Setting the stage: 2006 Institute of Medicine Report

Institute of Medicine (IOM). (2006).  Sleep Disorders and Sleep Deprivation. Washington, D.C.:  National Academies Press

Although the report was published in 2006, Sleep Disorders and Sleep Deprivation is a report of which the dental sleep medicine practitioner should be acutely aware.

The report is available in hard copy and the PDF version is free to download from www.NAP.edu.  Just search for the report by its title.

What does the Institute of Medicine say?

The IOM’s Sleep Disorders and Sleep Deprivation describes sleep loss and sleep disorders as “among the most common yet frequently overlooked and readily treatable health problems” (p. 56).

The 425 page report recognizes the shortage of practitioners trained to identify and treat sleep breathing disorders, as well as the lack of funding by organizations such as the National Institutes of Health (NIH) and others to address what the literature is showing to be a continuum of diseases with increasing prevalence in the United States.

Sadly, this lengthy examination of what the IOM calls an “unmet health problem” does not sufficiently explore the role and importance of the dental practitioner in identification and management of sleep breathing disorders.

In their discussion of treatment options, the authors of the IOM report understand the research to demonstrate that patients are most effectively treated with CPAP and weight loss, but, they admit, “the problem is that many patients are non-compliant” (p. 75).  Dental appliances are called “less effective,” indicated only when a dental problem is “etiologically related” (p.303) and are given only a passing mention (exactly twice throughout the whole report).

In its detailed recommendations, the IOM asserts the importance of support by the NIH, academe, and private foundations to develop an adequate workforce to address sleep disorders and sleep deprivation, and to strengthen the interdisciplinary aspect of the field. The report outlines the merits of interdisciplinary care, and states that the field of sleep medicine is “particularly well-suited to interdisciplinary and translational strategies” (p.14). However, the absence of the dental sleep medicine practitioner’s role in meeting what the IOM describes as an “unmet public health need” addressed via an interdisciplinary team of practitioners remains conspicuous.