89, 90-91
onset of sleep during, 226, 227, 262
OSA and, 69
physiological changes, 37, 38-39
suppressants, 83, 105, 106
Reaction/response time, 138, 140, 141-142, 148
Recommendations
academic interdisciplinary sleep programs, 18, 319, 321
accreditation standards, 11, 321
career development, 6, 250-251
National Somnology and Sleep Medicine Research Network, 12-13, 14, 285
NIH leadership role, 3-5, 7, 8, 10, 17, 277
professional education and training, 6, 8-9, 17, 202, 250-251
public education campaign, 7, 17, 182
sleep laboratories, 10-11, 286, 321
summary of, 17-18
surveillance and monitoring, 7-8, 17, 212
technology development, 10, 18, 229
REM. See Rapid-eye-movement sleep
Renal disease, treatment-related sleep problems, 105-106
Research. See Somnology and sleep medicine research
Research (R) awards, 234, 235, 236, 242, 255, 269-272, 273, 275-276, 296, 341-342, 352, 353, 354, 355, 356-359, 369
Respiratory activity, 38-39
Restless legs syndrome (RLS)
and accidents and injuries, 147
and ADHD, 22
defined, 342
diagnosis, 227
etiology and risk factors, 48, 98-99, 100, 105, 262
grants for research, 270, 273
manifestations and prevalence, 2, 20, 97-98, 295-296
pain and, 101
periodic limb movements and, 100
and quality of life, 152, 153
research grants, 355
treatment, 99-100
Restless Legs Syndrome Foundation, 22, 177
Rheumatologic disorders, 106
S
Schizophrenia, 80
Science Conference on the Manifestations and Management of Chronic Insomnia, 77
SCOR in Neurobiology of Sleep & Sleep Apnea, 352
Screen for Life campaign, 177-178, 180
Serotonin, 40, 41
reuptake inhibitors, 87
SF-36 scale, 151, 154
Shift work
disorder, 20, 21, 57, 58, 64, 77, 107, 109, 266
economic impacts, 158
and motor vehicle crashes, 148-149
obesity and metabolic disorders, 261
personnel turnover and retraining, 158
prevalence, 257
public education campaigns, 176
SIDS. See Sudden infant death syndrome
Silvio O. Conte Centers to Develop Collaborative Neuroscience Research, 281
Sleep Academic Award program, 189-190, 240, 241, 352
Sleep apneas, 105.
See also Obstructive sleep apnea;
Sleep-disordered breathing
and accidents and injuries, 147, 148, 149, 150
AHI for defining, 223
defined, 342
demand for diagnosis and treatment, 219
diagnostic technologies, 222, 223
economic costs of, 157
grants for research, 270
and insulin resistance, 264
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and oxidative stress, 263-264
and psychiatric disorders, 208
and quality of life, 151-152
treatment, 151
Sleep architecture.
See also Non-rapid-eye-movement (NREM) sleep;
Rapid-eye-movement (REM) sleep
age-related changes, 43-49
brain activity, 34, 265
cancer and, 103
cycles, 35-36, 44, 45
defined, 34
iatrogenic effects of medical therapies, 104-106
infections and, 102-104
neurological disorders and, 90, 92
pain and, 101-102
physiological changes, 37, 38-39
pubertal development and, 46-47
sleeping sickness and, 103-104
social cues and, 45, 46
stroke and, 95
types of sleep, 34-35
Sleep centers and laboratories, 22
accreditation, 11, 26, 196, 313-314, 321
community-based, 219
costs, 219
funding, 281
learning experiences in, 188
lung function laboratories compared, 224
models for, 278-282
in NIH clinical research program, 285-286
number in U.S., 218
quality of care, 313-314
recommendation, 10-11, 286
staffing, 219, 224, 307
telemonitoring of hospital polysomnograms, 228
utilization, 26, 182
Sleep-disordered breathing, 82.
See also Obstructive sleep apnea
and accidents and injuries, 147
and ADHD, 100
advances in research, 263-265
apnea-hypopnea index, 67, 95, 263
bed partners of individuals with, 154
and cognitive impairment, 146-147
economic impacts, 155
etiology and risk factors, 72-75, 263
manifestations and prevalence, 56, 65-72, 74
and metabolic syndrome, 353
and mortality, 70, 74-75
and periodic limb movement disorder, 100
and quality of life, 154
treatment, 75, 96, 104
utilization of health care, 155
Sleep disorders. See Circadian rhythm;
Insomnia;
Medical disorders and sleep;
Narcolepsy;
Neurological disorders with sleep abnormalities;
Parasomnias;
Psychiatric sleep disorders with sleep disturbances;
Restless leg syndrome;
Sleep-disordered breathing;
Sleep loss and sleep disorders
Sleep drunkenness (inertia), 84, 342
Sleep Heart Health Study, 61, 67, 68, 69-70, 71, 161, 223, 264
data coordinating center, 352
Sleep hygiene training, 78, 155, 184, 342
Sleep in America poll, 177
Sleep loss and sleep disorders, general.
