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Sleep medicine training beneficial for psychiatrists

The evolving field of clinical sleep medicine can offer psychiatrists a challenging, satisfying and rewarding career, according to a CME article published in Psychiatric Annals.

Psychiatrists led and played a major role in the early development of sleep medicine as a subspecialty, but the high prevalence of sleep disorders has led to the need for more clinicians to know how to diagnose and treat these disorders, Gregory Carter, MD, PhD, program director of the sleep medicine fellowship program at University of Texas Southwestern Medical Center, and colleagues explained.

“A physician can enter sleep medicine training from core residency programs, not only in psychiatry and neurology, but also in internal medicine, pulmonary and critical care medicine, pediatrics, family practice, anesthesiology and otolaryngology,” they wrote. “The multidisciplinary nature of the field leads to almost seamless collegiality and an engaging and rewarding practice setting.”

It is common for providers to underestimate the importance of sleep in patients with mental health disorders, according to Carter and colleagues.

Clinical training programs teach the connection between mental illness and sleep, but the idea that poor sleep may worsen psychiatric disease is not always known and psychiatrists are often the first providers who ask their patients about sleep. Carter and colleagues explained that psychiatrists with sleep medicine training can bridge the gap between providers from the non-psychiatric background and mental health providers, as well as help educate them on how to manage comorbid psychiatric and sleep problems.

However, the authors wrote that there is a shortage of psychiatrists trained in sleep medicine, and that they account for only 4% of all the sleep medicine providers in the U.S. In addition, many psychiatry residents are unaware that they can receive subspecialty training in sleep medicine.

“Training in sleep medicine offers a unique opportunity for working with members of other disciplines,” they wrote. “Reasons for psychiatrists to choose sleep medicine as a subspecialty include the following: (1) opportunity to work in a non-psychiatric setting; (2) stay connected with the field of medicine and other disciplines; (3) increase access to sleep medicine care for patients with mental health problems; and (4) take advantage of the growing research opportunities.”

The drastic increase in use of internet-connected devices with multiple screen types along with work/family responsibilities and keeping up with social networks and controversial news stories can undermine and take time away from restorative sleep, Carter and colleagues wrote. The need to make sleep more efficient and remove possible sleep pathologies will only continue to increase.

Sleep medicine is vital to research the role of sleep in health and disease, according to the article. Knowledge of sleep medicine as an exciting career has only just begun to reach the core clinical training programs, the authors explained. Because the total number of training positions is less than what is needed in the workforce, physicians training in sleep medicine will have their pick of practice types and locations, but there are other benefits as well.

“Parasomnias, consequences of insomnia, and new developments in hypersomnia will be areas where psychiatrists are fascinated and challenged in the future,” Carter and colleagues wrote. “Tools for improving diagnostic and therapeutic approaches include an emerging armamentarium of pharmacotherapeutics, neurostimulation, and novel diagnostic and therapeutic devices.”

Disclosures: Carter reports book royalties from Wiley Blackwell and contracted research from the Center for Clinical and Translational Science at Mayo Clinic; the Michael J. Fox Foundation; the National Heart, Lung, and Blood Institute; NIH; and the National Institute of Neurological Disorders and Stroke.