A woman sleeping in bed.

NIH Sleep Disorders Research Advisory Board Meeting

Event Details

December 04, 2025 2:00 PM
to
December 04, 2025 5:00 PM
Virtual

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Description

The purpose of this meeting was to seek guidance and gather input from the Sleep Disorders Research Advisory Board on research priorities conducted or supported by the Institute; and to continue discussions on the topics for the NIH Sleep Research Plan refresh.

MEETING SUMMARY

BOARD MEMBERS PRESENT
Dr. Esra Tasali, Chair
Mr. David Bishop
Dr. Josiane Broussard
Dr. Paula Desplats
Dr. Jeffrey Durmer 
Dr. Dayna Johnson
Dr. Pat McBride
Dr. Shaun Purcell
Dr. Alberto Ramos

BOARD MEMBERS ABSENT
None

EX OFFICIO MEMBERS PRESENT
Dr. Marishka Brown, Executive Secretary
Dr. Yejun (Janet) He
Dr. Amanda Hunt
Dr. Donald Shell

FEDERAL EMPLOYEES
Twenty-two Federal employes attended the meeting.

MEMBERS OF THE PUBLIC
Forty-nine members of the public attended the meeting (including researchers, clinicians, patients, and other stakeholders).

CALL TO ORDER
Marishka Brown, Ph.D., SDRAB Executive Secretary

  • The executive secretary called the meeting to order at 11:00 AM ET as announced in the Federal Notice [FR Doc. 2025-20130] on November 17, 2025. The meeting was fully open to the public in accordance with the provisions set forth in sections 552b(c)(4) and 552b(c)(6), Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act.
  • Board members were reminded they are required to absent themselves if their presence constitutes or appears to constitute conflict of interest.
  • Dr. Brown introduced the chair of SDRAB, Dr. Esra Tasali.
  • The Chair welcomed everyone and SDRAB members introduced themselves.

DIRECTOR’S REPORT - National Center On Sleep Disorders Research (NCSDR)
Marishka Brown, Ph.D., Director, NCSDR

OVERVIEW OF THE CLINICAL APPLICATIONS AND PREVENTION BRANCH
Nicole Redmond, MD, PhD, MPH
Acting Associate Director, NHLBI, Division of Cardiovascular Sciences (DCVS)
Acting Director, Prevention and Population Sciences Program