See also individual disorders
and academic performance, 142-144
access to care, 201, 294-295
adolescents, 142-144
and alcohol use, 63
animal studies, 21, 61-62
and cardiovascular morbidity, 62-63
challenges for individuals with, 174-178
cognitive effects, 138-142
cumulative effects, 2, 142
and diabetes, 61-62
effectiveness of interventions, 150-151
environmental factors, 143
etiology and risk factors, 34, 57-59
family and community effects, 153-155
fragmentation of sleep, 71, 147
and functional status, 151-152, 153-155
and glucose tolerance, 61-62
grants for research by type of, 270, 272-273
health effects, 2, 21, 25, 28, 56, 59-64
lifestyle and sociocultural factors, 174
management and treatment, 64-65
manifestations, 56, 57
and medical errors, 138, 139-140, 144-145
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and mood and behavior, 63
and mortality, 63-64
and obesity, 59-61
prevalence, 2, 20, 56, 57, 206
public health burden, 2, 56, 294
and quality of life, 48, 151-153
Sleep medicine. See Somnology and sleep medicine research
Sleep monitoring. See Portable monitoring and therapeutic devices
Sleep paralysis, 84, 87, 89, 90, 342
Sleep patterns
age and, 44-47, 142, 143
circadian rhythm disruption, 21
temporal distribution, 108
Sleep Research Society, 2, 22, 25, 29, 177, 235, 237, 249
Sleep Research Society Foundation, 177
Sleep restriction therapy, 77, 342
Sleep, Sleep Disorders, and Biological Rhythms, 176
Sleep spindles, 36, 186, 342-343
Sleep terrors, 89, 90, 227, 343
Sleep-wake regulation
brain processes and structures, 40-41, 43, 76-77, 80, 85, 92, 94, 261
iatrogenic effects of medical therapies, 104-106
immune system and, 102
phylogenetic studies, 261-262
two-process model, 39-40
Sleepiness, excessive daytime. See Hypersomnia
Sleeping sickness, 102-104, 335
Sleepwalking, 88, 89-90, 343
Slow-wave sleep
arousal disorders, 90
body temperature and, 43
characteristics, 36-37
defined, 343
depression and, 79
endocrine function, 39
infections and, 102
opioids and, 105
Small Business Innovation Research (SBIR) grants, 222
Snoring, 65, 66, 70, 73, 74, 99, 145, 150, 221, 266
Socioeconomic status
and insomnia, 160
and narcolepsy, 162
and OSA, 161-162
Somnology and sleep medicine research.
See also Career development in sleep research;
Interdisciplinary sleep programs
academic programs, 5, 235-236, 375-377
adolescents, 186
advances since 2003, 260-267
animal studies, 261-262, 271, 274, 352
basic, 23, 25, 240, 259, 261-262, 270, 272, 279, 282, 354
Basics of Sleep Research guide, 177
bias in studies, 59, 70, 74
Centers of Excellence, 278-282, 283
challenges, 6, 22-26
circadian rhythm, 260-261, 270, 272
clinical, 270, 272, 274, 279, 282, 285-286
collaborations, 28, 276, 277-278
coordination by NIH, 2, 3-5, 22-24, 186, 229, 240, 241, 244, 250, 254-256, 257-258, 267, 268, 275-276, 277, 357
defining, 2 n.1, 20, 23, 250, 342, 343
fellowship training, 192-197, 198, 199, 200
grants from NIH, 4, 200, 235-236, 254, 255, 256, 277, 282, 296, 340-342, 351-359, 368-373, 375-377;
see also Analysis of NIH grants
growth of field, 4, 22, 25, 234-238, 296
historical background, 21-22
human studies, 271, 274
insomnia, 265
interdisciplinary approach, 3-4, 6, 242, 254, 278-282, 297-300
investigator shortages, 2, 5, 6, 25-26, 27, 234, 296
knowledge base, 296
minorities in, 236-237
molecular/genetic studies, 262, 263, 271, 273
national network, 7, 14, 179, 279, 282-285, 320
neurobiology-related, 260-262, 352
next steps, 276-286
outlook for, 254, 267-268
pediatric sleep sciences, 265-266
phylogenetic approaches, 261-262
professional societies, 22, 235
recommendations, 4-5, 277, 283, 285-286
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resource allocation, 4-5, 26
sleep deprivation, 266-267
sleep-disordered breathing, 263-265, 352
sleep disorders, 262, 272-273
sleep laboratories, 285-286
technology development and assessment, 26, 273, 354
Standardized immobilization test, 227
Stigma of sleep disorders, 174-175
Stimulus control therapy, 78
Stress, 76, 77, 91, 94, 184, 222
Stroke, 93, 181, 262
and sleep architecture, 85, 95-96
sleep-disordered breathing and, 65, 69, 70, 95
sleep loss and, 56, 62
Sudden infant death syndrome (SIDS)
Back to Sleep campaign, 97, 180-181, 265, 273
etiology and risk factors, 96-97
grants for research, 273
manifestations and prevalence, 96
prevention, 97
Summer Research Institute, 249
Summer Sleep and Chronobiology Research Apprenticeship, 186, 248
Surveillance.
