So you want to be a sleep medicine doctor. You want to sit next to a complete stranger’s bed with a clipboard and take notes on how loudly they snore. Well—not quite.
Let’s debunk the public perception myths and give it to you straight. This is the reality of Sleep Medicine.
Welcome to our next installment in So You Want to Be. In this series, we highlight a specific specialty within medicine to help you decide if it’s a good fit for you. You can find the other So You Want to Be guides here on the Med School Insiders website as well as our YouTube playlist.
If you don’t see the specialty you’re interested in, subscribe to the Med School Insiders YouTube channel to help us decide what to cover next.
What Is Sleep Medicine?
Sleep medicine is an emerging field of medicine that’s gaining mainstream popularity due to influencers like Dr. Andrew Huberman, Dr. Peter Attia, and Bryan Johnson, and sleep experts like Dr. Matthew Walker. More and more people and society as a whole are coming to understand the critical role sleep plays in our health.
Sleep medicine is not about studying sleep; it’s about studying the processes of human physiology during a state of sleep, understanding the intricate rhythms of different organs, and the profound impact that sleep has on our physical health, emotional wellbeing, and cognitive function.
On a technical level, sleep medicine explores the nuances of various sleep disorders, from insomnia to sleep apnea. It’s a multidisciplinary field involving work from several different specialties, such as internal medicine, ENT, endocrinology, neurology, cardiology, pulmonology, psychology, and even dentistry.
Sleep medicine can be categorized in several ways:
Patient Population
First, let’s consider the patient population.
Adult sleep medicine focuses on sleep disorders that commonly affect adults, such as obstructive sleep apnea or OSA, insomnia, and restless leg syndrome, or RLS. Treatment may involve CPAP therapy, cognitive-behavioral therapy for insomnia, also known as CBT-I, and pharmacological approaches.
Pediatric sleep medicine is dedicated to addressing sleep disorders in children, such as pediatric OSA, behavioral insomnia, and parasomnias, which include sleepwalking and night terrors.
Primary Focus
Second, the primary focus of sleep medicine can also differ.
There are respiratory sleep disorders, such as obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. Management of these conditions often involves devices like the CPAP, BiPAP, oral appliances, and sometimes surgical interventions.
There are also neurological sleep disorders like narcolepsy, idiopathic hypersomnia, and restless leg syndrome. Treatment may include lifestyle modifications, specialized therapies, and medications like stimulants and dopamine agonists.
Then there’s behavioral sleep medicine, which focuses on conditions like insomnia and circadian rhythm sleep-wake disorders. Techniques such as CBT-I, light therapy, and chronotherapy are commonly used to help patients re-establish healthy sleep patterns.
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Practice Setting and Options
Third, sleep medicine physicians can work in different practice settings.
There are academic sleep centers, which are often affiliated with universities or research institutions. These centers combine clinical care with research and education and serve as hubs for studying emerging treatments and training future specialists.
There are also community-based sleep clinics that provide accessible care to local populations. They typically focus on the diagnosis and management of common sleep disorders, offering services such as sleep studies and basic therapies.
Then, there are multidisciplinary sleep practices that integrate with other medical specialties, bringing together specialists from pulmonology, neurology, psychiatry, otolaryngology, and behavioral health to address complex or comorbid sleep disorders. This collaborative approach ensures comprehensive, tailored care is provided to address the individual needs of every patient.
For example, neurologic sleep medicine specialists can become their region’s experts in sleep disorders with underlying neurologic diseases.
Or, sleep medicine physicians could join a startup or tech company like Apple, Whoop, Oura, or Ultrahuman as a sleep medicine expert who builds technology that scales globally. They could also go corporate and work with medical device or therapeutic companies to help them deliver better technologies.
Misconceptions About Sleep Medicine
Now, let’s clear up a major misconception about sleep medicine.
Sleep medicine is NOT sleep apnea medicine, as people often think. Sleep apnea is only one aspect of sleep health. Similarly, managing diabetes is not the same as managing metabolic health, and managing AFib is not the same as managing cardiovascular health.
Sleep should be thought of as a holistic discipline, a much deeper view of what our body is doing during a state of sleep. And also, continuous positive airway pressure, or a CPAP machine, is not the only treatment for sleep apnea. Often, people think sleep medicine equals sleep apnea, which equals CPAP.
However, sleep medicine is more complex and involves managing many different types of therapies that are coming to market. CPAP is only one of many.
How to Become a Sleep Medicine Doctor
There are a number of ways to get into sleep medicine, but each starts the same—with four years of medical school followed by residency. At this time, sleep medicine does not have its own residency and is instead a subspecialization, also known as a fellowship.
Sleep medicine fellowships follow several different residency programs, including:
- Internal Medicine,
- Pediatrics,
- Neurology,
- Psychiatry,
- Family Medicine,
- Otolaryngology, and
- Pulmonology and critical care.
Sleep medicine is typically a one-year fellowship, but it can be as long as two if combined with a research year.
Medical students who are interested in approaching medicine with a holistic lens and are fascinated with a multidisciplinary approach to health that utilizes functional medicine, integrative medicine, and alternative medicine will do well in this field.
