A Shot in the Arm for Obama’s Precision Medicine Initiative

.Precision medicine is a big idea. Tailoring drugs and therapies to a patient’s individual disease, lifestyle, environment, and genes could touch off a health-care revolution, or so the thinking goes. But first there is much we need to learn about what that all means to a person’s health. That’s why the Obama administration announced Wednesday evening that it is devoting $55 million this year to the creation of a public database containing detailed health information about a million or more volunteers. It’s also why it’s trying to figure out how to better regulate the fast-growing genetic testing market.

Precision medicine is not wihout high risk, as the molecules have powerful effects, and side effects that are potentially lethal.  Hence the need for clinical trials.

Called the Precision Medicine Cohort, the database will be the “largest, most ambitious research project of this sort ever undertaken,” said Francis Collins, director of the National Institutes of Health, during a call with reporters. It will contain medical records, sequenced genomes, blood and urine tests, and even data from mobile health tracking devices and applications. Collins stressed that the database will represent people from all races, ethnicities, and socioeconomic classes, and said it will track participants over many years.

In a separate but related project, also announced Wednesday, the U.S. Food and Drug Administration published draft guidance documentson how it might police the exploding field of genetic testing. The agency is concerned that a new generation of genetic tests could risk patient safety. The technology underlying these tests can quickly and inexpensively sequence an entire genome and identify millions of genetic abnormalities at a time. But interpreting the results is still a work in progress.

Many of the tests purport to tell patients whether they have or are at risk for certain diseases and even direct them toward targeted therapies. The whole area has been largely unregulated, but the FDA aims to use its regulatory power to assess how accurate and clinically useful the tests really are.

Advanced tests like these are “pivotal to the future promise of the Precision Medicine Initiative,” said Robert Califf, the FDA’s commissioner, but that promise is only “as good as the tests that guide diagnosis and treatment.” Califf wouldn’t say when the new regulations would be finalized, but the new information should clarify some of the regulatory uncertainty facing companies that develop such tests.

                                                                     (figure 1) retina of a patient with retinitis pigmentosa:

Patients with currently untreatable neurologic diseases may benefit from novel therapies such as Retinitis Pigmentosa, Schizophrenia and Parkinson's disease.

 (figure 2) Normal retina

VC companies are investing in companies such as  Retro-sense to develop novel methods using injectables directly into the eye.

The current clinical trial is now recruiting it's initial patient cohort. To learn more about the study, it is published at Clinicaltrials.gov  

RST-001 is a gene therapy given as an injection into the eye and delivers a gene encoding a photo switch, channelrhodopsin-2, (optogenetics) to cells in the retina of the eye. When expressed, the channelrhodopsin-2 protein can depolarize in response to light thus generating a signal that is transmitted to the brain.

The study is composed of two parts. An initial dose-ranging study (part 1) is proposed whereby three dose levels of RST-001 will be studied in three separate groups of adult patients with advanced disease. This first part of the study is aimed at determining a single dose of the experimental agent which is safe and well tolerated, to further evaluate in a fourth group of patients. The second part of the study is aimed at obtaining additional safety data at the highest tolerated dose and providing important additional clinical data to guide the design of future efficacy studies.)

A Shot in the Arm for Obama’s Precision Medicine Initiative

The Personalized Doctor Experience | Arlen Meyers, MD, MBA | Pulse | LinkedIn

The Personalized Doctor Experience | Arlen Meyers, MD, MBA | Pulse | LinkedIn

ANIHFMA lauds 150 healthcare providers for leading in patient financial communications

HFMA lauds 150 healthcare providers for leading in patient financial communications

A major complaint of patients is they are unable to obtain accurate costs for their health care and visits to the hospital.

Hospitals also have good reason to join patients and complain about predictive pricing. A typical explanation of benefits (EOB) is laden with misleading information. Furthermore it makes no sense, except to perhaps an accountant or health administrator on the inside. A Medicare EOB is quite different than one from a private insurer or  a managed care program. Furthermore there are no public documents that relate true costs for each service to the amounts on explanation of benefits.

