This is from Dying for a kip: the importance of sleep medicine published in the Student BMJ in 2005. Nothing much seems to have changed since then.
Sleep medicine in the United Kingdom is currently the preserve of a small number of interested clinicians, mainly with backgrounds in respiratory medicine, anaesthetics, or neurology (box 1). There is no formal training structure or official governing body. The British Sleep Society (www.sleeping.org.uk) has an active membership of clinicians, scientists, and healthcare workers and acts to promote awareness of sleep. In contrast, the USA has a very well circumscribed, well respected training system and it is possible to board in sleep medicine–the equivalent of gaining your CCST in the United Kingdom.3
On the more negative side, sleep medicine is currently underfunded and anyone considering sleep medicine as a future career should take this into account. At the moment there are no consultant posts devoted exclusively to sleep medicine, and those wishing to lead a sleep service will probably have to gain their consultant post and then set one up themselves. This will require significant entrepreneurial skills and persuasive argument, although some may see this as an advantage (box 3).
This is one of the reasons I’m still being treated for my sleep problems by my psychiatrist. It’s also why I haven’t had a polysomnography or actigraphy study and why I have no diagnosis. It may also be why melatonin isn’t licensed in the UK (it’s sometimes prescribed, but has to be bought from abroad or made specially) and why ramelteon (a new sleep medication that targets melatonin receptors) isn’t marketed at all. Oh, and probably also the reason why modafinil can be prescribed for narcolepsy, but not for other sleep disorders.
It’s so astoundingly frustrating that I really don’t have the words.