See also individual surveys
diagnoses of sleep disorders, 208
existing data systems and surveys, 203- 212, 257
importance, 203
incorporating new components in surveys, 210-211, 257
physicians’ role in, 191
questionnaire on sleep, 205
recommendations, 212
Sleep in America poll, 177
utilization of health care resources, 207-208
vital statistics, 206
Sympathetic nervous system activity, 38, 61, 63, 65, 68, 69, 71, 72, 73, 74
T
Technology development.
See also Portable monitoring and therapeutic devices
assessment criteria, 226
future directions, 228-229
grants for, 273
recommendation, 10, 229
Thermoregulation, 43, 45, 47, 48-49, 106
Time for Kids magazine, 176
Tonsil enlargement and tonsillectomy, 70, 71, 73, 75
Training. See Professional training
Training (T) awards, 238, 239, 250, 251, 275-276, 343-344, 354, 373
Trans-NIH Sleep Research Coordinating Committee, 4, 5, 6, 10, 12, 24, 186, 229, 240, 241, 244, 250, 254, 255-256, 257-258, 267, 276, 277, 283, 305, 357
Treatment.
See also Sleep loss and sleep disorders;
individual disorders
access to, 26, 201, 218-219
adherence to, 26, 68, 70, 77, 80, 147, 157, 177, 298, 299, 314
behavioral therapies, 77, 78, 87, 99, 109, 154-155, 265
clinical practice guidelines, 177
cognitive therapy, 78, 265
comorbid psychiatric disorders, 80-81
CPAP therapy, 68, 70, 71, 72, 75, 96, 147, 151, 153, 154, 156-157, 161, 177, 218, 228, 264, 295, 298, 299, 314
demand for, 218
economic costs of, 159, 160-161
effectiveness, 151, 154, 155
extinction program, 155
guidelines, 64
light therapy, 109, 110, 143
management approach, 28, 295-296
melatonin therapy, 109-111, 159
naps, 151
pharmacological, 64-65, 77-78, 87, 90, 93, 99-100, 155, 159;
see also individual drugs and drug classes
residual sleepiness, 295
sleep hygiene training, 78, 155
sleep restriction therapy, 77
Truck drivers, commercial, 149, 150-151, 263, 266
TV watching, 21, 58
Type I, II, III interdisciplinary sleep programs. See Interdisciplinary sleep programs
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U
University of Pennsylvania, 236, 239, 298, 307, 376-377
University of Pittsburgh, 236, 239, 376-377
Utilization of health care, 2, 21, 26, 155-157, 159, 161
V
Vigilance deficits, 138, 148
Viral infections, and sleep, 103
W
Wakefulness, 40-41
medications promoting, 64-65
sympathetic nervous system hyperactivity, 73
Weight gain, sleep loss and, 267
Wisconsin Sleep Cohort study, 66, 68, 72
Work.
See also Occupational safety and health;
Shift work
absenteeism, 154, 158, 160
accidents and injuries, 147, 149-150, 158, 160, 266
hours, 138, 139, 148
performance/productivity losses, 2, 146-147, 154, 158, 160
Y
Youth Risk and Behavior Surveillance System, 210
Representative terms from entire chapter:
sleep deprivation
