Editing Sleep disorder (section)

== Sleep medicine ==
{{Main|Sleep medicine}}

Due to rapidly increasing knowledge and understanding of sleep in the 20th century, including the discovery of REM sleep in the 1950s and circadian rhythm disorders in the 70s and 80s, the medical importance of sleep was recognized. By the 1970s in the US, clinics and laboratories devoted to the study of sleep and sleep disorders had been founded, and a need for standards arose. The medical community began paying more attention to primary sleep disorders, such as sleep apnea, as well as the role and quality of sleep in other conditions. 
[[File:To_Sleep_Forevermore.jpg|thumb|Sleep Medication.]]

Specialists in sleep medicine were originally and continue to be certified by the [[American Board of Sleep Medicine]]. Those passing the Sleep Medicine Specialty Exam received the designation "diplomate of the [[American Board of Sleep Medicine|ABSM]]". Sleep medicine is now a recognized subspecialty within [[internal medicine]], [[family medicine]], [[pediatrics]], [[otolaryngology]], [[psychiatry]] and [[neurology]] in the [[United States]]. Certification in Sleep medicine shows that the specialist:{{blockquote|has demonstrated expertise in the diagnosis and management of clinical conditions that occur during sleep, that disturb sleep, or that are affected by disturbances in the wake-sleep cycle. This specialist is skilled in the analysis and interpretation of comprehensive polysomnography, and well-versed in emerging research and management of a sleep laboratory.<ref>{{cite web|url=http://www.abms.org/Who_We_Help/Physicians/specialties.aspx|title=American Board of Medical Specialties : Recognized Physician Specialty and Subspecialty Certificates|access-date=2008-07-21|url-status=dead|archive-url=https://web.archive.org/web/20120508025259/http://www.abms.org/who_we_help/physicians/specialties.aspx|archive-date=2012-05-08}}</ref> }}

Competence in sleep medicine requires an understanding of a myriad of very diverse disorders. Many of which present with similar [[symptom]]s such as excessive daytime sleepiness, which, in the absence of volitional [[sleep deprivation]], "is almost inevitably caused by an identifiable and treatable sleep disorder", such as sleep apnea, [[narcolepsy]], [[idiopathic hypersomnia]], [[Kleine–Levin syndrome]], menstrual-related hypersomnia, [[idiopathic]] recurrent stupor, or [[circadian rhythm sleep disorders|circadian rhythm disturbances]].<ref>{{cite journal | vauthors = Mahowald MW | title = What is causing excessive daytime sleepiness? Evaluation to distinguish sleep deprivation from sleep disorders | journal = Postgraduate Medicine | volume = 107 | issue = 3 | pages = 108–10, 115–8, 123 | date = March 2000 | pmid = 10728139 | doi = 10.3810/pgm.2000.03.932 | s2cid = 42939232 }}</ref> Another common complaint is insomnia, a set of symptoms which can have a great many different causes, physical and mental. Management in the varying situations differs greatly and cannot be undertaken without a correct diagnosis.<ref>{{cite journal | vauthors = Araújo T, Jarrin DC, Leanza Y, Vallières A, Morin CM | title = Qualitative studies of insomnia: Current state of knowledge in the field | journal = Sleep Medicine Reviews | volume = 31 | pages = 58–69 | date = February 2017 | pmid = 27090821 | pmc = 4945477 | doi = 10.1016/j.smrv.2016.01.003 }}</ref>

Sleep dentistry ([[bruxism]], [[snoring]] and [[sleep apnea]]), while not recognized as one of the nine [[dentistry|dental specialties]], qualifies for board-certification by the American Board of Dental Sleep Medicine (ABDSM). The qualified dentists collaborate with sleep physicians at accredited sleep centers, and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.<ref>{{cite web|url= http://www.abdsm.org/|title= About the ADBSM |access-date= 2008-07-22 |publisher= American Board of Dental Sleep Medicine }}</ref> The resulting diplomate status is recognized by the [[American Academy of Sleep Medicine]] (AASM), and these dentists are organized in the Academy of Dental Sleep Medicine (USA).<ref>{{cite web|year=2008|title=About AADSM|url=http://aadsm.org/|access-date=2008-07-22|publisher=Academy of Dental Sleep Medicine}}</ref>

[[Occupational therapy]] is an area of medicine that can also address a diagnosis of sleep disorder, as rest and sleep is listed in the Occupational Therapy Practice Framework (OTPF) as its own occupation of daily living.<ref name=":23" />  Rest and sleep are described as restorative in order to support engagement in other occupational therapy occupations.<ref name=":23" /> In the OTPF, the occupation of rest and sleep is broken down into rest, sleep preparation, and sleep participation.<ref name=":23">{{cite journal | vauthors =  | title = Occupational Therapy Practice Framework: Domain and Process-Fourth Edition | journal = The American Journal of Occupational Therapy | volume = 74 | issue = Supplement_2 | pages = 7412410010p1–7412410010p87 | date = August 2020 | pmid = 34780625 | doi = 10.5014/ajot.2020.74S2001 | s2cid = 204057541 }}</ref> Occupational therapists have been shown to help improve restorative sleep through the use of assistive devices/equipment, [[Cognitive behavioral therapy for insomnia|cognitive behavioral therapy for Insomnia]], therapeutic activities, and lifestyle interventions.<ref>{{cite journal | vauthors = Ho EC, Siu AM | title = Occupational Therapy Practice in Sleep Management: A Review of Conceptual Models and Research Evidence | journal = Occupational Therapy International | volume = 2018 | pages = 8637498 | date = 2018-07-29 | pmid = 30150906 | pmc = 6087566 | doi = 10.1155/2018/8637498 | doi-access = free }}</ref>

In the UK, knowledge of sleep medicine and possibilities for diagnosis and treatment seem to lag. The Imperial College Healthcare<ref>{{cite web |url= http://www.imperial.nhs.uk/services/sleepservices/index.htm |title= Sleep services |access-date= 2008-08-02 |year= 2008 |publisher= Imperial College Healthcare NHS Trust |url-status= dead |archive-url= https://web.archive.org/web/20081004181017/http://www.imperial.nhs.uk/services/sleepservices/index.htm |archive-date= 2008-10-04 }}</ref> shows attention to obstructive sleep apnea syndrome (OSA) and very few other sleep disorders. Some NHS trusts have specialist clinics for respiratory and neurological sleep medicine.