Sleep Disorders in Primary Care Practice

Abstract

In 1991, the National Commission on Sleep Disorders Research, composed of the nation’s premier sleep medicine specialists and chaired by Dr. William Dement of Stanford University, found that 40 million Americans were ill with various sleep disorders (1), the majority of whom were not diagnosed, thus, not treated. Despite the existence of a large body of sleep medicine science and the availability of effective treatment for most sleep disorders, this knowledge base was virtually absent among primary care physicians and the lay public. After reviewing the computerized records of 10 million patients in large primary care databases, the Commission found only 73 diagnoses of obstructive sleep apnea (OSA), whereas thousands of cases would have been expected, based on known prevalence figures. In a survey of all accredited U.S. medical schools, the amount of time spent teaching medical students about sleep medicine was less than two hours (2). Thus, primary care health care providers were woefully undertrained to diagnose and treat the millions of patients in the US who are afflicted with sleep disorders. The Commission recommended that a nationwide program be instituted to educate the general population and the medical profession about sleep.