Sleep and dreams: how the American Academy of Sleep Medicine and its members have shaped the future of the sleep field for 50 years.

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Learn more: PMC Disclaimer | PMC Copyright Notice J Clin Sleep Med . 2025 Jun 1;21(6):1093–1102. doi: 10.5664/jcsm.11660 Sleep and dreams: how the American Academy of Sleep Medicine and its members have shaped the future of the sleep field for 50 years Raman K Malhotra 1, ✉ , Thomas M Heffron 2 , Ilene M Rosen 3 , Stuart F Quan 4, 5 , Clete A Kushida 6 , Lawrence J Epstein 4 Author information Article notes Copyright and License information 1 Sleep Medicine Center, Washington University School of Medicine, St. Louis, Missouri 2 American Academy of Sleep Medicine, Darien, Illinois 3 Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 4 Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 5 Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona College of Medicine, Tucson, Arizona 6 Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California ✉ Address correspondence to: Raman K. Malhotra, MD, American Academy of Sleep Medicine, 2510 N. Frontage Road, Darien, IL 60561; Tel: (630) 737-9700; Fax: (630) 737-9790; Email: contact@aasm.org Received 2025 Mar 11; Accepted 2025 Mar 11; Collection date 2025 Jun 1. © 2025 American Academy of Sleep Medicine PMC Copyright notice PMCID: PMC12134594  PMID: 40078100 Abstract Over the past century, sleep has transitioned from the domain of artists, poets, and philosophers to the realm of scientists and clinicians. In the 20th century, pioneering sleep researchers and clinicians advanced their respective fields by forming organizations such as the American Academy of Sleep Medicine (AASM). For 50 years, the AASM has played a leading role in creating and shaping the field of sleep medicine, leveraging the multidisciplinary expertise of its members to forge a new medical specialty. The organization emerged from a meeting in 1975, where academics whose research focused on sleep gathered to evaluate the necessity of establishing a new professional society to represent the nascent sleep disorders centers that were beginning to open across the country. The formation of the AASM was led by Dr. William Dement and other pioneers who played crucial roles in establishing the field through the clinical application of sleep research. Through the AASM, they created the building blocks of a medical specialty by developing accreditation and certification programs, diagnostic classifications, clinical practice guidelines, clinical training programs, peer-reviewed scientific journals, and a clinical and scientific meeting. Their persistent efforts eventually secured for the sleep medicine specialty both national recognition and broad acceptance within the medical community. Today, the field of sleep medicine remains strong as sleep physicians and other members of the clinical sleep team provide high-quality, comprehensive care for patients who have sleep and circadian disorders. Built on this solid foundation, the AASM and its members will continue to shape the future of sleep medicine. Citation: Malhotra RK, Heffron TM, Rosen IM, Quan SF, Kushida CA, Epstein LJ. Sleep and dreams: how the American Academy of Sleep Medicine and its members have shaped the future of the sleep field for 50 years. J Clin Sleep Med. 2025;21(6):1093–1102. Keywords: American Academy of Sleep Medicine, professional society, sleep medicine INTRODUCTION Over the past century, sleep has transitioned from the domain of artists, poets, and philosophers to the realm of scientists and clinicians. In the 20th century, pioneering sleep researchers and clinicians advanced their respective fields by forming organizations such as the American Academy of Sleep Medicine (AASM). For 50 years, the AASM has played a leading role in creating and shaping the field of sleep medicine, leveraging the multidisciplinary expertise of its members to forge a new medical specialty. The purposes of the AASM’s founders were to establish standards for the evaluation and treatment of sleep disorders, create a standard diagnostic classification of sleep disorders, provide a forum for the exchange of clinical information, and promote awareness of the field of sleep medicine among health care professionals, medical associations, federal and state regulatory bodies, federal and private health insurers, patients, and the public. 1 The organization now called the AASM emerged from a meeting held in 1975 at the Hilton hotel near Chicago’s O’Hare International Airport. Academics whose research focused on sleep gathered to evaluate the necessity of establishing a new professional society to represent the nascent sleep disorders centers that were beginning to open across the country. The fact that this foundational meeting was held in Chicago is symbolically significant, as the field of sleep medicine has deep roots in research conducted at the University of Chicago in the 1950s and earlier by Drs. Nathaniel Kleitman, Eugene Aserinsky, and William Dement, which led to the first publication describing rapid eye movement sleep. 2 At this meeting, the American Association of Sleep Disorders Centers (AASDC) was formed, making it the first organization dedicated to the evaluation and treatment of sleep disorders. Its establishment followed the formation in the early 1960s of the Association for the Psychophysiological Study of Sleep (APSS), the first society for sleep scientists, which was eventually renamed the Sleep Research Society (SRS). The formation of the AASDC was preceded by numerous steps and key events, led by Dr. Dement and other pioneering sleep medicine experts who played crucial roles in establishing the field through the clinical application of sleep research. 3 Psychiatry and neuroscience were the typical specialties of these sleep pioneers, and early sleep studies comprised electroencephalogram, electrooculogram, and electromyogram measures. One of the first landmarks for the field in the United States was the establishment in 1964 by Dr. Dement of a narcolepsy clinic at Stanford University in Stanford, California, where a colony of narcoleptic dogs was later raised and studied. 