Los trastornos del sueño y la promoción del sueño saludable

  

Background & Goal

Poor sleep is a lifestyle factor that plays a significant role in the development of chronic disease, including type 2 diabetes, cardiovascular disease, increased rates of obesity, poorer mental health and reduced quality of life. Unfortunately, nurses, physicians and other health providers receive little to no training in sleep disorders or sleep health promotion. The negative health consequences of poor sleep exacerbate existing health inequalities experienced by Spanish-only speaking individuals residing along the United States-Mexico border.  Carol Baldwin, PhD, RN, AHN-BC, FAAN, Cipriana Caudillo Cisneros, MSN, RN, Luxana Reynaga Ornelas, PhD, RN  and their bi-national inter-professional team, Lorely Ambriz Irigoyen, MSIS, Maria Teresa Cerqueira, PhD, Sergio Marquez Gamiño, MD, PhD and Stuart F. Quan, MD, FAASM developed and implemented Los trastornos del sueño y la promoción del sueño saludable (Spanish-language sleep program) , the first ever sleep health program to support community-based health promotion in urban and rural areas on both sides of the United States-Mexico border.

Program Description

The Spanish-language sleep program incorporates various learning tools to teach community health workers, known as promotores, culturally relevant health education and promotion methods to improve sleep health. The program is incorporated into a validated lifestyles promotion manual and companion workbook (Camino a la Salud (Su Corazon/Su Vida)), used to educate the promotores.  Upon successfully demonstrating their knowledge and understanding of the sleep training, promotores, who work in concert with community health nurses and other community-based providers, use the training to educate individuals and families on the importance of sleep health.  As respected community leaders who speak the language and understand the local culture, promotores serve as a valuable bridge between neighbors requiring health care and the nurses, physicians and other inter-professionals working to provide it.

Evidence of Success

Using 600 promotores as a representative number trained on an annual basis, 300 working within the U.S. and 300 working in Mexico, the cost savings realized by the sleep training is significant. Along the U.S. border, conservative estimates in cost savings for the care of obstructive sleep apnea (OSA), insomnia and restless legs syndrome (RLS) range from $315,000 in 2014 to $3,574,800 from 2014 through 2017. There are no extant studies of per person costs for sleep disorders in Mexico; therefore, cost savings for the sleep program along the Mexico border are extrapolated from numerous studies showing the linkage between OSA, insomnia and RLS with diabetes and hypertension, with the cost savings ranging from $145,500 to $209,700 for 2014 and $436,500 to $629,100 from 2014-2017.