Respiratory and sleep medicine are closely related areas of internal medicine. Specialists may choose to focus predominantly on one of these disciplines, or to combine them in their practice.

Respiratory medicine is a subspecialty of internal medicine that deals with diseases affecting the airways, lung parenchyma, pleura and mediastinum, and pulmonary vessels. It is also concerned with neuromuscular and structural abnormalities of the diaphragm and chest wall. The conditions encountered may be primary abnormalities of the respiratory system (e.g asthma, pneumonia, pulmonary embolism, occupational lung disease, lung cancer, and chronic obstructive pulmonary disease), disorders which secondarily affect breathing (e.g obesity-hypoventilation syndrome), or multisystem disorders such (e.g cystic fibrosis, connective tissue diseases and sarcoidosis). These specialists treat the full spectrum of illnesses from acute and life-threatening to chronic and/or terminal, and have a number of specialised diagnostic, therapeutic and palliative procedures at their fingertips.

Sleep medicine is a historically under-recognised discipline, concerned with sleep-disordered breathing and other conditions such as insomnia, restless-legs syndrome and narcolepsy. Neurological (e.g Parkinson’s disease) and psychiatric illnesses (e.g mood or anxiety disorders) affecting sleep are also dealt with. Obstructive sleep apnoea, the commonest form of sleep-disordered breathing, is present in about 20% of the population. It is associated with an increased incidence of daytime sleepiness, motor vehicle crashes, hypertension, angina, myocardial infarction and stroke, and there is effective treatment available. This gives some idea of the potential impact of sleep medicine.

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