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Department of Medicine, University of Chicago Pritzker
School of Medicine
Section of Pulmonary and Critical Care and The Sleep
Disorders Center
Chicago, Illinois
Department of Pediatrics, Kosair Children's Hospital
Research Institute
University of Louisville
Louisville, Kentucky
A discipline is dying if there are no more questions being asked or no one cares to ask them. This year marks the first time that a relatively large number of professionals with specialty training in five major specialties of Medicine coincided and subscribed to the rigorous process of taking an examination that tested their knowledge in the basic principles and clinical practice of a newly recognized specialty, Sleep Medicine. Many among those test takers were members of our Society. More importantly, many of the scientific and clinical principles currently providing the foundation of our clinical practice in sleep disorders either originated or were substantially developed by a cadre of innovative thinkers in respiratory medicine, individuals who dared to ask pertinent questions and further sought the answers to those questions. Their seminal contributions will undoubtedly withstand the test of time, and yet, they have raised many more questions that remain unanswered, attesting to the vibrancy of the discipline, and thereby opening the doors for many new inquisitive minds to probe in new horizons. Therefore, the future looks bright for Sleep Medicine, and it seemed only natural to take some time to pause and reflect on what we know and where we go from here. Logically, the main topic for this virtual symposium centered around sleep-disordered breathing.
Sleep-disordered breathing has become recognized as a prevalent disorder in both adults and children. Obstructive sleep apnea is now increasingly recognized as a significant chronic disorder that carries substantial end organ morbidity, and if left untreated can lead to increased health care expenditures, decreased quality of life, and to major cardiovascular, metabolic, and neurobehavioral complications. In fact, the burden of this relatively new disease of "modern society" may also carry increases in mortality. Despite the increased recognition of this condition by health care providers, a significant proportion of the population with sleep-disordered breathing still remains undiagnosed and untreated, and the potential societal, health-related, and economic consequences remain poorly defined.
Extensive research over the last decade has increased our understanding of the epidemiology, pathophysiology, and some of the morbidities of sleep-disordered breathing. With all these considerations in mind, the specific purpose of this "virtual symposium" is to thoroughly and critically review the current knowledge in sleep-disordered breathing, and to provide insight and guidance into important questions that require further investigation. To that effect, in this issue of the Proceedings, we have invited a cast of highly qualified experts and researchers in Sleep Medicine to discuss in great detail recent advances in epidemiology, pathophysiology, and diagnosis of adult and pediatric obstructive sleep apnea. Moreover, the emerging knowledge on cardiovascular and metabolic consequences of obstructive sleep apnea, as well as a variety of treatment modalities, are discussed in detail. For the sake of completeness, other sleep-related respiratory conditions during sleep such as central sleep apnea, obesity hypoventilation, and the overlap syndrome have been reviewed as well.
Our most fervent hope is that the state-of-the-art discussions in this symposium will stimulate the readership, and provide a focused assessment of the current state of knowledge on this new disease epidemic. We also wish that the review materials gathered herein will open a forum for discussion and for formulation of many probing questions waiting to be asked, and encourage many of our colleagues to join in, and help us find the answers in this exciting and important area of respiratory medicine.
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