[관련기사=세계수면학회장 "수면질환의 진단과 치료, 관리의 보편적 접근성이 보장되는 사회 꿈꾼다"]

The President of the World Sleep Society dreams of a society where the diagnosis, treatment, and management of sleep disorders are universally accessible.

[Interview] President Raffaele Ferri who visited the Korean Society of Sleep Research discusses the challenges in expanding accessibility to devices such as positive airway pressure machines. He emphasizes that generating clinical evidence regarding digital devices is crucial.

Raffaele Ferri, President of the World Sleep Society, visited Korea for the keynote lecture at the academic conference of the Korean Society of Sleep Research. In an interview with MediGate News, he stated, "In Korea, as well as in Italy, efforts have been made in recent years to foster medical scientists, but the reality is still challenging. Both countries are facing similar difficulties in this regard."

President Ferri explained, "Since research requires a significant amount of time, combining clinical work and research leads to a severe lack of personal time and adds to the physical and mental burden. In such circumstances, many medical researchers are drawn to countries that offer clear economic rewards for research, and it is not uncommon for them not to return to their home countries."

Sleep Medicine, Treatment of REM Sleep Behavior Disorder (RBD), and Active Research on the Relationship between Cancer and Sleep"
President Ferri pointed out that among the most actively researched topics in sleep medicine, REM Sleep Behavior Disorder (RBD) is one of the prominent subjects.

In particular, for REM Sleep Without Atonia (RSWA), unlike typical REM sleep where muscle movement is reduced, the muscles do not become paralyzed. This condition can lead individuals to act out negative dream content aggressively, potentially causing serious harm to themselves or others around them. Due to these risks, the need for appropriate treatment is emerging.

President Ferri stated, "RBD can manifest in the prodromal stages of neurodegenerative diseases like Parkinson's disease. If RBD appears before the onset of a neurodegenerative disease, it holds significance as it allows for early diagnosis and potentially delaying the progression of the underlying condition. While medications like melatonin are used, completely altering the disease course is challenging, and currently, the best approach is to mitigate the rate of deterioration."

He mentioned, "Amidst the commercial availability of various neuroprotective drugs, non-pharmacological approaches such as the Mediterranean diet have shown to be effective and are recommended. However, when it comes to food, proving a clear cause-and-effect relationship that definitively alters the disease course is challenging due to numerous confounding variables. Additionally, there are practical difficulties in investing the capital and time required for long-term follow-up studies spanning over 10 years."

In a similar context, epigenetics, which involves the study of multiple genes, also leads to non-singular causes. As a result, investigating the phenotypic aspects of Restless Leg Syndrome (RLS) from the perspective of proteomics, glycomics, and transcriptomics, which are influenced by epigenetics, inevitably becomes complex.

The correlation between cancer and sleep is also one of the research topics garnering attention in sleep medicine, alongside RBD.
He stated, "Cancer and sleep interact and influence each other. Cancer can have a negative impact on sleep, and on the other hand, sleep may be beneficial for cancer treatment. For instance, administering chemotherapy at specific times can improve treatment efficacy, highlighting the importance of chronotherapy in cancer treatment."

Efforts are being made to ensure universal accessibility to sleep disorder treatment, with a particular focus on exploring the effectiveness of digital healthcare. However, further observation is required to fully understand the potential benefits of digital healthcare in this field.
Upon assuming the position of President of the World Sleep Society last October, he has been dreaming of a society where the diagnosis, treatment, and continuous management of sleep disorders are universally accessible.

President Ferri expressed his expectations that through initiatives like the World Sleep Academy and the International Sleep Research Training Program, the gaps in knowledge within sleep medicine will be reduced. He also mentioned his desire to raise awareness by promoting proper sleep hygiene habits, such as ensuring adequate sleep time and creating a conducive sleep environment, on World Sleep Day.

He mentioned, "There are difficulties in expanding accessibility to diagnostic tools like polysomnography (PSG), which is used to clarify the causes of sleep disorders, and positive airway pressure machines used in sleep apnea treatment. Due to cost issues, these tools are not easily accessible in developing countries, and even in countries considered advanced, universal access is not well achieved."

He gave a positive assessment of home-based self-diagnosis using digital treatments and smartphone applications in sleep medicine. He mentioned that many issues have been addressed and the quality has significantly improved during the short period of research and development in this field.

However, President Ferri emphasized that this should be done under the strict supervision and management of medical professionals, with accurate scientific interpretation and clinical diagnosis based on proper diagnostic criteria. He mentioned that it is still challenging to definitively assert the clinical significance of treatment effects at this time.

He emphasized that objective clinical indicators, such as the amount of slow-wave sleep, which can objectively measure the quality of sleep, are being collected with the help of advancing technologies. When diagnostic and treatment methods are proposed, they must undergo meticulous validation. 

By Eun-byul Jung