  • Dr. Redmond explained that the Clinical Applications and Prevention Branch (CAPB) is one of the two branches with the Prevention and Population Sciences program within Division of Cardiovascular Sciences (DCVS). The other branch is the Epidemiological Branch which is home to many of the larger epidemiological cohorts such as the Framingham Heart Study.
  • CAPB supports, designs, and conducts research and supports training on behavioral, environmental, clinical, and healthcare approaches to prevent occurrence and reduce consequences of cardiovascular diseases. Sleep is among the clinical conditions and risk factors studied in the CAPB portfolios.
    • Clinical Applications - research examines approaches to improve healthcare delivery and patient outcomes.
    • Prevention - research examines effects of interventions to slow or halt risk factor or disease development or progression.
    • Training/Career Development
      • Patient oriented Research
      • Clinician Scientists
      • Behavioral Scientists
  • Considering the complexity of cardiovascular disease (CVD), current research requires:
    • Appreciation of the multi-level influences on health (e.g., socioecological model)
      • Individual, Family, Community, Institutions, Systems
      • These factors contribute to the exposome and phenotypic plasticity
    • Life-course health development framework - appreciation of the impact of early life exposures and life experiences on health trajectory and functional status
    • Awareness of the different levels of prevention
      • Primordial prevention (lack of signs) - to maintain CV health
      • Primary prevention (subclinical) - focused on detection and management of risk factors
      • Secondary prevention (disease) - to reduce morbidity, disability, recurrent events
    • Appreciation of the intersection of biological, psychological, and social risks
    • Need to accelerate translation across spectrum of scientific discovery, from the bench to bedside to population
      • CAPB portfolio is primarily focused on efficacy and effectiveness, and type 1 hybrid effectiveness/implementation studies
  • The NHLBI SV has been refreshed to address new complex areas of critical need across the 8 objectives by now including updated research priorities related to five crosscutting themes. Along with the five crosscutting themes, the following are examples of program areas that are new or enhanced:
    • Harnessing data science and new technologies to drive scientific discovery and precision health.
    • Using novel approaches for addressing health disparities and tackling their biological underpinnings for heart, lung, and blood diseases and sleep disorders.
    • Furthering the science on the importance of lifestyle.
    • Leveraging the power of community and patient engagement.
    • Supporting women’s health through the lifespan.
  • Additional research priorities now address HIV as a chronic condition, support sleep and circadian rhythm research, and further implementation science.
  • Dr. Redmond then shared with the community CAPB’s unique roles in DCVS and NHLBI to help applicants understand where their project fits within the institute.
  • 3 key areas of focus in CAPB; all of these incorporate a life course perspective and interest social determinants of health (SDOH)/health disparities
    • Behavioral-Social-Biological Mechanisms
      • Understand how social determinants influence behavior and biology
      • Mechanisms and interactions underpinning success and failure of prevention trials
    • Obesity, Nutrition, Physical Activity Sciences
      • Historically focused on nutrition and physical activity; and obesity, and clinical conditions such as diabetes and chronic kidney disease, particularly how they change over the lifespan and impact CV health
    • Precision Prevention
      • Leverage multi-dimensional data in designing and conducting prevention trials tailored to individuals and the environment in which they live
  • Dr. Redmond then turned her attention to sleep and CV health by noting that in 2022 the American Heart Association (AHA) evolved their framework for primary and primordial prevention from Life’s Simple 7 (not smoking, eating more healthfully, engaging in physically activity, achieving and maintaining a healthy weight, managing blood pressure, controlling cholesterol, and optimizing blood sugar) to Life’s Essential 8, to include the addition of sleep to the other health components.
  • This association between sleep and heart health has led to enhanced collaborations between DCVS and NCSDR with interest in the following intersecting areas of research:
    • Circadian influences on health behaviors and biological processes influencing CV health and CVD risk
      • Diet
      • Physical activity
      • Blood pressure
      • Inflammation
    • Impact of clinical and behavioral sleep interventions on CV outcomes
    • Addressing sleep health disparities and their impact on CV health disparities
  • Dr. Redmond summarized several of CAPB’s past and present major initiatives
  • A brief Q&A with the SDRAB followed.
    • Dr. Brown commented that CAPB is a strong partner in support of management of the sleep and circadian biology research portfolio at NHLBI.

HIGHLIGHTS from the Sleep in a Bottle Workshop
Barbara Sorkin, PhD
Program Director, NIH Office of Dietary Supplements (ODS)

