How does one go about specializing in this area? Do you do a fellowship? If so, is it very competitive or difficult? What do sleep doctors do most of the time? Is there really a need for them?

Three traditional routes: internal medicine/pulmonary fellowship(2-3 years)/sleep fellowship (1 year)
neurology/sleep fellowship (1 year)
psychiatry/sleep fellowship (1 year)

I think that ENT docs can also do sleep fellowships and run sleep clinics too.

To answer your other quesions:

There is definitely a need for sleep docs, because the diagnoses of sleep disorders requires a fair amount of very specialized testing. I don't think it's supercompetitive, but it is becoming moreso. Reasons: first, because this specialty is based on doing sleep studies, which are pretty pricy, it can be a big money-maker.
Secondly, you used to be able to get sleep board certified without actually doing a fellowship (you could sort of do "independent study" under a sleep-board certified doc and qualify for the exam). Nowadays they have changed that and the only way to get board certified is by doing a fellowship.

Sleep docs evaluate patients with sleep problems, which for the most part fall into two major categories:
1) Insomnia (not sleeping enough). There are many, many causes for this. Often requires a lot of attention to psychologic issues as well as medical.
2) Excessive daytime somnolence (sleeping too much at the wrong time). The most common specific diagnoses encountered here are obstructive sleep apnea (by far the most common), periodic limb movements of sleep, and narcolepsy.

You will interpret sleep studies, which is pretty interesting. Some sleep docs take a more active role in managing the patient once the diagnosis is made, others maintain a more consultant role and focus on diagnosis and management reccommendations, then hand the patient back to the primary care doc.

I talked to the attending at my med school who runs the sleep clinic (a neurologist), and he told me that the field is designing a residency program in sleep medicine that will be 2-3 years after a prelim medicine year, that you would match in straight from med school. This is because while the field is mostly neurologists now, sleep medicine combines a lot of aspects of pulmonary as well and extensive training in the other areas of neurology and pulmonary are not necessary for the practice of sleep medicine. He told me those graduating med school in 2008 should expect this to be an established residency choice, and the best way before then is still through neurology.

I was told a new sleep board exam will be held for limited times. neurologist with one year clinical experience in sleep medicine will be allowed to sit for the exam for 3 times.. there is no need for sleep fellowship. 2007, 2009 and 2011 will be your final attempt.

I was told a new sleep board exam will be held for limited times. neurologist with one year clinical experience in sleep medicine will be allowed to sit for the exam for 3 times.. there is no need for sleep fellowship. 2007, 2009 and 2011 will be your final attempt.



please share with your information

Sleep Medicine is really easy for Neurologists. All you have to add to what you know is: CPAP cures sleep apnea.
Oh, and you have to learn to read polysomnograms which are simply 4 channels of EEG plus some DC channels for breathing paremeters, eye movements, etc. added.
Having taught in a sleep fellowship program for a number of years, when the neurology residents came through, we just spent a day or so going over the difference between EEG and PSG, then had a good time learning the clinical aspects of parasomnias. When the pulmonologists rotated, OY! They had to learn all about EEG, didn't know squat about human behavior. All they knew was sleep apnea (see above).
I would strongly encourage any neurologist to go for the new sleep boards. Just get a good sleep text, spend some time looking at sleep studies at your local lab and you're good to go. I did it 20 years ago.

Sleep Medicine is really easy for Neurologists. All you have to add to what you know is: CPAP cures sleep apnea.
Oh, and you have to learn to read polysomnograms which are simply 4 channels of EEG plus some DC channels for breathing paremeters, eye movements, etc. added.
Having taught in a sleep fellowship program for a number of years, when the neurology residents came through, we just spent a day or so going over the difference between EEG and PSG, then had a good time learning the clinical aspects of parasomnias. When the pulmonologists rotated, OY! They had to learn all about EEG, didn't know squat about human behavior. All they knew was sleep apnea (see above).
I would strongly encourage any neurologist to go for the new sleep boards. Just get a good sleep text, spend some time looking at sleep studies at your local lab and you're good to go. I did it 20 years ago.

thanks for the info..

can you suggest a sleep textbook?

thanks for the info..

can you suggest a sleep textbook?


"Principles and Practice of Sleep Medicine" by Kryger, Roth and Dement is the "gold standard." There are many less voluminous textbooks if you are interested, just browse Amazon.

"Principles and Practice of Sleep Medicine" by Kryger, Roth and Dement is the "gold standard." There are many less voluminous textbooks if you are interested, just browse Amazon.

thanks!

"Principles and Practice of Sleep Medicine" by Kryger, Roth and Dement is the "gold standard." There are many less voluminous textbooks if you are interested, just browse Amazon.


would you share with me your way to score arousals, hypopneas . they seems to be quite confusing even among some sleep docs. thanks

anyone watch the cnn special on sleep medicine.. :laugh:

please share with your information


a new sleep board will allow neurology with 12-month experience accumulated from prior 5 years will sit for the exam. the first exam will be available in 2007. the detail will come out in the fall of this year. after 2011, you must go through a fellowship to get certified. there will be minimal numbers of patients and psg/mslt you need to document. also minimal one day per week is needed to devoted to sleep medicine.

Any one took the recent sleep board exam.?
It is still not too late to get practice experience to catch the final sleep board exam in 2011. good luck.