The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

Changing the Sleep Lab to a Sleep/Wake Center of Excellence

Pamela Minkley, RRT, RPSGT Wednesday, November 6, 1996

Changing the SLEEP LAB to a SLEEP/WAKE CENTER OF EXCELLENCE

Laboratory: A place used for experiments or research in science, pharmacy, etc. (Webster's Encyclopedia of Dictionaries)

Center: The mid-point of anything; pivot; axis; a point to which things move or are drawn. (Webster's Encyclopedia of Dictionaries)

The clinical study of sleep is a relatively new field. The quality of our sleep will greatly influence the quality of our wakefulness (alertness). The quality of our alertness greatly influences our performance, mood, and behavior. The events of our days affect quality of our sleep.

Did you know roughly 40,000 nonfatal injuries and 1,550 fatalities result from about 56,000 highway crashes annually in which driver drowsiness/fatigue was cited by police? (National Highway Traffic Safety Administration) Did you know very few police are trained to investigate drowsiness/fatigue a the cause of a crash? Did you know the average teenager may require 8-12 hours of sleep to adequately function in a learning environment but gets only 6-7?

It is no wonder these facts are likely to be new news to you, an informed healthcare professional. On the average medical students receive less than six hours of training in clinical sleep medicine! (National Commission on Sleep Disorders Research). The message here is that there is a black hole of education about sleep and its disorders. The relatively small numbers of professionals actively participating is research and clinical sleep medicine hold nearly ALL the knowledge.

By definition, a sleep laboratory is likely to be perceived by medical professionals and the community alike as a diagnostic testing facility. A sleep CENTER, however, implies a point to which things move or are drawn. A point of concentration of knowledge. Simply changing the name will not in of itself change the actual function or perception of the physical area where sleep evaluation, diagnosis, and treatment is accomplished.

A well planned and executed plan to educate the community medical professionals, health care provider systems, third party payors, and the sleep center staff is necessary. In today's environment of healthcare systems, the multi-disciplinary nature of sleep medicine is well suited. Diagnostic, critical care, transitional care, long term care, birthing centers, homecare, occupational programs, and wellness programs can benefit from the centers knowledge. By educating them about the effects of poor sleep on physical, mental, and physiological function and by educating them to recognize sleep pathologies, patients can often leave the units sooner and require less ongoing use of the healthcare system. Those with identified sleep pathologies will be referred to the center for evaluation and treatment.

To accomplish these goals the center itself must actively seek involvement from the medical and technical professionals in the primary disciplines associated with sleep medicine - neurology, pulmanology, psychology, and psychiatry - in both the adult and pediatric arena - and in all areas of the healthcare system. This team can plan and conduct formal educational program in the community, schools, industry, and healthcare systems. They can make the center's knowledge base resources available for brief telephone questions. They can establish the CENTER as THE resource on sleep/wake related issues for the community. Revenue streams can be gleaned from consultation, education, collaboration, and training as well as diagnostic testing. When the CENTER becomes THE community resource for sleep/wake issues it also becomes the prime REFERRAL choice.

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