Sleep medicine practices, training, and attitudes: a wake-up call for pulmonologists

STUDY OBJECTIVES: To determine attitudes and knowledge about sleep medicine among chest physicians. DESIGN:: Interactive survey of self-selected respondents. SETTING: Interactive session at the 1998 American College of Chest Physicians (ACCP) annual meeting. PARTICIPANTS: Approximately 60 chest physicians. INTERVENTIONS: Interactive questions about the knowledge, training, attitudes, and practice of sleep medicine. MEASUREMENTS AND RESULTS: Response rates demonstrated that 65% of respondents directed or were on the staff of a sleep laboratory, 18% had American Board of Sleep Medicine (ABSM) certification, and only 3% had completed formal sleep medicine training, and performance on test questions about sleep-disordered breathing was better than that on questions about "nonpulmonary" sleep disorders. We polled approximately 60 participants in an interactive session called "Issues in Sleep Medicine Education and Practice" at the ACCP annual meeting in October 1998. The group was well-credentialed, with about one third of participants being board-certified in pulmonary medicine and critical care medicine, and about 17% having passed the ABSM examination. About two thirds of the group spent < or = 25% of their time in the practice of sleep medicine, but > 30% directed sleep laboratories. Respondents thought that sleep training was better addressed in pulmonary fellowship training than in medical school or other postgraduate training experiences. Forty-three percent of the group had received training in sleep medicine as part of a pulmonary fellowship. About half of the sample thought that formal training should be required for eligibility to take the ABSM examination. When presented with two "nonpulmonary" sleep disorder cases, this well-trained and self-selected group did not perform very well. The findings suggest that pulmonologists are actively involved in the practice of sleep medicine and that they both need and desire formal training in sleep disorders during pulmonary fellowship training. CONCLUSIONS: Participants were actively involved in the practice of sleep medicine, most had trained informally, and performance on questions about nonpulmonary sleep disorders was not good.