Recovery Act Investments in Sleep

Public Health Burden

Sleep deprivation and sleep disorders are pervasive consequences of modern urban lifestyles that increase risk of cardiovascular disease, diabetes, obesity, accidents, and all-cause mortality. Even relatively small decrements in sleep quality or duration are associated with functional and emotional difficulties in family and workplace relationships, diminished cognitive performance, and depression.

Treatment

Although many available treatments appear to reduce the severity of sleep disorders and sleep-related symptoms, their prescription and use in practice vary widely because sleep problems are difficult to measure and rigorous evidence of their efficacy in reducing the risk of disease or death is lacking. Recovery Act-funded grants addressing treatment issues include investigations of:

• The effects of exposure to darkness and to lighting of various duration, intensity, timing, and wavelength on physiological functions, sleep, alertness, and performance.¹
• The potential of reducing the risks of heart and metabolic diseases by treating sleep apnea.²
• The potential of treating sleep-disordered breathing via modification of an individual’s sensitivity to arterial oxygen and carbon dioxide levels.³
• The effect of two alternative treatment strategies for sleep-disordered breathing on physiologic and biochemical indices of cardiovascular diseases, patient-reported outcomes, and quality of life.⁴
• The effect of rapid inpatient identification and treatment of sleep-disordered breathing on cardiac and functional outcomes during hospitalization and at three months after discharge.⁵
• The role of sleep deprivation in producing elevated stress hormone levels, diminished cardiorespiratory fitness, and increased risk of metabolic disorders.⁶
• The significance of gender-specific differences in fat distribution on the development of sleep-disordered breathing.⁷

Basic Research

Chronic sleep insufficiency—whether because of lifestyle choices or untreated sleep disorders—erodes health over time. Sleep duration and sleep pattern strongly influence how well organs work together to maintain health and enable top performance in work, school, or sports. Recent advances indicate that the genes responsible for the timing of sleep and wakefulness in the brain also produce cycles of cell function in tissues such as fat, heart muscle, and liver. A prolonged disruption of such rhythms results in abnormalities associated with disease.  Recovery Act funds are supporting a variety of basic science investigations addressing these topics, such as research on:

• The development of new analytical techniques that will allow physicians to assess sleep and breathing problems using routine clinical electrocardiograms.⁸
• The development of new laboratory tests using blood, urine, or saliva to measure the effect of sleep deprivation on cardiovascular, metabolic, and immunological health .⁹
• The identification of molecules in blood that connect the biological clock in the brain with the biological clock of cells in other organs and tissues such as the heart and liver.¹⁰
• The importance of circadian rhythm in determining the ability of immune cells to move into tissues and destroy disease-causing pathogens.¹¹
• The role played by damage to nerve endings that control upper airway muscles in determining who develops sleep-disordered breathing.¹²
• Genes and genetic risk factors that produce abnormalities causing people to sleep much earlier or much later than normal (circadian phase disorders).¹³

1. 1 RC2 HL101340-01 - Human circadian sensitivity to very short light pulses – Klerman, Elizabeth B (MA)
2. 1 RC1 HL100046-01 - Effective treatment of sleep apnea in prediabetes to reduce cardiometabolic risk – Tasali, Esra (IL)
3. 1 RC1 HL099724-01 - Targeted Therapies for Selected Phenotypes of Obstructive Sleep Apnea – Dempsey, Jerome (WI)
4. 1 RC2 HL101417-01 - Phase II Trial Of Sleep Apnea Treatment To Reduce Cardiovascular Morbidity – Redline, Susan (OH)
5. 1 R21 HL092480-02S1 - The Role of Obstructive Sleep Apnea in the Acutely Decompensated Heart Failure, Khayat, Rami N (OH)
6. 1 R01 HL092140-01A2 - Autonomic, Endothelial, and Inflammatory Correlates of Sleep Duration – Carnethon, Mercedes (IL)
7. 1 R01 HL037379-21A1 - Effects of sex and fat distribution on sleep disordered breathing – Smith, Phillip (MD)
8. 1 RC1 HL099749-01 - ECG-derived cardiopulmonary coupling biomarkers of sleep, and sleep-breathing – Thomas, Robert (MA)
9. 1 RC1 HL099701-01 - Biomarker for Sleep Loss: A Proteomic Determination - Naidoo, Nirinjini N (PA)
10. 1 R01 HL092571-01A1 - Neuropeptidomics of Clock-to-Clock Coupling – Gillette, Martha (IL)
11. 1 R01 HL088041-01A1 - Biology of the NK cell cytolytic activity rhythm – Sarkar, Dipak (NJ)
12. 1 R01 HL080492-05S1 - Sleep Apnea: Upper Airway Nerve Injury - Veasey, Sigrid C (PA)
13. 1 R01 HL080978-04S1 - Circadian & Genetic Evaluation of Extreme Sleep Timing - Duffy, Jeanne F (MA)

Last Updated April 26, 2010