4 Interest in sleep medicine continued to grow in 1971, when the first APSS international meeting was held in Bruges, Belgium. Eventually, by the early 1970s, under the guidance of Drs. Dement, Christian Guilleminault, Vincent Zarcone, and Mary Carskadon, the narcolepsy clinic at Stanford became the Stanford Sleep Disorders Clinic, a full-service sleep center addressing other sleep disorders with the capability to perform comprehensive overnight sleep studies and daytime tests (eg, the Multiple Sleep Latency Test). By 1974, the first North American clinical papers on what became known as obstructive sleep apnea (OSA) were published, 5 setting the stage for greater interest in sleep-disordered breathing and attracting to the field more pulmonologists and respiratory therapists. In 1975, at the second international APSS conference in Edinburgh, Scotland, individuals interested in advancing clinical sleep medicine began talking about the potential formation of a new society. This preliminary discussion led to the follow-up meeting later that year in Chicago, where the AASDC was born. 1975–1979: LAYING THE FOUNDATION Dr. Dement served as president of this new organization for its first 12 years. For the first decade, membership was available exclusively to sleep centers. In 1976, with Dr. Dement as president and Dr. Thomas Roth as executive secretary-treasurer, the AASDC established 4 subcommittees for certification (led by Dr. Milton Kramer), polysomnography (led by Dr. Roth), education (led by Dr. Elliot Weitzman), and nosology (led by Dr. Howard Roffwarg). The AASDC also established dues for center membership, and by November 1976, there were 6 dues-paying AASDC member centers: Baylor College in Houston, Montefiore Hospital in New York City, Ohio State University in Columbus, Stanford University, University of Cincinnati, and Western Psychiatric Institute in Pittsburgh. At the April 1977 meeting of the AASDC, the leadership decided to extract the word “American” from the organization’s name, changing it to the Association of Sleep Disorders Centers (ASDC). From its inception, one major goal of the ASDC was to accredit sleep centers to promote standardized, high-quality care for patients who have sleep disorders. The ASDC expedited the development of accreditation standards and a rigorous review process, and the centers at Montefiore Hospital (founded by Dr. Weitzman) and Stanford University became the first to be accredited on April 27, 1977. They were followed in October by the accreditation of the sleep centers at Baylor College, Ohio State University, and University of Cincinnati. Accreditation continues to be the gold standard by which the medical community and the public evaluate sleep medicine practices, and today there are about 2,300 AASM-accredited sleep centers ( Figure 1 ). Figure 1. Growth in the number of sleep disorders centers with active accreditation from the American Academy of Sleep Medicine by year from 1977 to 2024. Open in a new tab As OSA became increasingly recognized as a sleep disorder, cardiac and respiratory sensors began to be added to the traditional sleep study measures to identify physiologic markers of sleep-disordered breathing. This comprehensive sleep study came to be known as “polysomnography.” Another early priority of the ASDC was to establish an Insurance Committee, which worked with Medicare and other medical insurance carriers such as Blue Cross/Blue Shield of California to secure reimbursement for this new diagnostic study. The polysomnography standards developed by the ASDC were essential to the success of this initiative. In addition to prioritizing the accreditation of sleep centers, the ASDC focused on certifying sleep medicine professionals to verify clinical competence and expertise. The first board certification examination in “clinical polysomnography,” which comprised both written and oral components, was given in December 1977 and February 1978 in Cincinnati. It was organized under the direction of Dr. Roth, chair of the Clinical Polysomnography Committee, and Drs. Carskadon, Guilleminault, Kramer, and Helmut Schmidt. Twenty-one of the 28 candidates who took the examination to be certified as clinical polysomnographers passed it and were certified in April 1978. 6 The committee determined that 3 individuals—Drs. Dement, Roffwarg, and Carla Hellekson—should be singled out for their exceptional performance. Similarly, ASDC leaders believed that professional development and certification were important for the professionals who perform polysomnographic testing and score sleep studies. Therefore, the ASDC supported the formation in 1978 of the Association of Polysomnographic Technologists (APT), now the American Association of Sleep Technologists. Mr. Peter McGregor of the Montefiore Sleep-Wake Disorders Center led this effort. He was the founding president of the APT, and in 1978, he and another polysomnographic technologist, Mr. Wayne Flagg, were appointed by the ASDC to be liaisons with the APT. In October 1979, the APT administered the first certification examination in polysomnographic technology led by a joint testing committee composed of representatives from the APT and ASDC. Six of the 8 candidates passed the examination, which was the precursor to the current registered polysomnographic technologist examination administered by the Board of Registered Polysomnographic Technologists. Other foundational priorities of the ASDC were to develop a peer-reviewed journal for the field and publish a diagnostic classification of sleep disorders. In 1978, the first issue of the scientific journal Sleep was published, led by Drs. Dement and Guilleminault as editors-in-chief. The journal was sponsored jointly by ASDC, APSS, and the European Society for Sleep Research. The following year, a committee of the ASDC led by Dr. Roffwarg published in Sleep the first nosology of sleep disorders, “Diagnostic Classification of Sleep and Arousal Disorders.” 7 In 1979, the ASDC was incorporated as a nonprofit organization in the state of New York, and another 7 individuals were certified by the ASDC as clinical polysomnographers, bringing the total to 28. 