Patients must insist on receiving a full explanation of benefits and questioning the numbers as well as how they are derived.  The present system is corrupted and every patient should become a "whistleblower"

Managed care programs have different contractual reimbursement models, 

MANAGED CARE PAYMENT METHODS 

Many methods exist to pay for provider services, including discounted fee-for-service charges, and capitation. Listed below are some common terms used in insurance plans to define payment obligations on the part of a patient, provider of services, or the insurance company. 

Capitation A payment system in which health care providers (physicians, hospitals, pharmacists, etc.) receive a fixed payment per member per month (or year), regardless of how many or few services the patient uses. 

Coinsurance An insurance policy provision under which both the insured person and the insurer share the covered charges in a specified ratio (e.g., 80% by the insurer and 20% by the enrollee). 

Co-payment A cost-sharing arrangement in which the managed care enrollee pays a specified flat amount for a specific service (such as $15.00 for an office visit or $10.00 for each prescription drug). It does not vary with the cost of the service, unlike coinsurance which is based on some percentage of charges. 

Deductibles Amounts required to be paid by the insured under a health insurance contract before benefits become payable. 

Discounted Fee-For-Service An agreed-upon rate for service between the provider and payer that is usually less than the provider’s full fee. This may be a fixed amount per service or a percentage discount. Providers generally accept such contracts because they represent a means of increasing their volume or reducing their chances of losing volume. 

Fee-for-Service (FFS) Reimbursement Payment in specific amounts for specific services rendered. Payment may be made by an insurance company, the patient, or a government program such as Medicare or Medicaid. The form of payment is in contrast to payment retainer, salary, or other contract arrangements (to Physicians or other suppliers of service); and premium payment or membership fee for insurance coverage (by the patient). 

Out-of-Pocket Expense The amount not reimbursed by insurance coverage and paid by the patient such as co-payments, deductibles and premiums. 

Pharmacy Benefit Coverage of prescription drugs by an insurance company. Often, beneficiaries will have an identification card designating their eligibility and will have to pay partially for the drug in the form of co-payments, deductibles, or coinsurance. Also referred to as a “Prescription Drug Benefit.” This benefit may be offered through a company other than your health insurer. 

Premium The amount paid to an insurer for providing coverage, typically paid on a periodic basis (monthly, quarterly, etc.). 

Prevailing Charge This is a fee based on the customary charges for covered medical insurance services. In Medicare payments for services or items, it is the maximum approved charge allowed. 

Reasonable Charge A methodology used by Medicare to determine reimbursement for items or services not yet covered under any fee schedule. Reasonable charges are usually determined by the lowest of the actual charge, the prevailing charge in the locality, the physician’s customary charge, or the carrier’s usual payment for comparable services. 5 

Reasonable Cost A methodology used by Medicare to determine reimbursement for items and services that takes into account both direct and indirect costs of providers such as hospitals, as well as certain Medicare HMOs and competitive Medical Plans. 

Reimbursement Reimbursement Refers to the actual payments received by providers or patients for benefits covered under an insurance plan. 

Third-Party Payment (a) Payment by a financial agent such as an HMO, insurance company, or government rather than direct payment by the patient for medical-care services. (b) The payment for health care when the beneficiary is not making payment, in whole or in part, on his/her own behalf. 

Usual, Customary, and Reasonable (UCR) Charges Private health insurance offers the basis for reasonable-charge reimbursement of physicians. This approach was developed before the introduction of Medicare and was adopted by Medicare. “Usual” refers to the individual physician’s fee profile, equivalent to Medicare’s “Customary” charge screen. “Customary,” in this context, refers to a percentile of the pattern of charges made by physicians in a given locality. “Reasonable” is the lesser of the usual or customary screens.

Contrary to opinions of most pundits, the American health system is strong and robust. The strength can be measured by the survival of any system, at all given the proclivity for congress to make law that has little to do with enhancing patient care.

