NATIONAL CENTER ON SLEEP DISORDERS RESEARCH
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Sleep Disorders Research Advisory Board Meeting Minutes

June 14, 2006

The 24th meeting of the Sleep Disorders Research Advisory Board (SDRAB) was convened at 8:00 a.m. on Wednesday, June 14, 2006, in Room 6C of Building 31 on the National Institutes of Health (NIH) campus in Bethesda, MD. Dr. Rafael Pelayo presided as Chair.

TABLE OF CONTENTS

Attendees
Welcome And Introductions
National Heart, Lung, And Blood Institute Update
Acknowledgement Of Departing Board Members
Adoption Of Minutes From The December 6, 2005, Meeting
Report of the Acting Director NCSDR
Institute Of Medicine (IOM) Assessment: Sleep Medicine And Research
IOM Sleep Research Evaluation And Follow-Up
Election Of The Next SDRAB Chair
Public Reports
Other Business
Final Discussion
Adjournment
Certification


Sleep Disorders Research Advisory Board Page


BOARD MEMBERS PRESENT

Dr. Rafael Pelayo (Chair)
Ms. Sheila C. Connolly
Ms. M. Elizabeth Johns
Dr. Gina Poe
Dr. Susan Redline
Dr. Michael Sateia
Dr. Lorraine Wearley
Dr. Phyllis Zee

BOARD MEMBERS ABSENT

Ms. Julianne Hill
Dr. Kathryn Lee
Dr. Howard Roffwarg
Dr. Michael Smolensky

EX OFFICIO MEMBERS PRESENT

Dr. Thomas J. Balkin, U.S. Department of Transportation
Dr. Merrill M. Mitler, NINDS
Dr. Sam Speciale, (for Dr. Andrew Monjan), NIA
Dr. Elizabeth G. Nabel, Director NHLBI
Dr. Kevin Quinn, NIMH (for Dr. William Riley)
Dr. Michael Twery, NHLBI, Acting NCSDR Director

LIAISON MEMBERS PRESENT

Dr. Daniel P. Chapman, CDC (by phone
Dr. Harold Gordon, NIDA)
Dr. Akiva Liberman, U.S. Department of Justice

FEDERAL EMPLOYEES PRESENT

Ms. Alicia Bell, Office of Research on Women's Health
Mr. Al Golden, NHLBI
Dr. Dante Picchioni, Walter Reed Army Institute of Research and National Institute On Deafness and Other Communication Disorders
Ms. Sue Rogus, NHLBI
Ms. Ellen Sommer, NHLBI

MEMBERS OF THE PUBLIC PRESENT

Dr. Bruce Altevogt, Institute of Medicine
Dr. Charles Atwood, American College of Chest Physicians
Mr. Robert Balkam, Restless Legs Syndrome Foundation
Mr. Jerome Barrett, American Academy of Sleep Medicine
Mr. Darrell Drobnich, National Sleep Foundation
Mr. Richard Gelula, National Sleep Foundation
Dr. Edward Grandi, American Sleep Apnea Association
Dr. Sarah Hanson, Institute of Medicine
Dr. Allan Pack, University of Pennsylvania
Ms. Sharon Smith, Narcolepsy Network
Ms. Kelsey Spoon, Restless Legs Syndrome Foundation
Dr. Shipa Toshi, Institute of Medicine

INVITED GUESTS PRESENT

Dr. Harvey Colten, Columbia University

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WELCOME AND INTRODUCTIONS-Drs. Michael Twery and Rafael Pelayo

Dr. Twery welcomed the participants and asked the Board members to introduce themselves. He also welcomed the videocast community (the meeting was broadcasted live).

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NATIONAL HEART, LUNG, AND BLOOD INSTITUTE UPDATE--Dr. Elizabeth G. Nabel, NHLBI Director