8 By October 1979, the ASDC had a membership of 10 fully accredited sleep centers and 13 provisionally accredited centers, for a total of 23 dues-paying member centers. In 5 years, a solid foundation had been established for the continued growth and development of both the ASDC and the field of sleep medicine. 1980–1989: BUILDING THE INFRASTRUCTURE Another goal of the ASDC was to improve sleep education in medical school curricula, 9 and in the early 1980s, the ASDC Education Committee, led by Dr. William Orr, coordinated a joint government, academic, and private initiative to develop educational materials for distribution to every medical school in the United States. This collaboration was a part of the Project Sleep initiative founded by US Surgeon General Dr. Julius Richmond. These lecture materials included slide sets, a detailed outline, and tapes on 6 areas of sleep disorders medicine. 10 In 1981, Dr. Colin Sullivan and colleagues published an article in The Lancet describing continuous positive airway pressure therapy as a noninvasive treatment for OSA, 11 which up until that time was often treated by tracheostomy. 12 By stimulating greater interest in the treatment of sleep-related breathing disorders, this innovation would have a lasting impact on the growth of the field and the composition of the ASDC membership. That same year, the ASDC held its first annual meeting to share scientific information and clinical updates with a small group of attendees in Dallas. Subsequent annual meetings were held jointly with the SRS and other sleep-related medical societies. By August 1983, the ASDC roster of sleep centers comprised 23 accredited American centers, 28 provisional member centers, 14 “developing” centers, 4 Canadian centers, and 12 other sleep centers around the world. 13 By 1984, there were 99 individuals who had been certified by the ASDC in clinical polysomnography. Therefore, ASDC leaders identified the need for a professional society to focus on equipping and representing these sleep medicine clinicians. As a result, the Clinical Sleep Society (CSS) was started in 1984 by Dr. Philip Westbrook as a branch of the ASDC. While continuing to have sleep center members, the ASDC-CSS began offering membership for individuals, and this new individual membership category quickly grew to about 700 members by August 1985. Mrs. Carol Westbrook, Dr. Westbrook’s wife, served as the administrator for the CSS. Throughout its first decade, the organization conducted its activities from multiple offices, primarily those associated with its volunteer leaders. In January 1986, the ASDC-CSS Executive Committee decided to establish a central office for the organization in Rochester, Minnesota, and they agreed to hire Mrs. Westbrook to be the administrator of the office and hire appropriate staff. In 1986, the ASDC-CSS, the SRS, and the APT formed the Association of Professional Sleep Societies, assuming the historic APSS acronym, which was no longer in use by the SRS. Its goals were to organize an annual meeting; represent the interests of the sleep field to the government, private sector, and public; and publish the journal Sleep . The first annual meeting of the APSS was held in Columbus, Ohio, in 1986, with the program committee chaired by Dr. Schmidt. The Ohio State University Division of Sleep Medicine hosted this meeting, which had 739 attendees and 32 exhibitors. During this meeting, an ASDC-CSS task force developed consensus guidelines for the Multiple Sleep Latency Test, which were published later that year in the journal Sleep . 14 In 1987, Dr. Roth succeeded Dr. Dement as president of the ASDC-CSS, which was renamed the American Sleep Disorders Association (ASDA). Its administration continued to be led by Mrs. Westbrook from the organization’s national office in Rochester, Minnesota. Due to preexisting contractual agreements, the ASDA and SRS held independent annual meetings for the last time in 1987, with the ASDA conference taking place in San Francisco in September. The second APSS annual meeting was held in San Diego in 1988. There were more than 1,000 attendees, and the program was led by Dr. Roth, who chaired the APSS meeting for the first several years. In 1988, Dr. Dement and other ASDA leaders dedicated considerable time and effort to advocating in Washington, DC, to secure congressional support and funding for a national agency for sleep disorders. Legislation creating the National Commission on Sleep Disorders Research was included in the Health Omnibus Extension of 1988, which was signed into law in November. 15 It authorized a comprehensive study of the present state of knowledge of sleep disorders; evaluation of the facilities and resources available for diagnosis, prevention, and treatment of sleep disorders; and research into sleep disorders. The commission was chaired by Dr. Dement, and the vice chair was Mr. Joseph Piscopo, treasurer of the American Narcolepsy Association. In 1989, a record number of 101 individuals were certified by the ASDA in clinical polysomnography, bringing the 12-year total of certified clinical polysomnographers to 359, many of whom were practicing at 137 ASDA-accredited sleep centers. That year, the ASDA also accredited the first 3 fellowship training programs in sleep medicine at Georgetown University, led by Dr. Samuel Potolicchio; Stanford University, led by Drs. Dement, German Nino-Murcia, and Guilleminault; and the State University of New York at Stony Brook, led by Dr. Wallace Mendelson. Fellowship accreditation was administered by the ASDA Fellowship Training Committee, led by Dr. Virgil Wooten. By the close of the decade, the ASDA had established all the building blocks necessary for the development of a medical specialty: accreditation and certification programs, a diagnostic nosology, clinical training programs, a peer-reviewed scientific journal, and a clinical and scientific meeting. Sleep medicine was primed for expansion. 