Because our health system(s) are so diverse is it's main strength. When one segment gets out of balance another one rises to the occassion. Just recently the head of the Veterans Administration forecast that many of their beneficiaries would be sent out to civilian providers in order to meet the demand of primary and specialty care.  (they must not be aware of the dire situation of civilian primary care givers.)

At its 2016 ANI event, the Healthcare Financial Management Association on Sunday named 150 healthcare providers as leaders for adopting best practices when it comes to patient financial communications, an important benchmark as patient financial responsibility rises.

The award program was developed in 2013 to call attention to providers who excel at communications around billing, costs and payment options.

"Adopting the best practices promotes trust and helps prevent misunderstandings between patients and healthcare providers," said HFMA President and CEO Joseph J. Fifer, in a statement. "In a time when patients are paying more out of pocket for their health care, clear communication about financial matters is crucial. We encourage all provider organizations to seek Adopter recognition."

The organization said 85 hospitals and 68 clinics earned the recognition, though the bulk of the awardees were part of nine major healthcare systems. Those are Carolinas HealthCare, the Duke University Health System, Essentia Health, the Geisinger Health System, Intermountain Healthcare, Novant Health, St. Luke's Health System, The Metro Health System of Cleveland and UAB Medicine. Two critical access hospitals, Henry County Health Center in Mount Pleasant, Iowa, and Maury Regional Medical Center in Columbia, Tennessee, earned recognition.

According to Rodney Williams, senior manager of patient revenue management organization at Duke University Health System, the system makes it priority to understand how the cost of care affects its patients.

"We perform a comprehensive analysis to make sure that patients are not going to be surprised by the costs they are responsible for on the back end," he said in a statement.

Providers must attest to a range of patient communication best practices to earn the adopter status, the HFMA said.

Health Train Express.....A Venue for Health Reform and Health Information Technology

Rarely have two components of our health system advanced so swiftly.  There have always been advances in the science of medicine, however the speed of advances has increased, almost exponentially.  It has been fueled by increased computing power on the  desktop, mobile apps and the cloud. At the same time the cost of storing and processing information decreased considerably.



Individual users and enterprises can access information with little cost using only browser based access to large cloud servers providing software as a service (SAAS).

Is Obamacare Universal Health Care? - Rob Schwab

Senator Hatch sponsors bill targeting Affordable Care Act

U.S. will spend $2.6 trillion less on health care than expected before Obamacare, study projects

ObamaCare Facts: Facts on the Affordable Care Act

HolaDoctor: Helping the Hispanic Community Navigate the Changing Healthcare Landscape – Telehealth and Medicine Today ™

Reports shows catastrophic rise in uninsured rate should Affordable Care Act be repealed

Texas physician: MACRA law more dangerous than Affordable Care Act

Health Care Premiums: Up, and Rising Again | RealClearPolitics

The simultaneous changes in information technology and in  health finance administration has a double sided sword effect.

The Gary M. Levin Daily

The Coming Medical School Bust

Jun 20, 2016    |    Arlen Meyers, MD, MBA

Lower-tier law schools are in trouble. The latest saga is at Valparaiso, which faced a conundrum of whether to lower admissions standards to keep enrollment up, or maintain standards and suffer from falling revenue. Soon, we may be reading about the same thing for medical schools.

The Association of American Medical Colleges predicts that medical school enrollment will increase by 30% by 2019. But, suppose they are wrong? Suppose new business models make the physician shortage a myth?

The issues sound familiar:

1. Larger and larger student debt that may take an entire lifetime to pay off. 

2. A job market that is shrinking due to macroeconomic forces and the threat of substitutes, such as technology, robomedicine, and non-MD providers.

3. Adherence to an academic medical center model that is not suitable for most schools, given shrinking and vacillating basic science research funding, dwindling state support for higher education, and dropping reimbursement for the clinical cash cow.

4. Tenure policies that are no longer economically feasible.

5.  A business model that is broken. [ Many high tier academic centers refuse to believe this reality]
6. A PhD and post doc system that creates more and more student debt with limited academic tenure track possibilities.