Dr. Nabel, Director of the NHLBI, welcomed Dr. Twery, the Acting Director of the NCSDR, and acknowledged the service of his predecessor, Dr. Carl Hunt, She said that options for implementing a national search for a permanent director of the NCSDR will be considered at some point during the NHLBI strategic planning process now underway. Dr. Nabel reviewed the mission of the SDRAB, and focused on its role in identifying the most important scientific questions, setting and communicating priorities, as advisory to the NHLBI and other NIH Institutes that fund sleep research. She said that she believes it is more important to focus on critical and emerging scientific questions than on formal structures for research. Mechanisms are in place to facilitate coordinated activities and all NHLBI sleep initiatives are publicized and are open for other Institutes to cosponsor. Dr. Nabel stressed the need to work through the scientific community because its members are in the best position to bring potential studies to their respective institutions, and she asked the SDRAB to identify potential supporters and collaborators in the scientific community. Dr. Twery said that he will take the Board's recommendations for the most important scientific questions to the Trans-NIH Sleep Research Coordinating Committee (SRCC). In response to a question about the possibility of establishing a Sleep Laboratory at NIH, he noted that some intramural scientific programs/studies are in startup and could eventually require such a resource, but that there were no current plans by the NHLBI or the NCSDR to establish such a facility. Dr. Pelayo asked if the SDRAB could recommend the nomination of persons who had previously served as Board members after a period of 3 years. Dr. Nabel said that this could be done.

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ACKNOWLEDGEMENT OF DEPARTING BOARD MEMBERS

Dr. Twery recognized the four departing Board members who had completed their 4-year terms: Dr. Rafael Pelayo, Dr. Michael Sateia, Dr. Susan Redline, and Dr. Kathryn Lee (who could not attend today's meeting). He thanked them for their service and presented them with certificates of appreciation signed by Dr. Nabel.

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ADOPTION OF MINUTES FROM THE DECEMBER 6, 2005, MEETING

The Board unanimously adopted the minutes from the December 6, 2005 SDRAB meeting.

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NCSDR ACTING DIRECTOR'S REPORT-Dr. Michael Twery

Dr. Twery reviewed the information in the SDRAB meeting briefing book and acknowledged the assistance of NCSDR staff, including Mr. Al Golden, who put the information together. Dr. Twery also called attention to the NCSDR Web page at and said an updated version will be announced at the next SDRAB meeting. He reviewed the day's agenda and provided background information on the NCSDR, and the Trans NIH Sleep Research Coordinating Committee (SRCC) including its 14 member Institutes and Centers

Funding for Sleep Research:
Dr. Twery reviewed growth in NIH funding for sleep research since 1996 and how it compares with funding for total NIH research. From 1996-2005, the percent increase for sleep research kept pace with or slightly outpaced the increase for total NIH funding and represented approximately 1 percent of the total NIH research award budget each year. These data on funding are based on NIH Institute and Center submissions as required by Congressional disease category reporting (funded grants only). Additional useful information is obtained by tracking the number of total applications for sleep research, how many were funded, and how many applicants reapplied. Because the historical dataset does not code all sleep-related grants, estimates in the analyses presented are based on a keyword search of the title only. As a first step, the keywords "sleep" or "circadian" in a project's title were used as a barometer of overall grant activity. This provides a reasonable baseline estimate but may not capture all sleep/circadian science or embedded/cross-cutting sleep science. Based on a search for the two keywords, Dr. Twery presented a number of findings, including the following:

- The number of competing R01 sleep applications (both funded and non funded) from individual investigators showed some growth from 1996-2005 when the NIH budget doubled, followed by a slight decline. Success rates for sleep research were comparable to NIH R01 averages. Since 1996, the active grant pool increased 2.7-fold overall, but there was little growth in the number of competitive applications feeding the pool of active grants.

- The number of applications submitted in response to Requests for Applications (RFAs) and Program Announcements (PAs) initiatives has not increased. Forty-five percent of competing R01 applications submitted were in response to RFAs, and 30 percent were funded. RFAs and Pas contributed significantly to new sleep grant funding each year and to the number of active sleep grants today.

- Relatively small numbers of sleep training and career development grant applications and few amended applications were submitted. In 2005, these active grants included 21 fellowships (F grants); 17 Career Development Awards (K grants), and 5 Institutional Training Grants (T grants).

Dr. Twery said that although the number of grants for sleep research is small, the award success rate for sleep applications is equal to, or slightly better, than the rate for applications NIH wide. New models of interdisciplinary research may help define and communicate new scientific opportunities. Among scientific initiatives, he mentioned several that address interdisciplinary research, including The Role of Sleep and Sleep-Disordered Breathing in Metabolic Syndrome; Mechanisms Linking Short Sleep Duration and Risk of Obesity or Overweight; and the NHLBI Exploratory Program in Systems Biology (which will address the temporal organization of cellular function).