1990–1999: ADVANCING THE FIELD The 1990s marked a period of evolution and growth for the ASDA, which began the decade as an organization representing a “niche” area of medicine and ended it as a full-fledged professional society advancing a field of expertise that was on the pathway to becoming a recognized medical specialty. One catalyst for this progress was the publication of the first edition of the International Classification of Sleep Disorders in 1990. The ASDA appointed Dr. Michael Thorpy to chair the committee, which revised and expanded the previous diagnostic nosology. The book quickly became the authoritative reference for the diagnosis of sleep disorders, and updated editions of it continue to be published by the AASM today. The National Commission on Sleep Disorders Research held its first meeting in 1990, and the commission met in several cities in the United States to interview stakeholders, including patients, clinicians, school administrators, first responders, and shift workers. The commission’s final report was submitted to Congress, and it resulted in the establishment of the National Center on Sleep Disorders Research as part of the National Institutes of Health Revitalization Act of 1993. 16 , 17 Located within the National Heart, Lung, and Blood Institute and assisted by the Sleep Disorders Research Advisory Board, the center coordinates sleep and circadian biology research throughout the National Institutes of Health and other federal agencies. In 1990, the ASDA also established the independent National Sleep Disorders Foundation—now called the National Sleep Foundation—and provided the organization with start-up funds of $100,000 to focus on public health and well-being through sleep education and advocacy. Dr. Roth was appointed as the founding president, and Mrs. Westbrook transitioned from her role as ASDA executive director to become executive director of the foundation. As her successor, the ASDA hired Ms. Carolyn Hiller as executive director in 1991. The ASDA also incorporated the independent American Board of Sleep Disorders Medicine and Clinical Polysomnography in 1991, under the leadership of Dr. Schmidt. Now called the American Board of Sleep Medicine, it took on the administration of the certified clinical polysomnographer examination. The intent of this transition was to match the certification structure of other medical specialties and emphasize that the practice of sleep medicine involved more than just the performance and interpretation of polysomnograms. This change was further underscored by the publication in 1992 of the first paper developed by the Standards of Practice Committee of the ASDA, “The Clinical Use of the Multiple Sleep Latency Test.” 18 The ASDA published 11 more practice parameters papers in the 1990s, addressing critical topics such as portable recording, stimulants for narcolepsy, actigraphy, surgical modifications of the upper airway, indications for polysomnography, and nonpharmacologic treatment of chronic insomnia. The publication of practice parameters and clinical practice guidelines became an important function of the ASDA, providing essential guidance to sleep clinicians and promoting standardized care for patients who have sleep disorders. A significant milestone for the field was achieved in 1995 when the American Medical Association recognized sleep medicine as a specialty. This was followed in 1996 by the admission of the ASDA to the American Medical Association House of Delegates and in 1997 by accreditation of the ASDA as a sponsor of continuing medical education by the Accreditation Council for Continuing Medical Education. Other notable events occurred during the decade. As part of its mission to advocate for sleep research funding, the ASDA began meeting with leaders at the National Institutes of Health. Coupled with the establishment of the National Center on Sleep Disorders Research, this led to a call for proposals that culminated in the initiation of the Sleep Heart Health Study in 1994, the first multicenter, observational cohort study with a sleep disorder, OSA, as its principal outcome. 19 In 1995, when Dr. June Fry was installed as the 10th president of the ASDA, she became the first woman to hold this prestigious office, paving the way for future female presidents Drs. Gihan Kader, Mary Susan Esther, Nancy Collop, Ilene Rosen, Kelly Carden, Jennifer Martin, and Anita Shelgikar. Also in 1995, the APT withdrew from the APSS partnership, and the ASDA and SRS continued to organize an annual meeting and conduct other joint initiatives through the Associated Professional Sleep Societies. Today, the SLEEP annual meeting of the APSS remains the premier clinical and scientific conference for sleep medicine, sleep and circadian science, and sleep health, attracting more than 5,000 attendees and exhibitors. In April 1996, the ASDA hired as its executive director Mr. Jerome Barrett, who had experience in medical society management, including service as executive director of the Chicago Medical Society. He guided ASDA’s growth and development for the next 21 years. In 1997, the management office of the journal Sleep was relocated from Stanford University, where the journal was founded, to the home offices of the ASDA and SRS in Rochester, Minnesota, where the journal had a dedicated staff for the first time. The following year, Sleep began publishing a supplement with the abstracts from the annual meeting of the APSS. Previously, they were published in Sleep Research , a separate compendium compiled by Dr. Michael Chase. Also in 1998, the ASDA created the Sleep Medicine Education and Research Foundation to promote and sponsor educational activities and research grants in the sleep field. Its first grants were awarded to Stanford University and University of Pennsylvania. 