7. The changing sick-care landscape demanding graduates with knowledge, skills, and attitudes that medical schools refuse to teach

8. Online teaching technologies that make non-clinical face-to-face lectures and memorization, and the basic science faculty who teach them, increasingly irrelevant. There are many online courses in basic sciences that would prepare students for the Part I National Board Examinations.[Coursera is one source that could easily be expanded.. The cost would be a fraction of today's unrealistic model]
9. The potential collapse of the employed physician market with limited opportunities or desire to participate in independent clinical practice.

10. An aging and more heterogeneous physician workforce full of people who refuse to retire.[Perhaps they could not save enough to retire]

Premeds, medical students, and trainees should plan for a worst-case scenario. Just like there are many non-practicing lawyer opportunities for those with a JD degree, there will be many non-clinical practice opportunities for those with an MD degree. You should plan and borrow accordingly.
 

- See more at: http://www.hcplive.com/physicians-money-digest/contributor/arlen-meyers-md-mba/2016/06/the-coming-medical-school-bust#sthash.vL77GLWg.dpuf

Replacing Obamacare  from Intrepid Now with Sally Pipes as interviewed by Joe Lavelle.

Transformational Changes

Sally joined us to discuss why and how we should be replacing Obamacare and much more in this episode:

1. (3:39) What is Obamacare?
2. (5:07) Several insurers have noted that they are losing money on the health insurance exchanges. What does this mean for the future of the exchanges and its customers?
3. (11:29) What must the federal government do to make health insurance affordable and increase accessibility?
4. (16:07) Will you describe the Trump Healthcare Plan for our audience?
5. (20:54) Will you also describe the Hillary Clinton Healthcare Plan?
6. (22:18) If you were President, what healthcare program would you implement?

The Five Percent in Health

The Wealth and Health Divide
The Growing Gap in the United States
Between the healthy and the sick

We have all heard about the one percent that have 95% of the assets in America.  The middle class is 'dead'.  

The same is true of the understanding of health financing in America. Only about one percent of patients (and providers) have the time or in following the endless changes in this area.

 Now that I am retired I find it a rewarding activity during my day. Health IT and reform have stimulated a new interest for me.

The remainder of my professional life is now dedicated to health information technology and health reform. These are my missions in my blogs.  Health Train Express is available for general knowledge about breaking news in health research and public health.

Digital Health Space encapsulates knowledge about health information technology for patients and providers. It is essential that both sides of our equation are equal in order to maximize the tremendous potential of information technology and the use of the internet to disseminate and acquire knowledge as well as accessing personal health records.

My efforts are self-funded...a truly non-profit activity in which I invest time and some money. I am beholden to no-one, no foundations, pundits, experts, nor authority. At times I quote others or just curate content without modification. Some source articulate issues much better than I do. My linguistic style is not as erudite or polished as some. More important should be my ideas...serious with much sarcasm and some humor.

How long will this continue ?

The Event Horizon

The Affordable Care Act, Accountable Care Organization and the Election

Better Together Health 2016 Event - Better Together     Are we really

The Affordable Care Act has stimulated many changes in health care. What is  considered good or bad depends upon the viewpoint of the provider and/or patient.

We have not yet seen the details of the Republican plan so Health Train Express will not offer our evaluation. Decisions based upon political rhetoric are at the least foolish, and at the worst dangerous.

It is doubtful if the ACA will be repealed entirely. Significant amendments ill be made. Other than some displeasure in the provider and health insurance industry patients who are able to access care are at less risk of not getting urgent care.  Even that presents problems in terms of provider accesss and the high deductible and premium expence for most receiving a partial subsidy. For those who are indigent, they have not expenses.

The progress of the organization being promoted by Medicare and some private insurers is the Accountable Care Organization (ACO).  The progress of developing this organization is fraught with many barriers. The ACO is an HMO on steroids.

