Learn Everything About the Science of Sleep

What is online education?

The lives of people in the field of healthcare and medicine are very eventful and busy. Be it doctors, interns, nurses, pathologists etc. all of them have packed schedules. Their devotion to the profession is what gives them the strength to keep working hard and learn something new everyday. Online education can boost their knowledge and skills irrespective of the time constraints.
Online education is the use of the internet via electronic devices such as laptops, mobile
phones and other electronic devices to gain knowledge about a variety of topics. It allows mentors to reach out to a large number of learners. It allows students without access to traditional classes, working individuals and home-makers to learn new skills and topics. This mode of education has an edge over classroom learning because of its flexibility with respect to speed and time of learning, cost effectiveness and networking opportunities with people of different backgrounds.

What is sleep medicine?

Sleep is essential to survival. It is important for growth, normal functioning of the brain and other organs of the body and helps our tired body to re energize itself. Getting good quality sleep regularly is a priority. The duration depends mainly upon the health and age of an individual.
Sleep medicine is the field of study that focuses on diagnosis and treatment of sleep disorders.
Specialists in this field have special training that gives them the expertise to diagnose and treat sleep problems and disorders. They can treat a wide range of disorders related to sleep, such as breathing problems, abnormal activity during sleep, insomnia, hypersomnia, etc.
Patients with sleep issues can present to all disciplines and sleep issues can occur alone or co-exist with other medical conditions. Thus it is essential for specialists, physician's surgeons in all disciplines of medicine to be familiar with the conditions.

Factors responsible for sleep problems:

A number of factors are responsible for sleep disorders and its disruption.
This can vary depending on the type of disorder. A few of them are listed below.
Gender – Females are more prone to sleep disorders( Insomnia , RLS) as compared to males.
Lung disease – Both obstructive and restrictive lung diseases are associated with sleep
problems.

Renal diseases – About 80% of patients suffering from end stage renal disorders have reported sleep disorders. The symptoms include difficulty falling asleep, awakenings in the middle of the night, waking up too early, restless legs, jerking legs, and daytime sleepiness.

Endocrine disorders – Hypothyroidism and acromegaly are associated with Obstructive Sleep Apnea(OSA). Diabetes is associated with sleep disturbance, difficulty in falling asleep and maintaining a good quality sleep. Short duration sleepers are more prone to diabetes as compared to long duration sleepers. Also, glucose tolerance is impaired in patients with OSA. According to a study published in the Journal of Family Medicine and Primary Care(Bhaskar et al; 2016), with increasing age, diabetic patients are more likely to suffer from insomnia.

Infectious diseases – People with acute infection need more sleep. This may be due to the action of the immune system by the release of cytokines. People infected with influenza virus tend to sleep more during the symptomatic phase as compared to the incubation phase. Lyme disease, hepatitis B and C, brucellosis are infections in which the patient suffers from difficulty in getting a good quality sleep. Patients with HIV have reported insomnia, excessive daytime sleepiness, and multiple awakenings at night very frequently. In a longitudinal study by Choudhary et al, published in Cureus, a significant prevalence of insomnia has been reported in COVID-19 patients upto 30 days post recovery. The social confinement and financial constraints experienced by people worldwide during the pandemic is a reason for sleep problems, fatigue and excessive sleepiness that they experienced.

Menopause – Most women experience a lot of sleep related problem during menopause because of hot flashes, sleep apnea, restless legs syndrome, depression, and symptoms of fibromyalgia.

Cancer – Patients undergoing cancer therapy(especially lung and breast cancer) commonly report hypersomnolence, excessive fatigue, insomnia and multiple awakenings.
Neurologic disorders – These include Alzheimer’s, Parkinsons, epilepsy, etc. these patients report poor night sleep, rapid eye movement (REM) sleep behaviour disorder, insomnia, restless legs syndrome, etc.
Pregnancy – According to a study by Mindell et al(Sleep medicine, 2015), around 75% women experience poor quality sleep during the whole period of pregnancy. All of the subjects reported night time awakenings. This is mainly due to the frequent urinations and the difficulty in finding a comfortable sleep position. Theyalso reported insomnia, day time sleep, restless leg syndrome, etc.

Hence, keeping in mind the range of factors and diseases which can affect and be affected by
sleep, it becomes extremely important for all physicians and specialists to screen and treat all their patients for any sleep related problems. Online sleep medicine courses can be extremely helpful for them.

Who should enroll ?

Doctors who preferably should have additional training in sleep medicine include:

●Anesthesiologists (surgical care and anaesthesia)
● Cardiologists (heart)
● Family physicians
● Internal medicine doctors
● Neurologists (brain and nervous system)
● Otolaryngologists (ear, nose and throat, or ENT, specialists)
● Paediatricians
● Psychiatrists
● Pulmonologists (lungs)
● Psychologists – for special training in treating sleep related behaviours and insomnia
● Dentists – some of them create and fit dental devices used to treat sleep apnea.

Sleep medicine and management is emphasised upon very less in both undergraduate and postgraduate medical education in India. As a result, awareness about sleep(even among physicians) and presence of sleep labs across the country is very less. This also leaves patients unaware about the importance of sleep. They seldom realize that a health reason might be a result of sleep deprivation.
Knowing the importance and significance of sleep in our life, online comprehensive courses on sleep medicine in India should be extremely helpful for medical practitioners at all levels. It will increase sleep awareness among people in the society, improve the quality of life of the individual and have a long lasting effect on the community .

References:

Bhaskar, S., Hemavathy, D., & Prasad, S. (2016). Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of family medicine and primary care, 5(4), 780–784. https://doi.org/10.4103/2249-4863.201153


Choudhry, A. A., Shahzeen, F., Choudhry, S. A., Batool, N., Murtaza, F., Dilip, A., Rani, M., & Chandnani, A. (2021). Impact of COVID-19 Infection on Quality of Sleep. Cureus, 13(9), e18182. https://doi.org/10.7759/cureus.18182


Mindell, J. A., Cook, R. A., & Nikolovski, J. (2015). Sleep patterns and sleep disturbances across pregnancy. Sleep medicine, 16(4), 483–488.

https://doi.org/10.1016/j.sleep.2014.12.006
Parish J. M. (2009). Sleep-related problems in common medical conditions. Chest, 135(2), 563–572. https://doi.org/10.1378/chest.08-0934

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