Becoming a sleep medicine specialist

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Students pose in lab coats outside the hospital in Iringa, Tanzania. Although the amount of sleep a person needs may vary, sleep is essential for overall good health. You may not realize how important proper sleep is until you lack it. According to Stanford Medical Center, there are about 100 different types of sleep disorders that affect children and adults. Sleep disorders can lead to serious health problems, decreased productivity and poor quality of life.

Sleep disorders may directly or indirectly be related to abnormalities or conditions of the nervous system or the immune system. Psychological issues, obesity and alcohol and drug abuse can also lead to sleep disorders.

Because of the complexity of sleep disorders, their causes and how they can affect the body, the field of sleep medicine was born. Sleep medicine is a relatively new subspecialty in which board certification became available in the mid-1970s.

What does a sleep medicine specialist do?

Sleep medicine specialists are trained to diagnose, treat and manage various types of sleep disorders. Physicians in sleep medicine will perform a physical exam, take a medical history and may perform a variety of sleep studies or tests, such as a polysomnogram. A polysomnogram records a patient’s brain waves, eye movements, respiratory rate and other vital signs while the patient is sleeping. It is performed to diagnose certain sleep disorders, such as sleep apnea.

Not all sleep medicine specialists perform the actual tests. In many cases, the physician orders a test and a technologist does the study. The doctor then interprets the results in order to make a diagnosis. 

Sleep doctors may treat patients with conditions, such as narcolepsy, sleep apnea and restless leg syndrome. Additionally, patients with nightmares, REM sleep disorders and sleepwalking may also be treated by a sleep medicine specialist.

After identifying the specific sleep disorder, the specialist uses different methods to treat the condition. Treatment may include oral devices, medication or the use of a continuous positive airway pressure (CPAP) machine. Surgery to remove tissue obstructing the airway or lifestyle changes, such as weight loss, may also be advised. Physicians also teach patients optimal sleep hygiene techniques to improve sleep quality. 

Education, training and requirements

In order to become board certified in sleep medicine, the first step is completing a four-year undergraduate degree. Although a specific college major is not required, students will need to meet medical school requirements for completed science classes. After graduating from medical school, a residency needs to be completed in a specialty, such as internal medicine, anesthesiology, neurology, pediatrics, family medicine or otolaryngology. Residency length varies by specialty, but most of the above are three to four years.

Sleep medicine is a recognized subspecialty of all of the above areas of medicine. After completing a residency in one of the specialties above, physicians need to complete a one-year fellowship in sleep medicine. A fellowship in sleep medicine will include understanding the complexity of sleep disorders and how they impact various organ systems of the body. Passing the Sleep Medicine Certification Exam is the last step to become board certified.

Opportunities and advancements in sleep medicine

The field of sleep medicine continues to expand. As more is understood about the effects of sleep disorders on a person’s overall health, the need for accurate diagnosis and treatment is growing.

Many sleep medicine doctors work in sleep labs affiliated with hospitals or medical centers. They may also work in privately-owned sleep centers. Some physicians may also find opportunities in research and education. Advancement opportunities include becoming the director of a sleep center or owning a sleep center.

Salary and working conditions

Sleep medicine specialists spend their time working in hospitals and sleep labs. They may also see patients in their offices. Although the amount of hours worked may vary, sleep medicine may not require the extensive hours of specialties like surgery.

The salary of a sleep medicine doctor depends on whether he or she owns owns a sleep center or works in an independent sleep lab or medical center-based sleep lab. According to the Physician Compensation Report conducted by Medscape, the average salary for a sleep medicine specialist in United States in 2013 was $260,000 a year.

Traits needed to be successful in sleep medicine

Every medical specialty requires certain personality traits or skills in order to be successful and enjoy the work. Working in sleep medicine takes someone who is detail oriented. Interpreting sleep studies requires a doctor to pay attention to subtle changes. Missing small details may interfere with making an accurate diagnosis.

Having empathy is important in all areas of medicine and sleep medicine is no different. Patients may have suffered for years with sleep problems which significantly impacted their lives. Emotional support and compassion can go a long way for patients. 

Pros

There are several aspects of working as a sleep medicine specialist that some doctors may find attractive. For example, doctors often work predictable hours without the need to be on call or work overnight. Although sleep studies are often performed overnight, a technologist may do the study. The doctor may work during the daytime, interpreting results and then meeting with patients to discuss results and treatment options.

Unlike certain specialties, life-threatening situations are not part of the day-to-day work at a sleep lab. There may be less stress involved in being a sleep medicine specialist as opposed to other specialties, such as surgery or emergency medicine.  Because of the wide variety of sleep disorders and complexity of the conditions, the field can be very interesting. Doctors also get to work with patients of all ages.

Cons

If you thrive on excitement and working in a fast-paced environment, sleep medicine may not be the best fit for your personality. Some sleep clinics specialize in treating certain common sleep disorders, such as obstructive sleep apnea. If this is the case, the work can get repetitive at times.

Sleep medicine is also a bit of a narrow field to limit your practice to. Some doctors practice sleep medicine part-time at a sleep lab while still working in the specialty they trained in during residency, such as internal medicine. Another option is to combine your sleep medicine practice with your main specialty, such as neurology or family practice.  

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