A new survey confirms that pulmonary/critical care physicians are knowledgeable about women's sleep issues and are actively managing their patient's sleep problems. The survey, issued by the American College of Chest Physicians Sleep Institute (ACCP-SI), found that most pulmonary/critical care physicians are well informed about the sleep patterns of their female patients and are advising appropriate therapies to manage their patient's sleep problems. These findings are in contrast to the 2006 Institute of Medicine (IOM) report that shows health-care providers are lacking in sleep awareness and education, a gap that is leaving a significant number of patients with sleep problems remaining undiagnosed and untreated.
"Sleep problems that are undiagnosed and untreated can affect a patient's health and cognitive performance. Yet, patients may learn to live with sleep problems and their consequences, never revealing their personal sleep habits to a physician," said Charles W. Atwood, MD, FCCP, Chair of the ACCP-SI. "One thing we have learned is that pulmonary/critical care physicians are proactively inquiring about their patients' sleep habits. We are asking the right questions and are advising effective treatment. By doing so, we can begin to identify obstacles that may be prohibiting restful sleep for our patients."
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Dr. Atwood and members of the ACCP-SI surveyed 364 pulmonary/critical care physicians, who were identified as being interested in sleep and women's health issues, their knowledge of general sleep architecture, sleep issues as they pertain to women, and how they managed sleep complaints from their female patients.
The majority of respondents indicated that they regularly ask their female patients about their sleep patterns and the sleep habits of family members. The following was gathered from the respondents:
• 81 percent regularly ask patients about their quality of sleep
• 72 percent regularly ask patients about their amount of sleep
• 69 percent regularly ask patients about snoring
• 65 percent regularly ask about the sleep habits of a patient's bed partner
• 61 percent regularly ask about the sleep problems of family members
Preferred Sleep Therapies
The majority of respondents indicated behavioral therapy as the premier treatment for sleep problems in women, which is the accepted best practice in sleep medicine. Specifically, 67 percent of respondents were very or somewhat likely to use behavioral therapy for their female patients who have sleep disturbances, followed by hypnotics (33 percent), antidepressants (25 percent), and hormonal therapy (12 percent).
Pets in the Bedroom
In addition to behavioral therapy, the majority of physicians surveyed (53 percent) indicated they regularly counsel their patients about removing pets from the bedroom. According to the National Sleep Foundation (NSF) 2007 Sleep in America Poll, women who sleep with a pet in the bedroom are significantly more likely to report insomnia and daytime sleepiness than women who sleep with a spouse or child in the bedroom.
"Pets can have a calming effect on their owners, yet they can also keep their owners awake when they are allowed to sleep on the bed or in the bedroom," said Dr. Atwood. "If you are awakened by your pet on a regular basis, having a pet in the bedroom becomes counterproductive. When this happens, we recommend removing the pet from the bedroom to ensure it is not contributing to a patient's sleeplessness."
Sleep Awareness Gaps
According to the 2006 IOM report, approximately 50 to 70 million Americans suffer from a chronic disorder of sleep and wakefulness, hindering daily function and adversely affecting health. However, millions of individuals with sleep disorders remain undiagnosed and untreated, due, in part, to a lack of awareness of sleep disorders among health-care professionals and the general population.
"Healthy sleep habits are essential for our physical and mental well being," said Mark J. Rosen, MD, FCCP, President of the American College of Chest Physicians. "We are pleased that ACCP members are recognizing the importance of sleep medicine by actively inquiring about their patient's sleep habits."
The ACCP-SI supports the following sleep recommendations from the NSF:
• Keep a standard relaxing bedtime routine and regular sleep times. Keep your bedroom dark, cool, and quiet, and make sure your pillows, sleep surface, and coverings provide you with comfort.
• Exercise regularly, but finish your workout at least three hours before bedtime.
• Avoid foods and drinks high in caffeine and alcohol a few hours before bedtime.
The ACCP sleep survey was a voluntary, Web-based survey distributed to 2,690 members of the ACCP, who were identified as being interested in sleep and/or women's health issues. The survey was designed to gather the perspective of clinicians about women's sleep issues and complement the consumer-focused NSF 2007 Sleep in America Poll, which sought to look at the sleep patterns of adult women.
"This poll demonstrates that chest specialists take sleep problems seriously. ACCP members are asking about sleep problems and taking action when problems are identified," said Barbara A. Phillips, MD, FCCP, Chairman of the NSF Board of Directors and ACCP member. "The NSF thanks the ACCP for this collaboration; by working together, we may be able to improve the experience of people with sleep problems."
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