Perhaps the closest organization to an ACO is the Kaiser Permanente model. The Counsel of Associated Physicians Group recently held a symposium, Better Together Health 2016 Event - Better Together.

The speakers represent a broad spectrum of the view on Accountable Care Organizations.

ROBERT PEARL, MD   CHAIR, COUNCIL OF ACCOUNTABLE PHYSICIAN PRACTICES
Robert Pearl, MD, is Executive Director and CEO of The Permanente Medical Group and President and CEO of the Mid-Atlantic Permanente Medical Group. Dr. Pearl serves on the faculties of the Stanford University School of Medicine and Graduate School of Business. Dr. Pearl is a frequent lecturer on the opportunities to use 21st century tools and technology to improve both the quality and cost of health care, while simultaneously making care more convenient and personalized.

SENATOR JOHNNY ISAKSON    (R-GA), CO-CHAIR, SENATE FINANCE COMMITTEE CHRONIC CARE WORKING GROUP

Senator John Hardy Isakson (R-GA) is serving his second term in the U.S. Senate, and was recently tapped to lead the Senate Finance Committee’s Chronic Care Solutions working group with Senator Mark Warner (D-VA). The work of the bipartisan committee is to begin exploring solutions that will improve outcomes for Medicare patients requiring chronic care. Isakson is the first Georgian since the 1800s to have served in the state House, state Senate, U.S. House of Representatives and U.S. Senate. He also serves on the Senate HELP Committee, Senate Finance Committee, the Senate Foreign Relations Committee, the Senate Ethics Committee, and the Senate Veterans’ Affairs Committee.

TIM GRONNIGEr    DEPUTY CHIEF OF STAFF, DIRECTOR OF DELIVERY SYSTEM REFORM AT CMS
Tim Gronniger is the deputy chief of staff and director of delivery system reform at CMS. He was formerly a senior adviser for healthcare policy at the White House Domestic Policy Council (DPC), where he was responsible for coordinating administration activities in healthcare delivery system reform. Before joining DPC he was a senior professional staff member for Ranking Member Henry Waxman at the House Committee on Energy and Commerce, responsible for drafting and collaborating to develop elements of the Affordable Care Act. Before joining the Committee staff, Tim spent over four years at the Congressional Budget Office.

CECI CONNOLLY    PRESIDENT AND CEO, ALLIANCE OF COMMUNITY HEALTH PLANS

Ceci Connolly became president and CEO of the Alliance of Community Health Plans in January 2016. In her role, she works with some of the most innovative executives in the health sector to provide high-quality, evidence-based, affordable care. Connolly has spent more than a decade in health care, first as a national correspondent for The Washington Post and then in thought leadership roles at two international consulting firms. She is a leading thinker in the disruptive forces shaping the health industry and has been a trusted adviser to C-suite executives who share her commitment to equitable, patient-centered care.

KAREN CABELL, DO    CHIEF OF QUALITY AND PATIENT SAFETY, BILLINGS CLINIC

Dr. Karen Cabell is the chief of quality and patient safety and a practicing internal medicine physician at Billings Clinic, an integrated medical foundation healthcare organization, located in Billings, Montana. Dr. Cabell has implemented diabetes, heart failure and HTN disease management registries along with point-of-care tools for patients and clinicians to better manage chronic disease. She was involved with Billings’ rollout and adoption of an electronic health record implementation since 2004 including all clinic sites and regional partners to include 15 other hospitals with clinics across a 500-mile radius. Dr. Cabell has been instrumental in gaining alignment between the EHR, quality and patient safety as well as strategic planning to support Billings Clinic’s organizational goals of clinical excellence, operational efficiency, market growth and development, and financial strength.

REGINA HOLLIDAY    PATIENT RIGHTS ACTIVIST, ARTIST, AUTHOR

Artist Regina Holliday is a patient advocate known for her series of murals depicting the need for clarity and transparency in medical records, and for founding the Walking Gallery movement. The Walking Gallery consists of more than 350 volunteer members who make statements about the lapses in health care at public meetings by wearing business suits or blazers painted with patient stories. Holliday’s experiences during her husband’s illness and subsequent death inspired her to use painting as a catalyst for change. Backed by her own patient and caregiving experiences, she travels the globe heralding her message of patient empowerment and inclusion in healthcare decision making. Holliday’s mission is to demand a thoughtful dialog with officials and practitioners on the role patients play in their own healthcare.