Since sleep is a relatively new field with tons of opportunities for research and rapid advancements in consumer technology, students passionate about research, the future of health, and entrepreneurship through startups will also find a great deal to keep them engaged.
According to 2023 match statistics, of the 200 certified applicants with rank who selected sleep medicine as their preferred specialty, 183 were matched with a sleep medicine program.
Regarding the match, it’s important to keep in mind that sleep medicine is already a relatively narrow subspecialty, and there are no formal fellowship options specifically designed to further specialize after completing a sleep medicine fellowship.
While many sleep doctors find a focus area, such as research, behavioral sleep, narcolepsy, idiopathic hypersomnia, or restless leg syndrome, there is not much room for further specialization.
As far as compensation goes, since sleep medicine is still an emerging career path, the salary for sleep medicine is less widely reported and varies considerably. A sleep medicine doctor’s salary depends on their primary specialty training, practice setting, years of experience, and industry leadership, with salaries ranging from $240-$500,000.
For example, a pulmonologist who pursues further sleep medicine training stands to earn a higher paycheck than a family medicine physician who specializes in sleep medicine.
What You’ll Love About Sleep Medicine
There’s a lot to love about sleep medicine.
First off, it’s rewarding. If you can improve someone’s sleep, you can truly restore their life. And what’s more, you get to see a diverse patient population, as 50 to 70 million Americans have chronic sleep disorders.
The lifestyle and work-life balance of a sleep medicine physician is also excellent, as it’s primarily outpatient work with regular 9 to 5 hours and limited night or weekend responsibilities. You also have the flexibility to combine sleep medicine with other work, such as pulmonology and critical care, depending on your interests.
It’s also an ideal time to get into sleep medicine. Sleep disorders are quite prevalent in the population, creating a high demand for qualified sleep specialists.
Plus, more and more people are paying closer attention to their health from a longevity and wellness perspective, thanks to online longevity and health optimization personalities.
Sleep, along with nutrition and exercise, is one of the three pillars of health that make the largest impact on your wellbeing and effectiveness. As a popular and growing field, there are plenty of opportunities for entrepreneurship and key opinion leadership.
You could also collaborate and lend your expertise to the tech sector by working with an established sleep tech company or startup as a medical specialist.
Sleep tech is also developing at a faster and faster rate. With AI in sleep medicine, the dynamic nature of wearables, and the massive data sets they provide, there’s more information about sleep than ever before.
What You Won’t Love About Sleep Medicine
Of course, sleep medicine is not for everyone.
For one thing, it’s a slower-paced specialty, so it’s possible to become bored of reading sleep study after sleep study. This is especially dependent on what specialty you’re coming from. For example, if you’re coming from pulmonary medicine or critical care, you may miss the opportunity to save lives on a daily basis.
Now, while the rapid advancement of sleep technology and research will be a pro for some, it won’t be for everyone. The field requires ongoing learning and adaptation, and because it’s such a new field, your work could look completely different a decade from now.
Sleep medicine has many variables depending on the path you take to get there. It can be more demanding and may require working overnight for sleep studies. Additionally, you can encounter difficult patients who are not at their best due to a lack of sleep. Sleep-deprived patients can be irritable and frustrated with the situation they are in, and they may take it out on you.
Should You Become a Sleep Medicine Doctor?
So, should you become a sleep medicine doctor?
Sleep medicine isn’t a medical field for adrenaline junkies, as a great deal of your time will be spent reading sleep studies and conducting research. If you’re looking for a slower-paced career and don’t like participating in high-acuity care in the emergency department or ICU, sleep medicine may be a good fit.
It’s also an excellent field if you’re interested in holistic medicine. Sleep is a foundational component of our health, which means it involves several fields of medicine. You can customize your career based on your interests, and you’ll be able to interact with a number of colleagues from different specialties.
For example, the expert contributor for this guide, Dr. Sahil Chopra, started out as an intensivist and pulmonologist.
If you’re fascinated by technology, you’re also in luck. Sleep medicine is rapidly evolving, especially considering the rise of wearable sensors. The incorporation of technology will continue to be an increasingly critical aspect of sleep care.
If you love the idea of lifelong learning and prioritize work-life balance, sleep medicine won’t make you choose between your personal life and your work.
Do you struggle with sleep or frequently make the classic college mistake of pulling all-nighters?
Sleep is one of the three pillars of health that contribute to scholastic performance, and it’s what top performers know how to optimize. Don’t make the same mistakes as countless students before you who believed studying more and studying harder will equate to better grades.
The doctors you’ll work with at Med School Insiders go well beyond simple study hacks to provide an all-encompassing approach that takes into account your entire lifestyle. We know what it takes to become top of the class, score in the 99.9th percentile of the MCAT, and have the best medical schools in the country fighting over you.
Learn how we can help you design and achieve your ideal medical career path.
Special thanks to Dr. Sahil Chopra and the team at Empower Sleep for sharing their experiences and expertise for this video. They’re on a mission to extend human healthspan for the millions of people suffering from sleep disorders, many of whom go undiagnosed.
Now that we’ve covered sleep medicine, what specialty should we tackle next? Leave a comment to add your vote.
