From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
Department of Anesthesiology and Pain Medicine, Women's College Hospital, and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Anesth Analg. 2021 May 1;132(5):1296-1305. doi: 10.1213/ANE.0000000000005490.
There is common ground between the specialties of anesthesiology and sleep medicine. Traditional sleep medicine curriculum for anesthesiology trainees has revolved around the discussion of obstructive sleep apnea (OSA) and its perioperative management. However, it is time to include a broader scope of sleep medicine-related topics that overlap these specialties into the core anesthesia residency curriculum. Five main core competency domains are proposed, including SLeep physiology; Evaluation of sleep health; Evaluation for sleep disorders and clinical implications; Professional and academic roles; and WELLness (SLEEP WELL). The range of topics include not only the basics of the physiology of sleep and sleep-disordered breathing (eg, OSA and central sleep apnea) but also insomnia, sleep-related movement disorders (eg, restless legs syndrome), and disorders of daytime hypersomnolence (eg, narcolepsy) in the perioperative and chronic pain settings. Awareness of these topics is relevant to the scope of knowledge of anesthesiologists as perioperative physicians as well as to optimal sleep health and physician wellness and increase consideration among current anesthesiology trainees for the value of dual credentialing in both these specialties.
麻醉学和睡眠医学这两个专业有一些共同之处。传统的麻醉学住院医师睡眠医学课程主要围绕阻塞性睡眠呼吸暂停(OSA)及其围手术期管理展开。然而,现在是时候将与这些专业重叠的更广泛的睡眠医学相关主题纳入核心麻醉住院医师课程中了。提出了五个主要的核心能力领域,包括睡眠生理学;睡眠健康评估;睡眠障碍评估及其临床意义;专业和学术角色;以及健康(良好睡眠)。这些主题的范围不仅包括睡眠和睡眠障碍呼吸(如阻塞性睡眠呼吸暂停和中枢性睡眠呼吸暂停)的生理学基础知识,还包括围手术期和慢性疼痛环境中的失眠、与睡眠相关的运动障碍(如不宁腿综合征)和白天过度嗜睡障碍(如发作性睡病)。作为围手术期医生,麻醉师对这些主题的认识与他们的知识范围相关,同时也与最佳睡眠健康和医生健康相关,并增加了当前麻醉学住院医师对这两个专业双重认证价值的考虑。