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Sleep Medicine: The Uncertain Future

Published:September 07, 2022DOI:https://doi.org/10.1016/j.jsmc.2022.07.001
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      Ana C. Krieger, MD, MPH, FCCP, FAASM, Editor
      It is clear that knowledge in sleep medicine has been gained at a faster pace than ever. There are daily developments and discoveries in the basics of sleep science that will soon be translated into clinical care, including the development and validation of technological innovations to monitor sleep and sleep disorders. These changes are expected to continue into our future at a rapid pace as we integrate and share knowledge in a seamless manner.
      It is essential to recognize that the future of sleep medicine is not just about innovations in medications, procedures, or devices. It is much more than the latest articles showing better results or unrecognized dangers. And it is certainly more exciting than having newer companies or centers offering yet unavailable services, which can sometimes be a dangerous journey for patient care. Although new PAP technology, an improved oral appliance, and news regarding a more effective hypnotic or stimulant are important elements to patient care, there are a lot more exciting developments ahead.
      The greatest advances in sleep medicine will involve the way we think. It is how we use our scientific and clinical findings; these new devices, knowledge, and services; how we replace old technologies and select among the new ones, which ones are valid and should be embraced; how we combine them to advance and facilitate access to patient care; and how we continue to improve them. It is vital that we transform technology from a one-size-fits-all to targeted diagnostics and therapeutics. It is important that we change patient management by trial and error and what everyone else does toward sleep medicine by design, with personalized approaches. Lastly, it is crucial that we stop reflecting upon the way it usually is and allow ourselves to believe in the seemingly endless possibilities of science and health care.
      This new way of thinking will have a broad impact in all areas of sleep medicine: education and research, patient care and public health, regulatory policies, reimbursement for products and services, resource allocation, insurance coverage, and medical philosophy and ethics; in short, the way we learn, work, get paid, and feel about health care in sleep medicine.
      We cannot simply rely on our knowledge of yesterday and today to forecast the future. When attending conferences, we must avoid getting caught in the light of the latest flashing news and make sure we embrace the experiences and new research developments at large, not just from the keynote talks. An attentive look at the smaller sessions, abstracts, and poster presentations will provide a glimpse of what the keynote topics will be 10 years from now.
      There are brewing changes in product development. When searching for sleep products, we should go beyond just comparing devices and drugs that are available today, allowing time to also review new patent applications and technical and pharmaceutical journals; these are the inventions that we might be using a decade from today.
      This also applies when discussing sleep medicine, by not limiting our conversations with fellow health care providers and scientists. Rather, talking to engineers, information technology specialists, patients and their advocates, insurance providers, and policymakers. Consider mentoring new students or teaching a class; it is from them that you will acquire fresh perspectives, form new ideas, and identify new opportunities.
      Preparing for the future of sleep medicine is more than just bending with every new gust of knowledge, test, or treatment that comes our way. We can ill afford to either rapidly incorporate or disregard every new discovery; to purchase every new device and throw out every old; to disdain every new skill and persist in doing every old; or to follow every fad, fancy, or headline. It will take a lot of discipline and perspective to avoid seeing only sensational news and ignoring slowly moving trends.
      Our job, as scientists and health care professionals, is not to predict exactly how the future of sleep medicine will unfold, but rather to reduce uncertainties so that we and our patients are not caught unaware and unprepared. Predicting the future of sleep medicine is not a prophesy that everything will get better or that all will be worse. Rather, predicting the future is a conviction that things will change, and that, somehow, we can all help to improve it by playing an important role advocating for solid research, having a strong base of knowledge in science and patient care needs, and not losing perspective; otherwise, we may put the future at risk and allow it to become worse.