20 , 21 Later renamed the American Sleep Medicine Foundation and then the AASM Foundation, it has awarded more than $31.5 million to support sleep research, career development, and community programs. In 1999, the ASDA changed its name to the American Academy of Sleep Medicine (AASM), reflecting its primary focus on advancing the field of sleep medicine. By the end of the 1990s, the number of accredited sleep centers had doubled to more than 400, and individual membership had increased to more than 3,800 ( Figure 2 ). The AASM had matured and was now able to exert greater influence on the advancement of sleep care. Figure 2. Growth in the number of individual members of the American Academy of Sleep Medicine from 1995 to 2024. Open in a new tab 2000–2009: FORMALIZING A SPECIALTY The decade encapsulating the start of the 21st century was one of both explosive growth and dramatic impact as the AASM secured for the field of sleep medicine both national recognition and broad acceptance within the medical community. 22 In June 2002, the AASM relocated its headquarters from Rochester, Minnesota, to Westchester, Illinois, about 16 miles west of Chicago. The field of sleep medicine, represented by its professional society, had returned to its Chicago roots. Pivotal to the acceptance of sleep medicine by the medical community was the accreditation of sleep medicine fellowships by the Accreditation Council for Graduate Medical Education (ACGME) in 2003. This was a complex undertaking with critical meetings between Dr. Marvin Dunn of the ACGME, Mr. Barrett, and members of the AASM board of directors, as well as a site visit by Dr. Dunn to the Mayo Sleep Disorders Center in Rochester. This work culminated in a meeting in March 2002 in Naples, Florida, during which the board of directors wrote a complex application, which was eventually accepted by the ACGME. This accomplishment validated the field of sleep medicine as one that could attract the interest of physicians to pursue it as a career. Furthermore, it attested to the unique, multidisciplinary nature of sleep medicine by the inclusion of diverse specialties in the eligibility pathway. The first ACGME fellowship programs were accredited in 2005, and the first ACGME site visits occurred in 2007, paving the way for more than 100 sleep medicine programs and over 200 training positions that exist today. The annual number of clinicians certified in sleep medicine by the American Board of Sleep Medicine grew each year from 172 in 2000 to a peak of 621 in 2005. This growth coincided with another important milestone when the American Board of Medical Specialties recognized sleep medicine as a subspecialty in 2005. The lengthy process for this achievement was initiated by AASM leaders all the way back in 1985 and was only finalized after the ACGME began to accredit sleep medicine fellowships. Following the last administration of the American Board of Sleep Medicine examination in 2006, a cumulative total of 3,445 individuals had been certified in sleep medicine since the inception of the clinical polysomnography examination in the late 1970s. The first sleep medicine examination administered by member boards of the American Board of Medical Specialties was in 2007, replacing the American Board of Sleep Medicine examination. The examination reflects the multidisciplinary nature of sleep medicine, providing a formal certification pathway for anesthesiologists (added in 2011), family medicine physicians, internal medicine physicians including critical care physicians and pulmonologists, neurologists, otolaryngologists/head and neck surgeons, pediatricians, and psychiatrists. Other AASM initiatives and resources advanced the field in the 2000s. In 2003, the AASM administered the first behavioral sleep medicine examination for professionals with expertise in addressing the behavioral and psychological factors that affect sleep. The AASM published the first issue of the Journal of Clinical Sleep Medicine in 2005. Led by founding editor-in-chief Dr. Stuart Quan, it marked the introduction of a clinically focused journal complementing Sleep , which continued to focus more on basic and translational science. Its original, iconic black-and-white cover was the suggestion of Dr. Daniel Buysse, the journal’s first deputy editor. An expert task force led by Dr. Peter Hauri as chair and Dr. Michael Sateia as editor completed the second edition of the International Classification of Sleep Disorders in 2005, 15 years after publication of the first edition. Given the explosion of internet-based resources during this era, AASM launched the Sleep Education website in 2005. It remains a leading resource for public information about sleep and sleep disorders, and its directory of AASM-accredited sleep centers is a vital tool for patients who are seeking help for a sleep problem. The AASM published 20 new and updated practice parameters papers in this decade, including an update in 2006 supporting oral appliance therapy as a treatment option for mild to moderate OSA, 23 which stimulated professional growth in dental sleep medicine. The AASM also published 4 clinical guidelines, including an influential paper addressing the use of unattended portable monitors in the diagnosis of OSA in adults. 24 Another monumental undertaking was the publication of The AASM Manual for the Scoring of Sleep and Associated Events in 2007 under the leadership of Dr. Conrad Iber, who served as editor and led a steering committee comprising Drs. Sonia Ancoli-Israel, Andrew Chesson, and Quan. This essential resource for sleep clinicians succeeded the seminal publication, A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects (commonly known as “The R&K Manual”), developed by Drs. Allan Rechtschaffen and Anthony Kales almost 40 years earlier in 1968. In April 2009 in Bethesda, Maryland, AASM hosted its first Young Investigator’s Forum—now called the Young Investigators Research Forum—in collaboration with the National Heart, Lung, and Blood Institute of the National Institutes of Health. The annual program has equipped more than 450 young investigators with the tools they need to launch a successful sleep research career, covering the basics such as grant application development, presentation skills, planning controlled trials, and writing and reviewing manuscripts. In July 2009, the AASM had a groundbreaking ceremony to begin construction of its new headquarters building at 2510 North Frontage Road in Darien, Illinois. Given the rapid pace of changes in the field, including the development of portable monitoring technology for diagnostic testing, the AASM formed a Presidential Task Force on the Future of Sleep Medicine, led by Dr. Esther. It met in Chicago in December 2009 to begin developing strategies and plans to guide the field of sleep medicine. Although there were questions about the path forward for the field, there was also cause for optimism: By the end of the decade, the number of AASM-accredited sleep centers had tripled to more than 1,800, and the number of individual AASM members had doubled to more than 8,000. The sleep medicine specialty had arrived. 