During discussion, Board members identified the need to stay in the sleep research field. Asked whether RFAs generated more interest than other types of grants, Dr. Twery said that this type of analysis could be a future activity, with help from Board members. Asked why the Sleep Academic Award (SAA) program was not continued, he said the SAA awards had gone through three funding cycles, and had made significant contributions to sleep medicine education.

Other Sleep Activities:
Dr. Twery mentioned the following NHLBI and NCSDR activities, as well as activities of other organizations in the sleep field:

- Ongoing scientific activities include the Sleep Heart Health Study (SHHS) Phase III, the Apnea Positive Pressure Long-term Efficacy Study (APPLES), and Impact of continuous positive airway on Functional Outcomes in Milder Obstructive Sleep Apnea. New research is needed to maintain overall momentum as these studies are phased out in 2007 and 2008.

- Selected collaborative activities include the "Sleep" Nature Insight Supplement published in October 2005 and the Neuroimaging in Sleep Research conference that was cosponsored by several SRCC members. A future activity is the NHLBI Strategic Planning Initiative (2006-2007) that will involve consultation with the scientific community.

- Scientific meetings included participation in a Workshop to Develop Guidelines for Electronic Interchange of Polysomnography (January 2006); a symposium on Sleep Duration and Obesity held by the American Thoracic Society (May 2006); and the Symposium on Surgery, Sleep, and Breathing II (June 2006), at which Dr. Twery presented a talk on The Role of NIH in Advancing Treatments for Sleep Disordered Breathing (SDB). A meeting on the NIH Initiative on Knowledge Management of Disease Categories (March 2006) discussed develop a "fingerprint" to describe sleep applications, leading to an electronic format, for each of 200 disease categories reported to Congress. The Associated Professional Sleep Societies' SLEEP 2006 20th Anniversary Meeting (June 17-22) will include Dr. Twery's presentation, A Decade of Sleep Research at the NIH; a panel addressing Twenty-Five Years of Positive Pressure Therapy; and a presentation on The Role of General Clinical Research Centers and Clinical and Translational Science Awards in Promoting Sleep Research.

- Resources for scientists include NCSDR's newly developed catalog of Selected Existing Data Resources, which will be posted on its Web site during the summer of 2006. The NIH Sleep RFA Listserv informs interested researchers about sleep and circadian activities at NIH and other Federal agencies. The Neuroscience in Sleep and Circadian Biology DataBlitz program was held at the Society for Neuroscience's Annual Meeting in November 2005, and the DataBlitz for the 2006 meeting will be developed over the summer prior to the October 2006 Annual Meeting. A replacement is needed for Dr. Martha Gillette, who chaired the DataBlitz Planning Committee since its inception in 1996.

- Sleep education highlights include retention of a specific objective to reduce drowsy driving as part of the DHHS Healthy People 2010 Initiative. Your Guide to Healthy Sleep was developed by NHLBI and published in 2006. This 60-page handbook has been well highlighted by media attention. The NHLBI web-based Disease and Conditions Index (DCI) now provides health information via the Internet. Several DCI sleep topics have been added, and others are in development. The NIH Sleep, Sleep Disorders and Biological Rhythms Curriculum for high school students has proven popular and has helped increase sleep awareness among this population, as well as among teachers and parents. It was developed under the direction of Ms. Sue Rogus and Ms. Ellen Sommer in NHLBI's Office of Prevention, Education, and Control (OPEC). The NCSDR Web site also provides health information. Dr. Twery said that guidance from the Board is needed on future priorities of sleep and sleep disorders for education activities in order to increase public awareness

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INSTITUTE OF MEDICINE (IOM) ASSESSMENT: SLEEP MEDICINE AND RESEARCH-Dr. Harvey Colten

Dr. Colten discussed Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem, an IOM report published in 2006. Dr. Colten served as Chair of the IOM Committee on Sleep Medicine and Research that prepared the report. He said that the 14-member Committee (which included Dr. Susan Redline and Dr. Allan Pack) represented a balance of perspectives and points of view. It conducted its own research, held workshops to get testimony, and requested information from NIH. The collected data led to a draft report that underwent extensive review and was then sent to leadership at IOM for approval.

