| 40 million Americans are chronically ill with various sleep disorders and an additional 20 to 30 million experience intermittent sleep-related problems. The consequences of sleep disorders are diverse, serious, and often catastrophic. |
| Few people are aware that sleep disorders exist at every age level from the sudden infant death syndrome to sundowning in the elderly. Children, adolescents, young adults, middle-aged adults, and especially the elderly are afflicted. |
| Current research also indicates that these groups may have an even higher incidence of sleep related disorders, especially those associated with obesity, such as sleep apnea. |
| Falling asleep at the wheel is the most costly and devastating problem on American highways. Accidents in the workplace due to sleep deprivation are commonplace and damaging to industry. Students, asleep in classes, miss opportunities that will help them foster careers. Every component of society is seriously impaired by sleep deprivation. |
The cost in dollars, lives, and human suffering is very high
| There are no well-established databases on the cost of sleep disorders and sleep deprivation. The Commission was able to definitely assign 15.9 billion dollars as direct cost of sleep disorders and sleep deprivation with an estimated 50 to 100 billion in indirect and related costs when the cost of individual accidents associated with sleep disorders and sleep deprivation are assessed including litigation, destruction of property, hospitalization, and death. |
| The Commission found no component of society adequately aware of sleep and the facts of sleep deprivation. Most importantly, primary care physicians are in desperate need of adequate information. Currently 95% of patients with sleep disorders remain undiagnosed. |
| Many important areas of sleep research remain uninvestigated due to a lack of funding and coordination on a federal level. Some of the most crucial areas, for example insomnia which affects approximately one in three Americans, have little or no current research activity. |
| At present, there are under twenty young investigators in training programs for sleep research. Due to the multi-disciplinary nature of sleep research and sleep medicine, there are many qualified individuals within existing disciplines such as molecular biology and neurochemistry. With increased funding for training and research many could pursue careers in the field of sleep research. |
It is imperative that policy makers clearly understand both the magnitude of the problems and the strategy behind the recommendations that will provide solutions. Most Americans are not fully aware of the magnitude and seriousness of the major sleep disorders such as sleep apnea, narcolepsy, the insomnias and Sudden Infant Death Syndrome. The relationship of sleep-deprivation to accidents has been recognized, but few managers or workers understand the natural cycle of sleepiness and alertness or how to reduce sleep-related accidents and errors. Based on these findings, it is imperative that a strong national commitment be directed to sleep and sleep disorders.
The National Commission on Sleep Disorders Research has proposed for immediate implementation six basic recommendations that will ensure the greatest benefit at the smallest cost. Even if resources were unlimited, the ambitious goal of changing the way society deals with sleep could not be accomplished overnight. These six recommendations will launch the long-range national plan to create an environment in which research findings and education programs will lead to early diagnosis and prevention of sleep disorders, and reduce the impact of sleep deprivation.
Recommendation One: Establish a National Center
| Our nation needs an accountable structure to coordinate education and research on sleep and sleep disorders. The Commissioners unanimously agreed that the best possible mechanism to address the urgent needs of American society would be a national center within an existing Institute of the National Institutes of Health. The Commission recommends that the Congress authorize the establishment of and appropriate sufficient funds to support a national center for research and education on sleep and sleep disorders to be housed within an existing NIH Institute. The Center's activities will compliment the sleep and disorder related research currently undertaken by the various National institutes of Health (NIH) and the Alcohol, Drug abuse and Mental health Administration (ADAMHA), and, through its own award authority, shall encourage and support gap-filling and crosscutting research, and develop new research programs and educational/training initiatives in the field. |
Recommendation Two: Strengthen Ongoing Programs
| Solving society's biggest sleep related problems must be a national priority. The Commission recommends that federal support for basic, clinical, epidemiological, health services, and prevention research on sleep and sleep disorders be expanded. Existing research commitments by the NIH and the ADAMHA Institutes, as well as the Centers for Disease Control, Department of Veterans Affairs, Department of Defense, and other federal agencies currently engaged in sleep and sleep disorders research should be strengthened. |
Recommendation Three: Accountability in All Federal Agencies
| The Commission found a near total absence of overall coordination and accountability for issues related to sleep among widely dispersed activities managed and regulated by the many federal agencies. The Commission recommends the establishment of specifically identified offices on sleep and sleep disorders within all federal departments and agencies whose programs affect or are affected by issues of sleep and sleep disorders, and that the Office of Science Technology Policy undertake a feasibility study for the establishment of a special body to ensure coordination, cooperation, and collaboration among the separate agency-based sleep/sleep disorder offices. |
Recommendation Four: Training and Career Development
| The Commission identified a serious lack of career and training opportunities for young investigators interested in the field of sleep. Research is essential for cures and better treatments of sleep disorders. Currently, the important research questions far outnumber the available trained investigators. The Commission recommends that substantially increased levels of federal support be directed to the NIH and ADAMHA, as well as to the Centers for Disease Control, the Department of Veterans Affairs and the Department of Defense, specifically for sleep and sleep disorder research training and career development opportunities. |
Recommendation Five: Education of Health Professionals
| Ninety-five percent of victims remain undiagnosed, largely because health professionals have not had the opportunity to learn about sleep disorders and sleep deprivation. There is an urgent need for physicians, nurses, all health care professionals to be able to identify and refer or treat patients with sleep disorders. The Commission recommends that Congress encourage and support broader awareness of and training in sleep and sleep disorders spanning the full range of health care professions, particularly at the primary care level. |
Recommendation Six: An Educated America
| The lack of awareness throughout America about the nature and impact of sleep disorders and sleep deprivation is a national emergency. Witnesses asked repeatedly, "How many preventable deaths are going to occur this year?" "Why don't we do something right now?" "Why don't we save as many lives as possible now ‹ not years or decades from now?" The Commission has concluded that the American public has been inappropriately denied the benefits of the research knowledge its tax dollars have supported. The Commission recommends that a major public awareness/education campaign about sleep and sleep disorders be undertaken immediately by the federal government. |
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