MARC KLAU, MD

ASSISTANT REGIONAL MEDICAL DIRECTOR, SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

Dr. Marc Klau has been with the Southern California Permanente Medical Group for 31 years. He is currently the regional chief of Head and Neck Surgery, providing leadership for 100 surgeons.  He is also the Assistant Regional Medical Director for Education, Learning and Leadership. He now oversees the new KP School of Medicine and all of the Southern California Kaiser Permanente residencies, as well as continuing medical education and leadership.

JANET MARCHIBRODA

Artist Regina Holliday is a patient advocate known for her series of murals depicting the need for clarity and transparency in medical records, and for founding the Walking Gallery movement. The Walking Gallery consists of more than 350 volunteer members who make statements about the lapses in health care at public meetings by wearing business suits or blazers painted with patient stories. Holliday’s experiences during her husband’s illness and subsequent death inspired her to use painting as a catalyst for change. Backed by her own patient and caregiving experiences, she travels the globe heralding her message of patient empowerment and inclusion in healthcare decision making. Holliday’s mission is to demand a thoughtful dialog with officials and practitioners on the role patients play in their own healthcare.

DIRECTOR, HEALTH INNOVATION INITIATIVE, BIPARTISAN POLICY CENTER

Janet Marchibroda is the director of the Bipartisan Policy Center’s Health Innovation Initiative in Washington, DC. She has been recognized as one of the Top 25 Women in Healthcare by Modern Healthcare and is a nationally recognized expert on the use of health IT to improve healthcare quality.

LEANA WEN, MD  HEALTH COMMISSIONER, BALTIMORE CITY

Since taking the reins of America’s oldest health department in Baltimore, Dr. Leana Wen has been reimagining the role of public health including in violence prevention, addiction treatment, and urban revitalization. Under Dr. Wen’s leadership, the Baltimore City Health Department has launched an ambitious overdose prevention program that is training every resident to save lives, as well as a citywide youth health and wellness plan. She is the author of the book, When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests, and is regularly featured on National Public Radio, CNN, New York Times, and Washington Post. Her talk on TED.com on transparency in medicine has been viewed nearly 1.5 million times.

Better Together Health 2016 Event - Better Together

Accountable Docs Blog | CAPP

Accountable Docs Blog | CAPP

The Arts, Sciences and Medicine: BIRTH and DEATH (A Poem on How Cells Transcribe)

The Arts, Sciences and Medicine: BIRTH and DEATH (A Poem on How Cells Transcribe)

76th Scientific Sessions | American Diabetes Association

June 10th-14th is the 76th Scientific Sessions | American Diabetes Association meeting in New Orleans, LA.

Our Mission:  To prevent and cure diabetes and to improve the lives of all people affected by diabetes.

The program will begin on Friday, June 10 at 11:45 a.m. with our new Mini-Symposia sessions and conclude on Tuesday, June 14 at 12:15 p.m. following the ADA Presidents Oral Session.


The ADA maintains an archive of previous events, posters, abstracts and webinars:

Previous Scientific Sessions

Abstracts, Posters, and Webcasts

Are you at Risk ?    Diabetes Basics    Living with Diabetes  Advocacy   Food and Fitness

Research and Practice   

Remember, good blood sugar controls lessens the risks for retinopathy, renal disease, heart disease, and neuropathy.  Diabetes effects the entire body, not just blood sugar levels.

CURING CANCER

It’s far more important to know what person the disease has than what disease the person has.  – Hippocrates (460-370) B.C.






"Precision medicine" is not a new concept. It was a term coined by Eric Topol and then parroted by President Barak Obama  As early as 435 B.C.  Hippocrates gave us the quote noted above.