2010–2019: PREPARING FOR THE FUTURE On June 16, 2010, just under a year after the groundbreaking, the AASM moved into its new headquarters. The modern, state-of-the-art facility was built debt-free with attention to elements of the US Green Building Council’s Leadership in Energy and Environmental Design program, including energy, efficiency, and water conservation. On October 10, 2010 (10/10/10), the AASM hosted a grand opening ceremony attended by staff, leaders, local dignitaries, and a special guest of honor, Dr. Dement. To this day, the building is the focal point for AASM operations and is the hub for all critical activities associated with the foremost professional organization in sleep medicine. In 2010, the board of directors appointed another presidential task force on the future of sleep medicine with a steering committee led by Dr. Patrick Strollo. A summit of task force members and thought leaders in the field was held at the AASM national office in October. Three workgroups were formed to explore tools for diagnosis and treatment of sleep disorders (led by Dr. Ofer Jacobowitz), frameworks for health care delivery such as the patient-centered medical home model (led by Dr. Safwan Badr), and patient registries and new outcome measures (led by Dr. Clete Kushida). These workgroups prepared reports that were presented at a second meeting in La Jolla, California, in February 2011, and their final report was published in the journal Sleep . 25 Another milestone for the field was achieved when the Centers for Medicare and Medicaid Services recognized sleep medicine as a specialty in 2012, adding a new specialty code allowing physicians practicing sleep medicine to self-designate sleep as their specialty. Recognizing the need to adapt to the changes brought about by the adoption and implementation of the Patient Protection and Affordable Care Act, the AASM convened a Future Models of Care Summit of more than 50 sleep medicine leaders and stakeholders in Chicago in 2013. Discussions focused on comprehensive medical prevention and management; team-based, interdisciplinary care; and adoption of telemedicine. With entry into the field now restricted for physicians by the number of ACGME fellowship training positions, 26 the AASM developed the “Choose Sleep” initiative in 2015 to promote awareness of the specialty among medical students and residents. 27 This effort has helped increase the number of training programs participating in the National Resident Matching Program Specialties Matching Service, and it has contributed to a rise in the percentage of sleep fellowship positions that are filled through the match. The AASM also commissioned the Fellowship Models Exploratory Committee in 2016 to develop new training pathways that provide flexibility to trainees, while ensuring high-quality, comprehensive, and multidisciplinary sleep medicine training. As a result, the AASM was granted approval in 2017 under the ACGME Advancing Innovations in Residency Education initiative to implement a pilot program for novel, competency-based sleep medicine fellowship training pathways. An Innovative Fellowship Models Task Force currently oversees part-time and blended pulmonary/sleep training programs. 28 During this decade, there were significant changes to several key AASM resources. In 2012, the second version of The AASM Manual for the Scoring of Sleep and Associated Events was released, moved online, and reimagined as a living document with periodic updates. In 2014, the third edition of the International Classification of Sleep Disorders was published with Dr. Sateia serving as task force chair and editor. In January 2015, Dr. Collop succeeded Dr. Quan as editor-in-chief of the Journal of Clinical Sleep Medicine , and in 2016 the AASM sold its ownership in the journal Sleep to the SRS. This transaction made the SRS its sole owner and strengthened the AASM’s commitment to fortifying the Journal of Clinical Sleep Medicine as the premier clinical journal in the field. The AASM also published 12 new and updated practice parameters papers and clinical practice guidelines, including its first guideline for the pharmacologic treatment of chronic insomnia in adults. 29 For years, the AASM had continued building on the public awareness efforts of early leaders such as Dr. Dement, focusing on promoting the importance of sleep health for public health and safety. These efforts contributed to the announcement in 2010 by the US Department of Health and Human Services that it was including sleep health as a new topic area in the Healthy People 2020 initiative. Building on this success, the AASM launched the 5-year National Healthy Sleep Awareness Project in 2013. Established by a cooperative agreement between the Centers for Disease Control and Prevention and the AASM, with the SRS as a key partner, it increased public awareness of the importance of healthy sleep and promoted the treatment and prevention of sleep disorders. As part of the project, the AASM and SRS hosted a consensus conference with Dr. Nathaniel Watson serving as chair. 30 It resulted in the publication in 2015 of recommendations on the amount of sleep for healthy adults, 31 and the AASM held another conference led by Dr. Shalini Paruthi to develop recommendations for pediatric populations, which were published in 2016. 32 Under Dr. Watson’s leadership, the AASM also published its first position statements on drowsy driving in 2015 and on delaying middle school and high school start times in 2017. 33 , 34 Under the direction of a task force led by Dr. Timothy Morgenthaler, the AASM published quality measures in 2015 for insomnia, OSA, narcolepsy, and restless legs syndrome. 