People with sleep disorders, especially those who have received effective treatment, are a potential resource for change and should be enlisted as advocates and educators.

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Sleeping Beauty: Who can awaken her?

We are a nation asleep. Millions of Americans don't get enough restful sleep. If life were like a fairy tale, sleep disorders would not still be a major public health problem. If the wonders of medical science were applied by physicians, if the public was informed and motivated, and if a dysfunctional health care system was not getting in the way, the magical "kiss" of healing would already have awakened us.

Unfortunately, we have a long way to go. Today, reading the gloomy observations and conclusions of the Institute of Medicine, and even giving full credence to their excellent recommendations and proposals, I do not see that magic kiss being realized in the near future. Perhaps what is mising is a public outcry that could create the political will to allocate resources and to change outmoded systems. I believe that, if we could mobilize the people with sleep problems, there might be a solution.

In 1972 I began to awaken from the daze caused by sleep apnea. I believed that if people and physicians knew how to recognize and diagnose sleep apnea and other sleep disorders, society would quickly recognize the benefits (health, well being, savings in healthcare costs) and allocate the resources and the energy to eliminate the scourge of untreated sleep disorders. Unfortunately, many of the observations and conclusions by the Institute of Medicine in 2006 are essentially the same as I and many others have noted since 1972.

Since 1972 I have been privileged to work with leaders in the field of sleep in educating people about sleep apnea and teaching them how to overcome this problem. I co-authored and published a book and created a web site. These publications were premised on the idea that people with a chronic condition like sleep apnea need to manage their health care in collaboration with their physicians. Many others--scientists and clinicians with impressive credentials, as well as many organizations and industry, as well as a growing community of sleep medicine professionals--have worked to educate and inform the public and the medical community. Yes, there has been progress, and yes, sleep disorders, especially sleep apnea, is a rapidly growing industry.

But what remains? Here are just a few salient problems noted in the 2006 report by the authoritative Institute of Medicine of the National Academies, Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem.

As I write this, in 2007, I believe a new strategy is needed. The problem is not with knowing what to do, it is the lack of a national will to act.

With respect to the proposals of the Institute of Medicine, they represent essentially the view of the professional community. The proposals focus on changes to professional education and practices, increased funding for training and research, as well as public education. However, a key resource is ignored.

People with sleep disorders, especially those who have received effective treatment, are a potential resource and should be enlisted as advocates and educators. Imagine the impact that a feedback loop of treated patients could have on the health care system, politicians, and the public. If every awakened sleep patient were to tell their doctors and their elected representatives to pay more attention to sleep disorders, this could be a tremendous engine for change. Perhaps even the kiss that awakens.

Jerry Halberstadt


Committee on Sleep Medicine and Research, Institute of Medicine of the National Academies, Sleep disorders and sleep deprivation: an unmet public health problem. Washington: National Academies Press.

T. Scott Johnson MD, William Broughton, MD, and Jerry Halberstadt; with contributions by B. Gail Demko, D.M.D. Forewords by Carl E. Hunt, M.D., Director, National Center on Sleep Disorders Research, NHLBI, NIH, William C. Dement, M.D., and Colin E. Sullivan, M.D. Sleep Apnea--the Phantom of the Night, Peabody MA: New Technology Publishing, Inc., 2003.

Halberstadt, Jerry, The Chronic Disease Crisis


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