Susan Redline, M.D., M.P.H.
Susan Redline, M.D., M.P.H.
Professor, Case Western Reserve University, Cleveland, Ohio
PHASE II Trial of Sleep Apnea Treatment to Reduce Cardiovascular Morbidity
Administered by the NHLBI Division of Lung Diseases, National Center on Sleep Disorders Research
FY 2009 Recovery Act Funding: $2,190,865
Research Focus: More than 12 million American adults have sleep apnea, a disorder where breathing repeatedly pauses or becomes shallow during sleep. The condition can double or even quadruple a person's risk of heart disease, high blood pressure, and stroke.
Despite sleep apnea's prevalence and risks, an estimated one in 10 patients isn't diagnosed or treated. One reason for the low treatment rate is that doctors lack evidence about which sleep apnea therapies actually reduce cardiovascular disease risk. On top of that, some patients who do get diagnosed may not follow through with their prescribed treatment because they think it's uncomfortable or awkward-looking.
Grant Up Close: Supported by an NHLBI Recovery Act-funded Grand Opportunity grant, Susan Redline, M.D., M.P.H., is leading the first large-scale study in the U.S. to determine whether two common sleep apnea treatments reduce patients' risk of cardiovascular disease. Her team is recruiting 1,400 cardiovascular clinic patients who have moderate to severe sleep apnea and monitoring their sleep at home.
One group of patients will receive extra oxygen at night. Dr. Redline wants to know if this simple therapy reduces the health risks of sleep apnea by compensating for lost breaths, or raises the risks by not increasing patients' breath rates.
A second group of patients will receive another common sleep apnea treatment, continuous positive airway pressure (CPAP), in which a machine blows air into the throat each night through a mask worn over the nose and mouth. Although both CPAP and oxygen therapy are widely used, researchers haven't yet established whether using them to treat sleep apnea reduces cardiovascular disease risk. Dr. Redline's team will conduct comparative effectiveness research into the two treatments.
A third group of patients will not undergo sleep apnea treatment.
All three groups will have their early signs of cardiovascular disease treated.
Together, these groups will help Dr. Redline's team begin to determine whether treating sleep apnea can change patients' risk of cardiovascular disease. The results of the study will also set the stage for advanced clinical trials.
Her goal is to help doctors integrate sleep medicine into routine cardiology care and develop evidence-based treatment guidelines, ultimately lowering deaths from sleep apnea-related heart disease.
'A true multidisciplinary team': The study includes cardiologists and sleep medicine experts from four sites across the country. Some of them already collaborate through the NHLBI's Sleep Heart Health Study, a multi-center population study examining the cardiovascular effects of sleep apnea.
"My colleagues include engineers, informaticians, physiologists, geneticists, epidemiologists and clinicians," said Dr. Redline. "I meet regularly with these diverse and talented people to review our common or overlapping goals."
Economic Impact: Thanks to Recovery Act funds, the team was able to create 12 new jobs. They also bought new equipment, including portable devices to measure patients' blood pressure and other responses to sleep apnea treatments.
Because the trial involves several sites, the team developed an advanced web-based data management platform. Researchers beyond the study can adapt it to their own needs so they can start new studies faster and manage them more efficiently.
Broadening her Dream: "As a child, I wanted to be a general physician, with a shingle on my door, and simply help people feel better," said Dr. Redline. She was accepted into an accelerated six-year medical honors program when she was just 15 years old. Then her dream began to evolve.
"As I was exposed to academic medicine and powerful epidemiological methods, I realized that I wanted to work on broad issues that impact the health of the community, especially the underserved," she said. Learning about how the environment can impact people's lung health, and seeing how common but poorly understood sleep disorders were, Dr. Redline decided that researching sleep medicine was the way she could help improve public health.
Outside the Lab: Dr. Redline likes to spend time reading, biking, and kayaking.
Aiming High: Dr. Redline wants to find a practical treatment for sleep apnea that improves people's sleep quality and lowers their risk of heart disease; and to uncover genes that contribute to sleep apnea, so researchers can develop better targeted treatments.
By Stephanie Dutchen
|Dr. Redline demonstrates the proper fitting of a breathing mask for sleep apnea during a training session for staff and investigators in Cleveland, Ohio, Dec. 2009.|