  • Dr. Sorkin shared that the idea for the workshop stemmed from a paper on the Quantity of Melatonin and CBD in Melatonin Gummies Sold in the U.S.  that showed calls for pediatric melatonin ingestion to U.S. Poison Control Centers increased 530% from 2012 to 2021 and were associated with:
    • ~27,800 emergency department and clinic visits
    • ~4,100 hospitalizations
    • ~290 intensive care unit admissions
    • 2 deaths
  • A 2024 survey revealed 1 in 5 children were given melatonin in the previous month, half of these without healthcare provider recommendation.
  • More than half the dietary supplements (DS) in ODS’ Dietary Supplement Label Database (DSLD) that are marketed for sleep contain melatonin.
  • There is substantial use of these products:
    • 1 in 5 U.S. adults use either prescription or over-the-counter (OTC) sleep aids
    • In the 2002 National Health Interview Survey (NHIS) 64.8% of people who reported insomnia or trouble sleeping used “biologically-based approaches” (mostly ingested products such as herbs, nutritional products)
    • Nutrition Business Journal reports strong sales of DS for “Sleep Health” (> for brain health or healthy aging, < for weight loss)
  • There are a total of 2,685 on-market sleep advertised products DS in DSLD with “sleep” on the label.
  • ODS decided a workshop was needed to address the public health concerns. Many of these products have a long tradition of use, but there are few rigorous and replicable DS clinical trials.
  • There remains much we don’t know about sleep DS, such as what is the chemical composition of these products, are they safe and effective, what doses are appropriate, what are the associated risks?
  • The goal of the workshop was to identify research needs and gaps in ingested, non-prescription strategies for healthy sleep.
  • Q&A with the SDRAB followed.
    • Given the variability in composition, impurities, and changes overtime the degree of confidence we can have in some of the published studies of DS is uncertain.
    • A recent published observational study showed that following the recommendations for dietary intake of fruits and vegetables has an almost immediate effect on the next night’s sleep quality, improving it by 16%. We need to consider what can be learned from studies like this about which DS to take to improve sleep.
    • There is also the consideration of timing and dietary content, which needs to be studied further. We sleep on a circadian basis and clearly this has some relationship to energy and metabolism.

SDRAB MEMBER DISCUSSION OF TOPIC 2: Sleep and Circadian-Based Strategies for Prevention and Mitigation of Chronic Disease
Moderated by Dr. Esra Tasali

  • The Board found the topic of individual sleep sufficiency was very interesting and increasingly important as we move toward precision medicine. The interactions and the two-way drive between metabolism and sleep suggest there may be some metabolic markers and targets for insufficient sleep.
  • Sleep health promotion is not one size fits all and must be tailored to the patient culture and contents.
  • A key part of training is teaching providers how to do clinical decision making and tailoring.
  • We need to be mindful of balancing the tension between leveraging digitally-delivered interventions and the recommendation to limit screen time.

HIGHLIGHTS from the Neurodevelopmental Disorders and Sleep Workshop
Larry Baizer, PhD
Program Director, NCSDR

  • Dr. Baizer began by sharing the rationale for the workshop:
    • Sleep problems are a common comorbidity in many neurodevelopmental disorders (NDDs), with >1 in 4 affected individuals exhibiting a variety of sleep disturbances
    • These sleep problems can exacerbate behavioral manifestations of the disorders; conversely, some aspects of these behavioral manifestations may aggravate the sleep problems.
    • Some NDDs e.g. Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), show significant sex differences in their prevalence, and the basis for this bias is currently unknown
  • Many neurodevelopmental disorders with sleep phenotypes have been described and were discussed in workshop.
  • This is an expanding area of research with broad interest over the past 20 years as evidenced by a fourfold increase in publications in PubMed and a significant increase in applications on NDD symptoms.
  • Dr. Baizer then described the themes and take home messages from the workshop sessions:
    • Treating sleep disorders can mitigate NDD symptoms, e.g. with OSA in epilepsy.
    • Common NDDs and associated sleep problems persist throughout the lifespan.
    • Cohort studies can chart developmental trajectories, potential mechanisms and environmental influences.
  • Cohort studies can identify important questions, but prospective analyses are essential for definitive information
  • Dr. Baizer concluded his presentation by summarizing the critical gaps and opportunities identified by the workshop:
    • Basis for sex bias (M>F): hormonal effects on development?
    • Detailed study of specific NDD phenotypes and sub-phenotypes might improve the understanding of specific genetic etiologies. However, multiple factors, including environmental exposures, must inform analyses of these disorders.
    • Many workshop participants recommended a holistic approach to treatment that addresses core NDD symptoms, co-occurring conditions, and sleep disturbances simultaneously. Treatment plans should address the primary complaints of patients and their families and could include pharmacological, behavioral, environmental, and surgical strategies, as well as other interventions.
    • Cohort-based studies and large population data sets have the potential to illuminate the relationships among NDDs, sleep, genetics, environmental factors, co-occurring conditions, and other influences. (NIH Autism Data Science Initiative)
    • New remote monitoring technologies including wearable and nearable devices will enable less burdensome collection of longitudinal sleep-related data in individuals with NDDs.
    • Providing information to families facing problems with NDDs and sleep is crucial and can help initiate productive conversations with health care providers.
    • Studies in animal models can provide researchers with more controllable experimental parameters, greater uniformity of genetic background, and increased accessibility to the brain.
    • Some of these conclusions (e.g. assessing environmental influences, remote monitoring, engaging patients and their families) are relevant to efforts related to MAHA and its focus on chronic disorders

