Many editions of FP Essentials discuss topics that we as family physicians regularly encounter in the course of our practice. In its discussion of sleep, this issue is a little different in that it addresses a topic that has directly affected all of us.

I completed my training during the period that saw the introduction of work hour restrictions. As a medical student with some rotations exceeding 120 hours per week in the hospital, I had multiple colleagues who were in motor vehicle crashes after falling asleep at the wheel on the way home from work. I remember many days driving home with the radio blaring and the windows open in subfreezing temperatures just to stay awake long enough to get home. Although this experience was a rite of passage, the dazed look I saw in the mirror and in the faces of my colleagues after 24 hours of work without sleep reflected not only the significant cost to us as individuals but also the risk of error that our patients were forced to bear.

As is true for most of you, the effects of practicing medicine on my sleep did not stop when I became an attending physician. From late nights spent working in the electronic health record, to the middle-of-the-night patient calls or trips to the hospital, to the nights lying awake worrying about patient or practice issues, medicine has too often affected my ability to care for myself, and subsequently my patients, in the best way possible. As I have progressed through my career, I have become better at prioritizing self-care, including adequate sleep, but this continues to be a struggle at times.

Section One of this monograph reviews normal sleep and its central role in health. Section Two reviews insomnia, including risk factors, evaluation, and management with nonpharmacologic approaches and medications. Section Three reviews parasomnias. Section Four addresses sleep in the special populations of hospitalized patients and physicians.

I hope this monograph will give you the information, confidence, and motivation to address sleep issues that adversely affect both your health and the health of your patients.

Ryan D. Kauffman, MD, FAAFP, CCFP, Associate Medical Editor
Family Medicine Physician
Erie Shores Family Health Team, Leamington, Ontario, Canada