The report found that the NCSDR and SRCC had a major impact on sleep related research. NIH funding for sleep research increased more than 150 percent since the NCSDR became operational in 1993. Despite the public health importance of sleep research and scientific opportunities, there is a disproportionately small number of scientists in the field. Sleep has been a distinct specialty that needs to draw people in from other areas. Current grant initiatives are leveling, with a small number of T grants and relatively small numbers of K and F grants. These numbers need to be increased over time.

Findings:
The IOM report highlighted the following needs:

- The available human resources/infrastructure supporting sleep research, clinical care, and education is not sufficient to meet the current problem. New trainees are needed .

- Public and professional awareness of sleep disorders is relatively low compared to the health burden these disorders represent.

- Research and clinical care is fragmented in most academic institutions. Sleep is a multidisciplinary problem that requires input from many disciplines. Many Academic Health Centers have tried to address this issue, but a range of organizational and administrative obstacles exist

Solutions.
The Committee could not recommend a single solution for all academic institutions. Potential solutions ranged from strategic recommendations to tactical approaches:

- Establish a workforce required to meet the demand.

- Increase awareness among the general public.

- Expand awareness among health care professionals.

- Strengthen the national infrastructure for sleep research.

- Develop and validate diagnostic and therapeutic techniques. (This recommendation was emphasized.) Existing technologies must be validated to ensure that they are revealing what they should and that they are accurate, sensitive, and receive appropriate reimbursement. There is likely to be an IOM led workshop within 6 months to address this issue, pulling together experts from industry, engineering, and science.

- The Association of Academic Health Centers and IOM will sponsor a meeting of academic Deans this fall to examine how to address structure for cross-cutting disciplines as it applies to sleep research. The Role of the SDRAB. According to the IOM Report, The Board could enhance its contributions in three areas:

- Urge the collection of appropriate data so that future planning is based on evidence from previous initiatives. Collect data on the number of applications and success rates and how the NIH supports sleep research.

- Advise NIH regarding priority directions for sleep-related research to address. Identify and communicate the priorities most likely to yield new initiatives.

- Continue and enhance encouragement of trans-NIH, activities. The future of the field depends on input from the NHLBI, other Institutes, and Federal agencies.

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IOM SLEEP RESEARCH EVALUATION AND FOLLOW-UP-Dr. Michael Twery

Dr. Twery noted that many aspects of the IOM report were relevant to the goals and questions envisioned in the original proposed evaluation of sleep research. He noted that the SDRAB had initiated the process that led to the IOM evaluation. As he mentioned in his Acting NCSDR Director's Report, the NCSDR has reviewed data on the growth of sleep research and more analysis is needed. As an example, it was noted that at 20 U.S. academic institutions, 5 or more faculty members have submitted sleep applications in the last 10 years, for a total of 237 competing applications. Funded applications have been proportionate to applications submitted, but relatively small number of amended applications indicate a potential problem area.

Dr. Twery noted that a Board subcommittee could examine and analyze the data to help answer questions such as the following: What are the capabilities of researchers at these institutions? What questions could be reported to the sleep community? How does training levels influence grant award rates over time? Is the time lag between the number of years from receipt of K awards to receipt of R awards a barrier? How can potential research trainees be tempted to stay in sleep research? The IOM report includes a call to establish more health surveillance, but there is also a notable gap in the use of existing data by biomedical researchers?

In closing, Dr. Twery noted that goals need to be set and communicated by the Board. Much has been achieved, but much is left to do. The Board voted to conduct regular monthly planning calls between regularly scheduled in-person meetings to enhance the value of in person meetings.

Discussion of the IOM Report

The Board thanked Dr. Colten and the IOM for their work on the report,. Their comments and questions are summarized below.

- The Report. The report identified the fundamental principles of leadership (a major challenge), fiscal autonomy, and transparency with respect to policy and funding. The path to a solution is not specified. Part of the solution is science; enhancing grant applications is another. The bottom line is that there is a crisis in the current and projected size of the workforce. Creative ways are needed to attract researchers.

- The Sleep Research Field. The field should view sleep medicine as offering chronic disease management strategies, not just diagnosis. There should be an emphasis on delivery of services to people with sleep disorders. More integration is needed in sleep research because each laboratory tends to work independently.

