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Sleep Epidemiology
Last edited |
06/13/2006
Written by Maurice M. Ohayon, MD, DSc, PhD
Various epidemiological studies have been conducted in the last
fifteen years in the general population, still, many domains in the field of
sleep epidemiology remain to be explored, in particular the repercussions of
poor sleep on society
Since the 1960s, numerous laboratory studies
conducted in sleep centers or clinics have identified both mechanisms and
disorders of sleep
The monitoring of patients in institutions or by their physicians
has also provided valuable data.
In comparison, we possess little data on the characteristics
of sleep in the general population.
For our part, we were interested in finding out what effect, if
any, sleep disorders and their therapies have on such parts of society as the
work place, health care and public safety.
The biggest consumers of hypnotics and tranquilizers are the
elderly and we know that prescriptions for sleeping drugs are generally long
term and their use fluctuates from one medical category to another.
However, still, little is known about the consequences such as
dependency, disorders of cognition and effects on memory and alertness.
An in-depth look at general population investigations of sleep
disorders (especially insomnia) reveals many differences between them.
Inconsistent methodologies translate into inconsistent and
incomparable results between studies.
Differences are seen in the types of questions and forms of
questionnaires used to assess the presence and severity of sleep disorder
symptoms and the impact symptoms have
on daily functioning.
Finally, although some studies have suggested a
connection between sleep disorders and an organic or
psychiatric condition, studies with
greater statistical power are greatly needed to confirm or reject such
suspicions
Moreover, most of the epidemiological data we have on sleep
disorders have come to us from surveys which consider the problem of sleep
within a larger spectrum of problems, and thus important questions about sleep
disorders are lacking, resulting in an incomplete picture of the problem.
With the benefit of the experiences from those who had gone
before us and after years of planning and adjustments, we set out on the task at
hand: an epidemiological survey of sleep disorders from general populations
around the globe.
Our plan of attack for this daunting task required several
fundamental items:
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First, in order to achieve thousands of interviews and record
our interviewees' remarks "live", person to person, but without any medical
involvement, we conducted telephone interviews using interviewers without
medical training.
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Next, we took advantage of the many opportunities computer
technology affords us today.
A kind of artificial intelligence known as an expert system was designed and
programmed by myself to uncover sleep disorders through the use of specific
individualized questionnaires.
Just as a medical doctor uses expertise to make diagnoses through a line of
questions based upon the answers given to specific questions, so does this
system. In addition this type of approach offered the advantage of improved data
reliability.
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