13
AASM Membership Sections Newsletter
■
Issue #6
wearable fitness monitors depicting their sleep patterns as part of the
typical report. Although these gadgets have not been scientifically
validated, the information can be used, along with the patient report,
to potentially assess the effectiveness of a treatment program in a
relative manner.
As scientists we may hedge our reluctance to harness this
technology, citing lack of validated research trials showing efficacy
and positive results. However, in a clinical setting is the need to
have an app or a gadget validated a necessity? Many medications
are used “off label” to treat insomnia – why not add an app or two
to the treatment mix? The vast array of apps, gadgets, and devices
encourages patient involvement in their care. As clinicians we can
benefit by using this information to supplement and verify patient
recall.
Insomnia in Hospitalized Patients – What if
the Cure Lies Inside Us?
By Dr. Miguel A. Sánchez-González, MD, PhD
Sleep disruption has been shown to impair glucose metabolism
and worsen hypertension. It also leads to increases in physical
morbidity and mortality. How do our patients sleep in our
hospitals? Bad, you would say. And you would be right. Anyone
that provides care for hospitalized patients knows that (and is in
part responsible for) sleep being the big missing piece there. Much
needed emphasis is not paid to this important aspect with sleep,
even though sleep disruption is due to potentially reversible causes.
Nighttime measures working towards better sleep environment are
lacking in most hospitals, and the common rule is that personnel
and machines act and sound not very similarly from how they do
during daytime shifts. Daytime measures like physical exercise and
appropriate light conditions are also not taken into account.
Helping our admitted patients sleep better could probably pose a
great benefit not only to their comfort and mood, but it would also
likely help in their medical recovery. It will be wise to take advantage
of the healing power of sleep that lies inside every one of us. Let’s
turn on that healing machinery through sleep.
References:
1. Lynne Lamberg. Manual updates sleep disorders diagnoses.
Psychiatric News, August 14, 2014
2.
3.
4.
5.
6. Masters PA. Insomnia. Ann Intern Med. 2014;161(7).
7. Rosen RC, Rosekind M, Rosevear C, Cole WE, Dement WC.
Physician education in sleep and sleep disorders: a national
survey of U.S. medical schools. Sleep. 1993;16(3):249-254.
8. Hayes SM, Murray S, Castriotta RJ, Landrigan CP, Malhotra
A. (Mis) perceptions and interactions of sleep specialists and
generalists: obstacles to referrals to sleep specialists and the
multidisciplinary team management of sleep disorders. J Clin
Sleep Med. 2012;8(6):633-642.
9. Khawaja IS, Hurwitz TD, Herr A, Thuras P, Cook B. Can Primary
Care Sleep Medicine Integration Work? Prim Care Companion
CNS Disord. 2014;16(2). pii: PCC.13br01593. doi: 10.4088/
PCC.13br01593. Epub 2014 Apr 24.