- Sleep Centers. The notion of research, clinical care, and education in a single entity is a successful model in other areas. An infrastructure to establish centers of excellence for sleep research. Another approach might involve establishing an organization that can compete for support independently. However, there are numerous organizational, administrative, and political issues outside the scope of this Board that would need to be resolved if such a model were to be considered.

- Institutions. What goes on in individual institutions? How do the top five institutions in terms of receiving grants differ in terms of academic structures, total NIH grants, and grants for sleep research? A challenge will be to determine what can be done about structural barriers in institutions and academia. Structural change is one factor but not a solution in itself. Some individuals have been able to initiate structural change for sleep research based large on scientific accomplishment and growth. Academic Health Centers vary in organization. Engaging established researchers in this effort will be an important element for change.

- Training. Training of colleagues in related fields may be the fastest way to expand the scope of sleep research activities. It was noted that a majority of trainees appear to be leaving the field if their initial grant applications are unsuccessful . How do these applicants differ from the ones who remain in the field or submit amended applications? What are barriers and incentives to continuing in the field?

- Data. More evidence is needed to support the conclusion that treatment of sleep disorders makes a clear difference in health status and clinically significant health outcomes. Population-based studies are lacking. Objective information on sleep disorder interventions is needed. It is unclear where the manpower to conduct these analyses will come from if the sleep research trainee community is not growing rapidly.

- Public Health Surveillance Databases. Sleep questions should routinely be included in selected health surveillance studies. There should also be greater efforts to mine existing databases, such as the National Health and Nutrition Examination Survey (NHANES), the Behavioral Risk Factor Surveillance System (BRFSS), and the National Ambulatory Medical Care Survey (NAMCS). The data could relationships relationship between sleep duration, lifestyle, cardiovascular disease risk factors such as obesity and differences in sleep habits between rural and urban populations. It was noted that existing databases do not typically include any sleep questions, and that the questions are often of limited utility for secondary analyses.

- Health Education. Public awareness about sleep has increased, and there is more patient demand for treatment. Continuing public awareness campaigns could lead to increased research and training. Short sleep duration as a lifestyle is associated with other disease risks. Healthy lifestyle public awareness campaigns should incorporate sleep as one component of a healthy lifestyle. It was noted that various NHLBI health promotion and disease prevention campaigns have not incorporated the potential contribution of untreated sleep disorders and short sleep duration in developing cardiovascular disease and related risk factors into messages.

Possible Directions

- Encourage evolution in health promotion and disease prevention messages by raising awareness at the grass roots level. Consider the potential role of community-based organization models such as the NHLBI Enhanced Dissemination and Utilization Centers (EDUCs), which are education projects that focus on cardiovascular health in high-risk communities. Request an update from NHLBI staff on the EDUC mechanism.

- Articulate "hot" areas for future sleep research to stimulate applications and bring people from other disciplines to sleep research. Consider using short courses and research education programs (R25s) to attract young people into the sleep field. Build in evaluation outcomes.

- Increase knowledge about sleep disorders to stimulate more research. Consider strategies that will enhance sleep and biological timing in inter-disciplinary research at NIH and academic institutions.

- Consider the potential role of supplements to support change in existing studies and provide planning grants similar to those used in the Clinical and Translational Science Awards (CTSAs) program.

-Mentor new investigators. Reach post-doctorate investigators preparing for their first academic appointment. Sell the "Sleep is where you should be going" message to pre/post-doctorates-a younger audience.

- Articulate the state-of-the art science, which is needed to compete with other areas (e.g., cancer, heart disease).

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ELECTION OF THE NEXT SDRAB CHAIR

Board members participated in a brief Session to select the next SDRAB Chair. When the group reconvened, Dr. Twery announced that the Board had elected Dr. Phyllis Zee to serve as new chair effective July 1, 2006.

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PUBLIC REPORTS

Representatives of the following organizations referred to their full reports in the meeting briefing book and also mentioned recent activities of their organizations.

American Academy of Sleep Medicine (AASM)-Mr. Jerome A. Barrett

- The SLEEP 2006 20th Anniversary Meeting of the Associated Professional Sleep Societies will be held June 17-22, 2006, in Salt Lake City. About 5,400 attendees are expected. Dr. Pack will be the keynote speaker. In the next 3 years, the meeting will be held in Minneapolis, Baltimore, and Seattle, respectively.

