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Fostering Sleep and Circadian Research
The National Center on Sleep Disorders Research (NCSDR), housed within NHLBI, supports research on sleep and circadian biology and coordinates sleep research across federal agencies. The impetus for this work has been well-established. Sleep and circadian rhythms profoundly influence the crucial functions of nearly every cell and organ in the body. NCSDR’s mission areas are:
- Sleep and circadian research projects related to the regulation of sleep and sleep disorders and the etiology and treatment of heart, lung, and blood diseases.
- The diagnosis, treatment, and prevention of sleep disordered breathing.
- Studies to determine how the brain controls breathing during sleep.
Sleep and the Opioid Epidemic
The Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, is an aggressive, interagency effort to speed scientific solutions to stem the national opioid public health crisis. Almost every NIH Institute and Center is accelerating research to address this public health emergency from all angles. The initiative is funding hundreds of projects nationwide. Researchers are taking a variety of approaches to tackle the opioid epidemic through:
- Understanding, managing, and treating pain
- Improving prevention and treatment for opioid misuse and addiction
NCSDR is contributing to the HEAL initiative by funding studies to examine how sleep and circadian rhythms affect opioid use disorder (OUD) and response to medication-assisted treatment. Some FDA-approved medications for other conditions are also potential treatments for OUD and pain. For example, the insomnia treatment suvorexant is being tested for its ability to improve sleep and address other withdrawal symptoms in people with OUD. HEAL scientists showed that suvorexant effectively treats sleep problems related to withdrawal, mitigates opioid craving, and has little potential for harmful use.
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NIH Sleep Research Plan
In December 2021, the Institute released the NIH Sleep Research Plan. It is based on a set of research needs and opportunities identified with input from researchers, public representatives, NIH workshop participants, and NHLBI programmatic staff. The plan incorporates cross-cutting NIH priorities that address topics such as minority health and health disparities, sex/gender, sleep across the lifespan, the impact of opioid addiction, and how poor sleep may exacerbate the risk and outcome of infectious diseases such as COVID-19. The plan also covers the development of personalized treatments for sleep and circadian disorders.
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Advancing Sleep and Circadian Research
Studies have shown that elevated nighttime temperature lowers sleep quality, with the largest effects being felt by older adults and low-income individuals. There are also biological differences in sleep quality and its health impacts. For example, women report poorer sleep quality and have higher risk for insomnia than men do and may be affected by changes in sleep related to menstruation, pregnancy, post-childbirth, and menopause.
- NHLBI research has revealed that exposure to even ambient light while sleeping was linked with obesity, diabetes, and high blood pressure in older adults.
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Research to Address Sleep Disparities
Appropriate sleep is key to the proper function of the human body. Unfortunately, some groups, such as racial and ethnic minorities and those of lower socioeconomic status, are disproportionately affected by poor sleep. Suboptimal sleep environments, including those burdened by climate change, also influence how and how well people sleep.
- Sleep dysfunction and insufficient sleep are associated with Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD). African Americans are disproportionately affected by higher rates and earlier onset of ADRDs relative to White Americans.
- In a study sample of predominantly African American older adults, both the amount of time spent awake while in bed (known as low sleep efficiency) and frequently waking up while sleeping (known as wakefulness after sleep onset, or WASO) were associated with poorer cognitive function. Improving sleep health may help prevent ADRD and reduce health disparities.
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Sleep Health and Immune Function
A 2022 study supported by NHLBI and the NCATS found that getting a consistent good night’s sleep supports normal production and programming of hematopoietic stem cells in humans and mice. Sleep has long been linked to immune function, but researchers discovered that getting enough of it influenced the environment where monocytes form, develop, and get primed to support immune function. They analyzed how sleep disruptions increased circulating levels of these immune cells and changed the environment in the bone marrow. Prior studies have identified genetic mutations that drive the proliferation of hematopoietic stem cells. However, this study found that putting pressure on the hematopoietic system, in this case through sleep restriction, produced similar results without the driver mutations. The findings underscore the importance of establishing sound sleep patterns early in life, which may reduce the severity of other inflammatory conditions.