Scientific Presentation: Major Gaps and Opportunities in Pediatric Sleep Research
Ariel Williamson, PhD, DBSM
Assistant Professor of Psychiatry and Pediatrics
Perelman School of Medicine, University of Pennsylvania

SDRAB MEMBER DISCUSSION OF TOPIC 3: Sleep and Circadian Rhythms in Development, Child, and Adolescent Health
Moderated by Dr. Esra Tasali

  • We need to do a better job at identifying the underlying issue of sleep insufficiency in the pediatric population rather than just treating the symptoms/manifestations disorders, such as ADHD. How to disentangle these cooccurrences is an intriguing challenge that has yet to be solved.
  • It is important to determine whether poor sleep quality is due to behavioral issues versus a diagnosis.
  • System-wide screening is an important strategy to help interventions reach populations experiencing disparities in sleep health such as in rural settings. But if you screen, you must intervene.
  • Another important strategy is integrating training about sleep into the different allied health professions. For example the Ballmer Institute is developing a new undergraduate behavioral health workforce who can after their 4-year degree gain certification as child behavioral health specialists. They are not diagnosing or treating, but they can help with sleep health promotion.
  • Among adults there have been huge movements to increase the health workforce by using lay community providers and peer specialists.
  • One way to design for implementation and account for the years long gap between research and practice is by testing initial studies on strategies known to work in the real world because.
  • Digital approaches hold a lot of promise but they must be designed with the patient in mind.

PUBLIC QUESTIONS/COMMENTS

  • How is digital CBT-I different from CBT-I and which is more effective and practical for pediatric and women’s health issues?
  • Unfortunately there is still a lot of stigma around delayed sleep phase disorder (DSPD) with children being perceived as lazy or undisciplined. It is important to build more awareness about DSPD in neurodivergent children among teachers, school nurses, student counselors. Patient advocacy group can play a pivotal role in this area.
  • The “Seizure-Safe Schools" program supported by the Epilepsy Foundation and the CDC has been broadly successful in educating school nurses and the general public in identifying symptoms of epilepsy. The sleep patient advocate community has been working on proposing a similar program to further localize sleep screenings.
  • Research has shown that sleep disturbance and circadian rhythm disruption are considered strong candidate endophenotypes for the risk of bipolar disease and are a transdiagnostic feature and risk factor in various NDDs.

NEXT STEPS FOR SLEEP PLAN REFRESH
Marishka Brown, Ph.D., Director, NCSDR

  • Dr. Brown thanked the Board their participation and noted this was an atypical meeting due to the compressed timeline for planning and uncertainty around having the meeting at all due to the government shutdown.
  • NIH will use the input from the SDRAB to inform the continuing development of the Sleep Plan refresh.
  • The other topics proposed for the refresh will be further refined and discussed at the April 2026 meeting.
  • Although several SDRAB members’ terms are expiring at the end of December, we will invite those representatives back to the meeting in April as ad hoc members of the Board to provide continuity as we continue these discussions.
  • We recognize the importance of fresh ideas as well and we will continue to have outside speakers present at these meetings as well to enhance the discussions.

The meeting adjourned at 5:00 PM