- The Accreditation Council for Graduate Medical Education announced the first round of sleep medicine fellowship training programs, with 20 programs receiving accreditation. To date, 43 programs have been accredited.

- A task force on the use of portable monitors of constant positive airway pressure (CPAP) will be established by the AASM. Examination of industry's application of Compliance Policy Guide (CPG) codes could lead to discussions with industry.

- The AASM Standards of Practice Committee developed and published a number of practice parameters. It will work with the Association of American Medical Colleges and the American Medical Association Council on Education to focus on medical school curricula.

National Sleep Foundation (NSF)-Mr. Richard Gelula

- On June 6, 2006, the NSF held a meeting with 24 government and nonprofit organizations to move forward with the development of the National Sleep Awareness Roundtable. This coalition can help identify how to work together to meet the IOM recommendations.

- The IOM report will be highlighted in a future issue of SleepMatters, the NSF's quarterly print publication.

- At the SLEEP 2006 conference on June 19, there will be a reprise of the State-of-the Science Workshop on Sleep and Obesity: Intersecting Epidemics. NSF co-hosted the initial scientific workshop on this topic last March 27-28, 2006, in Washington, DC. Presentations at the conference workshop will be available on the NSF Web site.

- The NSF, AACP, and the American College of Occupational and Environmental Medicine have formed a task force to conduct a literature review and achieve consensus on obstructive sleep apnea (OSA) in commercial drivers. A paper on this topic will be published in two journals this fall.

Narcolepsy Network (NN)-Ms. Sharon Smith

- The NN launched its first Narcolepsy Awareness Campaign featuring actor Isaiah Washington who appears on Grey's Anatomy. In mid-June, 15-, 30-, and 60-second public service announcements (PSAs) about narcolepsy will be aired throughout the country. The PSAs are also available on the NN's Web site.

- Narcolepsy Awareness Buttons have been mailed to members to promote awareness of narcolepsy and all sleep disorders during National Sleep Awareness Week (NSAW).

- Efforts to attract new members resulted in a 20-percent increase in membership in 2006. The NN Web site includes a mailing list feature.

- The NN has encountered a growing number of individuals with questionable narcolepsy diagnoses resulting from failure to follow diagnostic criteria. A common mistake is diagnosis of both sleep apnea and narcolepsy, resulting in inappropriate treatment. Another problem is when undetected breathing disorders lead to a mistaken narcolepsy diagnosis. Dr. Pelayo suggested that the general public be informed about the need to seek treatment for narcolepsy at accredited sleep centers.

American Sleep Apnea Association (AASA)-Dr. Edward Grandi

- The first Annual Apnea Support Forum was launched on June 14, 2006. This forum provides an online exchange of information among sleep apnea patients.

- AASA has established a Spanish-language section on its Web site.

- The AASA registered the domain name sleepapnea.tv. It is developing a Web site to provide high-quality educational video broadcasts over the Internet on topics related to sleep apnea.

- A second Sleep Apnea Awareness Day lecture was presented on March 30, 2006.

American College of Chest Physicians (ACCP)-Dr. Charles Atwood

- The ACCP is concerned with advocacy for patient-centered care and patient education. An initiative in 40 metropolitan areas provides education on sleep disorders for primary care physicians.

- A Consensus Conference on Continuity of Care, to be held in September 2006, will focus on OSA and what happens after diagnosis and positive pressure therapy.

- The ACCP is one of several organizations that are updating guidelines for commercial drivers with OSA.

- A planned technology assessment will expand the range of diagnostic tools to diagnose SDB and other disorders.

Restless Legs Foundation-Mr. Robert Balkam and Ms. Kelsey Spoon

- Mr. Balkam will speak as a patient at a Disease Management Conference in Australia to reply to a paper alleging an imagined need for treating RLS that was published in April 2006 issue of Public Library of Science (PLoS) Medicine. This case underscores the need for improving awareness among medical professionals. Mr. Richard Waterman, the Chair of the MIB, Group, Inc. (an association of life insurance companies), is preparing a response that will be placed in journals. One problem could be that RLS suffers from a "trivial name."

- The RLS Foundation is considering restructuring its research program on a larger scale to include new ways to engage young clinical researchers. It will explore Centers of Excellence and the IOM's Health Centers Network.