35 To demonstrate the economic impact of undiagnosed and untreated OSA for payors, employers, and patients, the AASM commissioned a report by Frost & Sullivan that combined a review of medical and economic literature with the company’s modeling and forecasting. Released in 2016, the report estimated that 29.4 million adults in the US had OSA, with 23.5 million of them undiagnosed, costing the US approximately $149.6 billion in 2015. 36 To explore new and innovative clinical approaches to address the problem of undiagnosed OSA, the AASM hosted a Sleep-Disordered Breathing Collaboration Summit in 2018. Thirty-five representatives from 14 medical societies, nurse practitioner associations, and patient advocacy groups gathered to discuss strategies to improve the diagnosis and treatment of OSA. They focused on the challenges and opportunities associated with promoting the development of multidisciplinary, collaborative health care delivery models involving primary care professionals, sleep physicians, and other specialists. 37 In 2017, Mr. Barrett retired after serving for 21 years as executive director of the AASM, and Mr. Steve Van Hout was hired as his successor. With this change in leadership, the AASM also adopted a new logo and branding, and the American Sleep Medicine Foundation was renamed as the AASM Foundation. By 2019, the number of AASM-accredited sleep centers had grown to more than 2,600, and the AASM had more than 9,200 individual members. Yet the field was facing challenges. The financial paradigm of sleep medicine was changing as many payers implemented prior authorization policies to reduce the use of polysomnography in favor of home sleep apnea tests. 38 The model for diagnosing OSA had been disrupted. The AASM focused on helping members and sleep centers navigate these changes while also preparing members for the impact of technological innovation through the appointment of task forces and committees focusing on telemedicine, consumer sleep technology, and artificial intelligence. 39 – 41 However, the AASM and the field of sleep medicine were about to encounter new and unanticipated challenges. 2020–2025: LEADING THROUGH CHALLENGES In the spring of 2020, the sleep field and the entire world were rocked by the COVID-19 pandemic and public health emergency. The AASM responded to this challenge by rapidly forming a COVID-19 Task Force and a Telemedicine Presidential Committee, which assisted AASM members in adapting to safely take care of patients in this unfamiliar environment. These volunteer groups helped sleep centers quickly adopt new patient safety protocols and implement telemedicine. They also offered billing and coding compliance education, held webinars and virtual town halls, and surveyed AASM members to identify and ameliorate issues that arose during this challenging and complex period of uncertainty. 42 Sleep clinicians and scientists were saddened by the news in June 2020 that AASM founding president Dr. Dement had died at the age of 91. Special tributes to him were made at the SLEEP 2020 annual meeting of the APSS. Originally scheduled to take place in Philadelphia in June, it was transitioned to a virtual conference, which was held in August. Technology enabled participants to network and learn from a distance, providing a vital opportunity to reconnect during an unusual time of social isolation. Throughout the pandemic, AASM staff in the national office also worked remotely, and the board of directors held its meetings virtually. The field of sleep medicine experienced another generational challenge when an emergency recall of millions of positive airway pressure devices was announced in June 2021. 43 This sudden development, followed by sometimes conflicting and frequently changing information, left many clinicians and patients confused about how to safely and effectively treat OSA. 44 The recall contributed to a worldwide shortage of positive airway pressure devices, which was exacerbated by a pandemic-related scarcity of computer chips. Led by its Public Safety Committee, the AASM quickly began offering webinars for members, collaborating with other professional medical societies, providing information for clinicians and patients, and meeting with policy makers and representatives from the US Food and Drug Administration to help advocate for a rapid resolution to this crisis. Despite the pandemic and the recall, the AASM continued to focus on its vision that sleep is recognized as essential to health. The AASM’s efforts led to the establishment in 2020 of a Congressional Sleep Health Caucus led by founding cosponsors Representative Zoe Lofgren from California and Representative Rodney Davis of Illinois. In 2020, the AASM published its first position statement on the issue of daylight saving time, 45 and in 2021, the AASM published, “Sleep is Essential to Health,” a position statement that was endorsed by more than 25 other medical, scientific, and civic organizations. 46 In 2021, the AASM was awarded a grant from the Centers for Disease Control and Prevention for a collaborative project involving other partner organizations, including the SRS. Its focus was to increase awareness of OSA among the public and health care professionals, specifically focusing on addressing health disparities in Hispanic, Native American, and Black communities. 