IN MY OPINIONLooking Beyond the Current State of Sleep Medicine: Sleep as a Diagnostic, prognostic and therapeutic strategy across Medicine for More Optimal OutcomesBy Anne Marie Morse, Director, Division of Pediatric Sleep Medicine, GeisingerWe are sleeping on the opportunity to transform healthcare and achieve the value-based outcomes everyone is talking about but failing to achieve. Yes, the play on words is completely intended, both to emphasize the missed opportunity and to illustrate how many continue to view sleep as a non-contributory temporary escape from the day and not the dynamic homeostatic biomarker and tool that it is. The sleep-when-I-am-dead mentality that continues to be embraced in healthcare will only help accelerate getting to that eternal resting place much sooner. To appreciate the current state and future opportunities for sleep as a tool, a brief review of the history highlights the barriers, opportunities, and needs. Records depicting sleep's relevance to human health date back to Hippocrates, who identified sleep as one of the six prerequisites for health around 400 BC; however, robust scientific study only developed in the mid-20th century. In 1989, the role of sleep in health and wellness was further clarified. One theory suggested "core" and "optional" sleep, indicating we could "get away with less sleep." A myth that continues to plague us. In parallel, Rechtschaffen definitively illustrated the biological need for sleep with a series of sleep deprivation studies in animals, resulting in temperature instability, metabolic derangement, susceptibility to illness, overwhelming sepsis, and death. With this stated, sleep medicine as a medical discipline in the United States is young, with the initial accreditation of sleep centers, first board certification and formalized sleep training within the past 50 years. The International Classification of Sleep Disorders characterizes over 70 sleep-wake disorders (SWD), and an explosion of research illustrates the pivotal role of sleep across every organ system and contributing to all ten leading causes of death in the US. The Nobel Prize was awarded to Anne Marie Morse8 OCTOBER 2024
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