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OTHER BUSINESS

Neuroimaging in Sleep Research Conference-Dr. Michael Twery and Board

Board members are asked to review the DRAFT summary of the Conference and send any comments or suggestions to either the NCSDR or to the Conference co-chairs, Drs. John Mazziotta and Allan Pack.

SDRAB's Role in Updating Public Information-Dr. Michael Twery and Board

The Board can contribute to ensure that the best information is available on the Diseases and Condition Index (DCI) Web site. Members are encouraged to bring additional sleep topics to the DCI. The NCSDR Website update will be discussed at one of the Board's upcoming conference calls.

Sleep Reviewers List-Dr. Gina Poe and Board

Dr. Poe reported that "Potential Grant Reviewers/Study Section Members" is included in the meeting book. This list was prepared by the Sleep Research Society's (SRS) Research Committee and was updated in December 2005. Information on each person on the list includes field of expertise, affiliation, and e-mail address. With the Board's endorsement, the list will be transmitted to the Center for Science Review (CSR), and all members of the Trans-NIH SRCC. Dr. Kevin Quinn added that the CSR would like more senior researchers on review committees.

Annual Report of Trans-NIH Sleep Research Coordinating Committee-Dr. Gina Poe

Dr. Poe suggested that the Annual Report, which is available online, could list publications coming from all sleep-related grants. It was pointed out that this would duplicate other available sources where complete publications are available, such as via 'PubMed'. One suggestion is to create a unique resource that is not available on PubMed-e.g., What's New in Sleep Research-that could be distributed to news agencies. This effort would help identify the science addressing sleep. The Board voted to move forward with discussing suggestions to add to the format of the Annual Report.

Proposed Initiatives-Dr. Michael Twery

- Research Education Grants for Sleep Disorders Medicine and Research (R25). The goal of this proposed initiative is to develop innovative approaches for educational training and dissemination activities, including short courses and seminars for health care practitioners, researchers, public health personnel on recent findings and advances in sleep medicine. This effort will require interdisciplinary effort with academic medical educators. The R25 grant could potentially be used to increase patient awareness, leading to an R18 (demonstration grant). The Board agreed that this project is a good idea. Dr. Zee and Dr. Poe volunteered to work on this project if it is approved.

- Biological Clock Pathways Associated with Heart, Lung, and Blood Disease Mechanisms (R01). The goal of this proposed RFA initiative would be to elucidate the specific molecular pathways through which the genetic program of the biological clock influences peripheral tissue function and how mutations in the molecular clock components contribute to heart, lung, and blood disease and developmental pathogenesis. This is fundamental research and would be limited to peripheral tissues. Board members are asked to send comments/suggestions for this initiative.

- Digital Watermarking Algorithms for Physiological Signal Recordings. The goal of this contract solicitation is to develop and validate computational approaches to embed identifying information into physiologic signal datasets, such as PSGs, without interfering with biological analyses. Dr. Redline has developed a prototype technology provides for encoding the data so that data integrity and source can be conclusively determined. Discussion of Future Initiatives

Dr. Twery noted that the Board had tentatively agreed to schedule monthly conference calls to plan for future meetings. The agendas will include topics related to ongoing NCSDR activities. He added that the Board might consider the use of new technologies, such as Web-based Breeze Support Forums, to communicate. This form of communication could also be used for mentoring and to answer questions about funding. The group discussed whether people would attend these sessions and whether it would make a difference. Input is needed from SRCC members.

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FINAL DISCUSSION

The group briefly discussed the possibility of changing the paradigm of insomnia research to focus on molecular biology and neurobiology. It then discussed the need to take advantage of the expertise of members who completed their term by inviting them to speak and consult with the Board. ,P> Dr. Pelayo put forth the following resolutions: (1) Allow ex-members to be reappointed to the Board after 3 years. (2) Hold 1-hour planning calls once a month at the same day and time. The Board voted unanimously to approve these resolutions.

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ADJOURNMENT

Dr. Pelayo thanked the Board for their contributions and adjourned the meeting at 3:50 p.m.

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CERTIFICATION

I hereby certify that the foregoing minutes are accurate and complete.

Rafael Pelayo M.D.
Chair, Sleep Disorders Research Advisory Board

Michael Twery, PhD
Acting Executive Secretary, Sleep Disorders Research Advisory Board

Formal adoption of the June 2006 Minutes will be before the Full Board at its December, 2006 meeting.

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