Hippocrates established this idea long before the science of biochemistry, genomics, proteomics and DNA sequencing. Since 400 B.C. we have managed to prove his hypothesis, expanding our understanding and developing nomenclature to connect the dots.

Physicians have studied diseases and pathology to understand their process better. Each person however reacts differently to the disease, and so too does the disease react differently to the patient.  It clearly defines to what the term 'patient-centered medicine' applies.

To say that the disease choses the person is to 'humanize' illness. Illness is what occurs when disease conquers human defense mechanisms. in truth, a constant battle is taking place in our bodies each day as bacteria, viruses, autoimmunity and uncontrolled cell multiplication takes place. Inherent in our bodies is a wide array of defense mechanisms. Cellular immunity, circulating antibodies, free radical scavenging biochemisty, enzymatic defense, inflammatory mechanisms, apoptosis and others.

Sleep is not an option. A behavior that is common to all of us

What do Arianna Huffington and Oncologist Dr Steven Eisenberg have in common ? Like us, they require sleep to allow our brains to recover, store energy, and allow our neural network to organize our thoughts and emotions.

Consequences of Insufficient Sleep

  

In the short term, a lack of adequate sleep can affect judgment, mood, ability to learn and retain information, and may increase the risk of serious accidents and injury. In the long term, chronic sleep deprivation may lead to a host of health problems including obesity, diabetes, cardiovascular disease, and even early mortality.

Sleep and Disease Risk

The price of insufficient sleep may be poor health. Study after study has revealed that people who sleep poorly are at greater risk for a number of diseases and health problems. And now the search is on to discover why this might be. more

Sleep, Performance, and Public Safety

Lack of sleep exacts a toll on perception and judgment. In the workplace, its effects can be seen in reduced efficiency and productivity, errors, and accidents. Sometimes the effects can even be deadly, as in the case of drowsy driving fatalities. more

At a Glance

• The cost of poor sleep is much greater than many people think: it may have profound consequences for our long-term health.
• Research has revealed that people who consistently fail to get enough sleep are at an increased risk of chronic disease, and scientists are now beginning to understand why.

Treating sleep as a priority, rather than a luxury, may be an important step in preventing a number of chronic medical conditions.

Sleep deprivation research 

Researching the Link Between Sleep Duration and Chronic Disease

There are three main types of study that help us understand the links between sleep habits and the risk of developing certain diseases. The first type (called sleep deprivation studies) involves depriving healthy research volunteers of sleep and examining any short-term physiological changes that could trigger disease. Such studies have revealed a variety of potentially harmful effects of sleep deprivation usually associated with increased stress, such as increased blood pressure, impaired control of blood glucose, and increased inflammation.

The second type of research (called cross-sectional epidemiological studies) involves examining questionnaires that provide information about habitual sleep duration and the existence of a particular disease or group of diseases in large populations at one point in time. For example, both reduced and increased sleep duration, as reported on questionnaires, are linked with hypertension, diabetes, and obesity. However, cross-sectional studies cannot explain how too little or too much sleep leads to disease because people may have a disease that affects sleep, rather than a sleep habit that causes a disease to occur or worsen.

The third and most convincing type of evidence that long-term sleep habits are associated with the development of numerous diseases comes from tracking the sleep habits and disease patterns over long periods of time in individuals who are initially healthy (i.e.,longitudinal epidemiological studies). We do not yet know whether adjusting one’s sleep can reduce the risk of eventually developing a disease or lessen the severity of an ongoing disease. However, the results from longitudinal epidemiological studies are now beginning to suggest that this is likely.

Why Sleep Matters

Benefits of Sleep

Why Do We Sleep, Anyway?

Sleep, Learning, and Memory

Consequences of Insufficient Sleep

Sleep and Disease Risk

Sleep, Performance, and Public Safety

Historical and Cultural Perspectives of Sleep

The Science of Sleep

Getting the Sleep You Need

The Dr. Steven Show | Arianna Huffington - YouTube