U.S. National Center on Sleep Disorders Research:

The Federal Government's Role

| Funds | Background | Functions | Education |

Federal Research Funds: "How has the U.S. government influenced sleep research?" (1)

"The U.S. government has done a lot, and is certainly in the lead in giving national attention to sleep research." (1) It was 1993 when Congress passed a law "to improve the health of Americans by supporting research, training, and education about sleep disorders," and created this Center within the National Heart, Lung, and Blood Institute of the National Institutes of Health. [NCSDR, NHLBI, NIH] (2)

The Federal government has spent almost 100 million dollars from NIH funds on neurological, mental disorders, pulmonary, heart, and other medical reserach on sleep up through Fiscal Year 1999. Now the Dept. of Transportation will be devoting about two million dollars each year on a special emphasis to reduce drowsy driving. Other Federal agencies are also becoming more involved in sleep awareness and research.

Background

Mr. James Kiley, Ph.D., has directed the National Center on Sleep Disorders Research for its first five years. The existence of this Center has focused on the health component of sleep research. Formerly a pulmonary specialist within NIH, now Mr. Kiley leads and manages this center which coordinates, facilitates, and collaborates in programs not only within NIH, but also with the Departments of Transportation, Education, the National Air and Space Administration, and the Dep't of Veterans Affairs. The Center has also developed a large educational program for the public, for industry, for schools, and for medical schools. They award extramural research, but also make sure that other agencies are moving "in concert" toward mutual goals for improved sleep health.(1) Mr. Kiley has been invited to go to speak to other countries who praise and are perhaps envious of the tremendous resources that the U.S. Congress has devoted "to move sleep research and awareness forward in a significant way" because of the interest and need of the American public. (1) Germany, Scandinavian countries, and the United Kingdom have also been contributing major research. However, the United States has an advantage in having this unique National Center to coordinate and to encourage sleep research. "Health, biomedical, and societal issues converge in this most important issue of sleep."

Functions: Research, Training [sleep researchers], Technology Transfer [to Health care professionals and the public], and Coordination [of Federal efforts on Sleep]

The Center does no direct research, but initiates and coordinates "extramural research" and awards grants and contracts. The Center's Research Advisory Board makes sure to support the science and to help to disseminate information, also to help make sure the program is not missing anything important. The combination of governmental and private, and nonprofit organizations and patient representatives all help to keep healthy sleep promotion and scientific sleep research "on track where all are headed." (1) Another major function is to educate the public so that those who suffer from sleep disorders will know where to go to get effective treatments for sleep problems.

Education & Awareness of both Public and Medical Personnel

James Kiley believes that the most problematic sleep issue is the "real urgent need for people to be aware of the consequences of sleep deprivation and what that means to overall good health." (1) Sleep deprivation causes both decreased alertness and decreased performance. Special programs target shiftworkers and people in transportation at risk for drowsy driving.

"We function in a 24 hr. a day society that doesn't stop. How do we best manage those operations that we do and still guard or protect that time we need for sleep so we can function best?"(1) People need to understand that having the need for sleep does not mean being lazy. Sleep is a biological necessity that needs to be taken seriously as a part of a healthy routine. People should understand the biology of when and how sleep occurs.

Youth - As sleep research progresses, Center and those cooperating with it try to get out messages, especially targeted to youth (ages 16-25). Mr. Kiley believes that many youth will make changes if they become aware of the biological processes involved in the issues of sleep, including drowsy driving problems. Young adult males have been found to be in a high risk group for falling asleep at the wheel while driving. Youth need to become aware of the steps to overcome potentially dangerous behaviors, like taking a long road trip and trying to drive straight through the miles and hours without sufficient rest breaks. This "self-induced problem" makes it likely for the driver to fall asleep while driving, at great risk of both personal injury and property damage.

Children - The government is also trying to reach elementary school aged children. Not only will this help to instill good habits early, it will also help to educate the parents. If children learn, then they will help to protect themselves and their parents as well, just as what happened when seat belts were developed.

It is important to be sure that everyone is informed about the important aspects of sleep. Many people who have disorders aren't getting proper diagnosis or treatment. In a recent initiative, awards have been granted to twenty medical schools to develop formal "curricula and educational resources to enhance the knowledge of sleep and sleep disorders in students, house staff, practicing physicians, and other health care professionals." (2) It is also hoped that public health practitioners and specialists in primary care will become more informed about sleep disorders and treatment through the efforts of these projects. People need to understand the importance of protecting that time for sleep.

(1) Interview with Mr.James Kiley, Ph.D. Director, National Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. Interviewed by Emilie Sutterlin, 5 August, 1999. This same week was a busy one for sleep in the news, with Stanford U. research about narcolepsy gene and other news about limitations on truckers to prevent drowsy driving. Mr. James Kiley is often interviewed by the press on sleep news.

(2) "National Center on Sleep Disorders Research," Bethesda, Md., NHLBI, NIH, Feb. 1994. [8] p. At that time, early estimates found "about 70 million Americans suffer from a sleep problem; among them, nearly 60 percent have a chronic disorder. . . . Most cases remain undiagnosed and untreated. Each year, sleep disorders, sleep deprivation, and sleepiness add an estimated $15.9 billion to the national health care bill." Additional socioeconomic costs had not been calculated.

(3) "Sleep Academic Award Program," [Bethesda, Md.], NHLBI, NIH, Aug. 5, 1999. New mini-brochure lists the following participants: Bowman Gray School of Medicine, Brown U., Case Western Reserve U., Dartmouth Medical Center, Eastern Virginia Medical School, Harvard Medical School, MCP-Hahnemann Univ., Northwestern U. Medical School, Stanford U., U. of Alabama, U. of Chicago, U. of Illinois (Chicago), U. of Iowa School of Medicine, U. of Kentucky Medical Center, U. of Michigan, U. of Minnesota Medical School, (UMDNJ Robert Wood Johnson Medical School, UNC-Chapel Hill, U. of Pennsylvania, U. of Wisconsin. [8] p.