Funded Projects

Stroke is the leading cause of adult disability in the US. The purpose of this research is to better understand the role of slow wave sleep (SWS) in post-stroke recovery by using chemogenetics to locally manipulate SWS and track recovery. This has the potential to clarify the basic mechanisms of how SWS regulates neuronal repair and recovery after stroke with the ultimate goal of identifying novel, sleep-based stroke rehabilitation therapies.

Many people with narcolepsy have episodes of cataplexy, sudden weakness triggered by positive emotions. The amygdala mediates behavioral responses to emotions, and these experiments will determine if cataplexy is triggered by a specific class of neurons in the central nucleus of the amygdala that activate brainstem pathways that regulate the paralysis of REM sleep. By improving our understanding of cataplexy, this research should bring us closer to better treatments for narcolepsy.

More than half of returning Veterans who screen positive for hazardous drinking report clinically significant symptoms of insomnia. In turn, insomnia symptoms have been associated with increased risk of alcohol-related problems, perhaps due to insomnia-related impairments in executive functioning, negative emotionality, and craving. The proposed project examines improvements in insomnia as a mechanism for improvement in alcohol use among heavy-drinking Veterans with insomnia via randomized controlled trial. This will inform prevention and intervention efforts.

Social workers often serve populations who experience health disparities. However, social work programs rarely incorporate sleep health training in their curriculum. To improve public health through promotion of healthy sleep practices, this project will develop and assess an online learning module for social work students at Florida Atlantic University. The overarching goal of the module is to equip social work students with the education and training to promote sleep health among their clients.

Studies suggest emotional distress/ stress are important factors contributing to sleep disturbance in Hispanic immigrants. This is a preliminary investigation into efficacy of auricular acupuncture for improving sleep through mitigating emotional distress/ stress. The study design compares sham and true auricular acupuncture intervention groups on measures of ethnic discrimination, acculturation stress, sleep, and emotional stress over 5 weeks. The study will inform future larger studies and is an intervention readily implemented for Hispanic immigrant communities.

Insomnia is endemic to pregnant women and increases risk for perinatal depression. Rumination, a modifiable cognitive factor, may link insomnia to depression. Our randomized controlled trial compares digital cognitive-behavioral therapy for insomnia (dCBTI) vs sleep hygiene education control. We predict that pregnant women with insomnia who receive dCBTI will report lower levels of insomnia and rumination than controls, and that reductions in insomnia and rumination will be associated with lower levels of postpartum depression.

Evidence suggests that insomnia may generate atherosclerotic development, though few studies have identified early markers of subclinical cardiovascular disease in diagnosed insomnia compared to rigorously-defined good-sleeping controls. We hypothesize in the proposed research that patients with insomnia will have greater endothelial dysfunction, arterial stiffness, and evidence of cardiac structural aberrations than will good sleeping controls. In this study, community-based young adults with diary and actigraphy-assessed insomnia compared to good-sleeping controls will undergo cardiovascular sonography assessment.

Among patients with obstructive sleep apnea (OSA), arousals related to respiratory disturbances can occur frequently and contribute to poor sleep and many deleterious sequelae. Knowledge on the neural mechanisms of respiratory arousals is needed for developing novel treatment approaches that suppress these arousals and improve sleep. This study will conduct functional magnetic resonance imaging (fMRI) with simultaneous electroencephalography (EEG) and respiratory monitoring in OSA patients during sleep. The team will test the hypothesis that during respiratory arousals, the somatosensory cortex in both hemispheres is strongly activated and has elevated HIFC, which corresponds to increased interhemispheric EEG coherence, whereas cortical regions implicated in spontaneous arousals may not be strongly activated. This study will pioneer the use of combined EEG-fMRI during sleep in OSA and facilitate future studies to understand and treat respiratory arousals in sleep breathing disorders.

Treatment of obstructive sleep apnea (OSA) may prevent cardiovascular (CV) events, but benefits of positive airway pressure (PAP) are related to adherence. To evaluate the impact of high PAP adherence on risk of CV events and healthcare utilization (HCU) in OSA patients, we will conduct a retrospective cohort study using a 5% sample of Medicare claims 2007-2015. We hypothesize that high PAP adherence is associated with reduced risk of CV events and reduced HCU.

Obstructive sleep apnea (OSA) is common and underdiagnosed in law enforcement officers (LEOs). Adherence to first-line therapy, positive airway pressure, is low. This is a randomized pilot study that compares usual care against a novel pathway that uses telemedicine and care management to promote adherence to PAP. We anticipate that, at the end of two years, our novel program will result in improved sleepiness and workplace outcomes and lower healthcare costs, compared against usual care.

There is a critical need for an automated solution that translates polysomnographic physiological data to inform accurate and personalized cardiovascular risk prediction in patients with obstructive sleep apnea. This proposal will develop a platform that automates signal-processing steps and implements cardiovascular risk prediction models derived from the analysis of the Sleep Heart Health Study data. We hypothesize that this tool will improve cardiovascular risk prediction when compared to demographic, clinical or conventional polysomnographic factors alone.

Obstructive sleep apnea (OSA) is a prevalent condition and has been associated with increased mortality. It is unknown whether OSA-related changes on markers of ventricular repolarization are responsible for mediating the relationship between OSA and death. A retrospective analysis of existing sleep study databases will be performed to review baseline markers of ventricular repolarization in patients with OSA and evaluate the impact of apneas/hypopneas and all modes of noninvasive ventilation on markers of ventricular repolarization and mortality.