For child neurology medical trainees several subspecialties that feature a serious unmet clinical need currently exist. In a paper published in Neurology, researchers from the University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia emphasized the need for more child neurology trainees to enter a sleep medicine fellowship in an effort to improve the outcomes of children with neurologic disorders that may be linked to sleep disruption.
Modern sleep medicine is a relatively recently established scientific discipline, having been jump-started by the development of the human EEG in the 1920s. In 2018, an American Academy of Sleep Medicine compensation survey found that only 1.9% of respondents were certified in neurology with a special qualification in child neurology, with only 9% of respondents reporting that they only treated children.
According to the investigators, a child neurology-trained sleep medicine fellow can help meet a unique demand that is currently only being met by a limited number of physicians. Pediatric neurology trainees who choose to specialize in sleep medicine can become adept at understanding positive airway pressure regimens and mechanical ventilation, gain knowledge in sleep-related breathing patterns and their influence on the health of children with neurologic disorders, and learn how to diagnose and treat pediatric patients with complex genetic and neurodevelopmental disorders who also present with concomitant sleep disruptions.
Associations between circadian rhythms and seizures have been explored, and research initiatives are needed to identify the role of sleep in improving seizure outcomes in pediatric patients. The overlap between sleep medicine and neurology research, combined with the need for more neurologists who treat sleep disorders in children, makes sleep medicine exposure in pediatric neurology trainees an important topic for discussion in residency programs.
The researchers suggest that child neurology residencies should look for ways to improve exposure to sleep medicine among trainees. Doing so, they argue, will both enhance training and provide medical trainees with sufficient experience in this field to consider it as a potential career path. In addition, they wrote that “the child neurology residency programs will allow their trainees to take full advantage of the many opportunities for clinical and research leadership in this young and important discipline.”
Stowe RC, Elkhatib Smidt SD, Mason TA. Emerging subspecialties in neurology: sleep medicine fellowship after child neurology residency. Neurology. 2020;94(6):278-281