Oh what a great day Thanksgiving can be – good food, family and a good snooze during the football game!  But wait, why do we celebrate Thanksgiving? Oh yeah, that Pilgrim and Native American thing.  The first “American Thanksgiving” probably occurred in the 1500s in Saint Augustine, Florida; but for the Pilgrims, the official date was Dec. 13, 1621.  In 1789, our first president, George Washington, decreed the first “United States” Thanksgiving Day; but it still wasn’t an official holiday. Abraham Lincoln set aside the last Thursday in November as the national day of Thanksgiving; but again, not until 1941 did Congress permanently establish the day, the fourth Thursday in November, as a national holiday.

Although we usually associate Thanksgiving with a good nap, one could speculate about how much “sleeping” was going on at that first Thanksgiving.  It was a three-day celebration, and I have seen the little cottages at Plymouth – they were not exactly roomy.  Historians say the Wampanoag Indians probably slept on the ground.  (This is a potential tactic you might want to remember when cousin Eddy acts up at your house!)  They didn’t have overstuffed chairs, chaise lounges and comfy sofas.  But they probably did eat some type of fowl, and we all know that makes you sleepy, especially when combined with mashed or sweet potatoes.  And maybe some imbibed in some type of alcoholic beverage (although one website I read said all they had was water – the Pilgrims were pretty straight folks).  They were all together, hooting and hollering, so all the wild animals that used to eat them, like mountain lions and black bears, probably high-tailed it far away from all the racket – so they were more relaxed than usual.  So I am seeing this tranquil sight of Miles Standish and Massasoit sitting back on some wooden chairs, catching a few zzzz’s…

We have this kind of corny thing we do at our family Thanksgiving dinner where we go around the table and ask everyone what they are thankful for.  I have noticed that the older we get, the more we lean toward saying “good health” or “being thankful we are able to celebrate Thanksgiving this year,” aka “still alive!” 

But let me ponder — what do we as a sleep society have to be thankful for?  I would say a lot of things.    The specialty has really come into its own in the past few years with our own CMS specialty designation, an ABMS certification exam, ACGME-accredited fellowships, and increased public awareness about sleep and sleep disorders, to name a few.  And I, as president, have a number of things to be thankful for, including being able to work with an energetic and capable AASM staff; having a congenial and thoughtful board of directors; getting to interact with many of the members at meetings, on phone calls and by email; and moving new initiatives forward with the help of all of those groups. 

Many of us are worried about the future of our field, with some regions of the country dealing with the indiscriminate usage of home sleep testing by insurance companies to cut costs without providing quality patient care.  However, I believe that the field of sleep medicine is on solid ground.  I feel like this indiscriminate use of HST will in the long run increase costs and result in many disgruntled and inadequately treated patients, with the ultimate outcome being a more measured and rational approach.  So although the current climate in many of your regions may give many of you indigestion on Thanksgiving, please know that we at the AASM are actively addressing this issue, working on the premise that sleep specialists need to be in the lead for the care of patients with sleep disorders.

I wish you all a happy and relaxing Thanksgiving and a peaceful and refreshing nap!

Nancy Collop, MD