47 In 2022, the AASM launched, “Sleep is Good Medicine,” a national public awareness campaign about the importance of sleep for health and well-being. The AASM also formed a new Coalition for Permanent Standard Time in 2023 to advocate for the introduction and adoption of federal legislation making standard time permanent across the United States. The founding organizational members of the coalition were the AASM, National Sleep Foundation, Save Standard Time, SRS, and Society for Research on Biological Rhythms. This effort was strengthened by the publication in 2024 of an updated AASM position statement urging the United States to eliminate seasonal time changes in favor of permanent standard time. 48 In 2024, the AASM also finalized a new 3-year strategic plan, which included an updated vision, “Sleep and circadian care is fundamental to health care.” This statement emphasizes that the work AASM members do every day is vital and foundational for the success of the health care system. In the first half of the decade, the AASM also implemented other strategies and initiatives to address strategic priorities. In 2020, the board of directors created a Diversity, Equity, and Inclusion Committee, which evaluated AASM activities, bylaws, and processes and then made recommendations to improve transparency and create a welcoming environment for all members. This feedback led to changes in nominating processes and selection methods for leaders, volunteers, award recipients, and Fellows of the AASM. A Patient Advocacy Roundtable was formed by the AASM in 2021 to improve collaboration with patient advocacy organizations and increase the patient’s voice in AASM activities. In 2022, Dr. Martin became the first clinical psychologist to serve as president of the AASM, and under her leadership the AASM hosted a virtual Insomnia Summit to discuss how to improve accessible, high-quality care for people who have insomnia disorder. 49 The AASM released updates to 2 of its most important resources in 2023 with the publication of a text revision of the third edition of the International Classification of Sleep Disorders and Version 3 of The AASM Manual for the Scoring of Sleep and Associated Events . AASM overhauled its accreditation program by introducing in 2024 a new service-based accreditation model, which took effect in January 2025. Based on feedback from members and accredited programs, it provides greater flexibility to accommodate all practice types, making it easier to manage, add, and remove accredited services so that sleep centers can evolve and succeed in a competitive health care environment. Through January 2025, the AASM also published 5 new and updated clinical practice guidelines along with a clinical guidance statement on the use of polysomnography and home sleep apnea tests for the longitudinal management of OSA in adults. 50 Today, despite practice management challenges such as ongoing implementation of prior authorization policies and cuts to physician reimbursement rates, the field of sleep medicine remains strong as sleep physicians and other members of the clinical sleep team provide high-quality, comprehensive care for patients who have sleep disorders. There are about 5,700 physicians who currently have an active certification in sleep medicine administered by 1 of 6 member boards of the American Board of Medical Specialties ( Table 1 ), 51 and they ensure the quality of care provided at 2,300 AASM-accredited sleep centers across the United States. There are more than 16,000 sleep technologists with an active RPSGT credential issued by the Board of Registered Polysomnographic Technologists. 52 More than 1,400 respiratory therapists have earned the Sleep Disorders Specialist credential from the National Board for Respiratory Care; 53 more than 1,300 US medical centers are treating OSA with a surgical implant that provides hypoglossal nerve stimulation; 54 and 1,000 dentists are certified by the American Board of Dental Sleep Medicine to treat snoring and OSA with oral appliance therapy. 55 There are more than 250 psychologists and other clinicians who are certified in behavioral sleep medicine by the Board of Behavioral Sleep Medicine, 56 and a growing number of nurse practitioners and physician assistants are providing sleep care at accredited sleep centers. With more than 9,500 individual members, the AASM constituency reflects this professional diversity and expertise. Table 1. Number of board-certified physicians in the United States with an active subspecialty certificate in sleep medicine recorded in the American Board of Medical Specialties database as of June 30, 2024. ABMS Member Board No. of Sleep Physicians Anesthesiology 21 Otolaryngology/Head and Neck Surgery 254 Family Medicine 279 Pediatrics 380 Psychiatry and Neurology 1,319 Internal Medicine 3,445 Total 5,698 Open in a new tab CONCLUSIONS In the past 50 years, the AASM has grown and prospered as a professional medical society while simultaneously establishing sleep medicine as a recognized medical specialty. As the most prominent voice in the field of sleep medicine, the AASM has been the leader in establishing clinical standards, providing professional education, advocating for sleep medicine professionals, publishing and funding scientific research, raising public awareness, and promoting patient-centered care. It is anticipated that the next 50 years will be both exciting and challenging for the AASM and its members. Changes on the horizon include the expanded use of artificial intelligence in clinical care; continued proliferation of consumer sleep tracking devices; new discoveries in genomics, physiology, and neurophysiology; and novel diagnostic and therapeutic options for sleep and circadian disorders. The lessons from the past 5 decades are that the AASM is focused on advancing sleep and circadian care while equipping sleep medicine professionals, and the organization is member driven, adaptable, and forward thinking. The success of the AASM can be attributed to the visionary work of its founders and the dedicated service of its leaders, volunteers, members, and staff. Built on this solid foundation, the AASM and its members will continue to play a leading role in shaping the future of sleep medicine. DISCLOSURE STATEMENT Mr. Heffron is employed by the American Academy of Sleep Medicine (AASM), and the other authors are past presidents of the AASM. ACKNOWLEDGMENTS The American Academy of Sleep Medicine thanks the leaders, volunteers, members, and staff who have empowered the organization’s success in the last 50 years. The authors thank Dr. Mary Carskadon, Dr. Seema Khosla, Dr. Meir Kryger, Dr. Thomas Roth, the other members of the AASM 50 th Anniversary Task Force, Dr. Vishesh Kapur, Dr. Eric Olson, Dr. James Rowley, and the other members of the AASM board of directors for reviewing this manuscript and providing feedback. 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