The AASM Foundation funds high-impact projects that are aimed at improving sleep health for all. In the past 20 years, the AASM Foundation has invested more than $13.5 million in funding career development, high-impact research, clinical training and community initiatives. These cross-cutting sleep research projects range from molecular mechanisms of sleep to population sleep health.
Congratulations to the recipients of our 2019 award cycle.
2019 Physician Scientist Training Grant Recipients
Obstructive sleep apnea (OSA) is associated with diabetes and cardiovascular disease by unknown mechanisms. We have shown that OSA induces adipose tissue lipolysis, which increases plasma free fatty acids (FFA) during sleep. Excess FFA may cause metabolic dysfunction. We hypothesize that beta adrenergic blockade will mitigate this effect of OSA. Our study is a randomized clinical trial of propranolol versus placebo on nocturnal FFA levels during sleep in subjects exposed acutely to OSA (CPAP withdrawal).
Both short sleep duration and sleep apnea are associated with an increased risk of atherosclerosis. This proposal will investigate the relationship between actigraphically-estimated sleep duration and carotid vascular inflammation in patients with sleep apnea, employing hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) with 18-F-fluorodeoxyglucose tracer as a robust measure of plaque inflammation. The study will help delineate the influence of short sleep duration on atherosclerosis and lay the groundwork for investigating short sleep duration as an under-appreciated risk factor for cardiovascular risk in patients with sleep apnea.
2019 Bridge to Success Grant Recipients
Neurodevelopmental and neuropsychiatric disorders often show comorbid sleep disturbances and impaired social behavior. Whether a causal relationship or a common etiology underlies these impairments remains unknown. This project uses genetically targeted techniques in mice to test whether oxytocin neurons in the paraventricular hypothalamus recruit arousal-promoting and sleep-promoting neurons from the lateral hypothalamus to promote social interactions and enhance social memory. These are essential first steps in defining the influence of oxytocin on sleep and memory.
Only one in seven emerging adults age 18-25 with type 1 diabetes (T1D) achieve targets for glycemic control (A1C < 7%) and, therefore, are at increased risk for premature macrovascular and microvascular complications. The purpose of this research is to better understand the role of sleep deficiency in glucoregulation over 14 days. This will inform our development of a sleep self-management intervention to extend sleep in this high-risk population of emerging adults with T1D.
The goal of this study is to advance our understanding of the impact of sleep and circadian rest/activity rhythms (RARs) on brain connectivity and cognition during the early phases of Alzheimer’s disease. To accomplish this, we will use standard and novel actigraphic indices of sleep and circadian RARs, resting-state functional magnetic resonance imaging, and diffusion tensor imaging. The expected research outcomes may help inform therapeutic strategies targeting sleep and RARs to improve cognition.
This study will evaluate circadian mechanisms of wearable bright light therapy for postpartum depression. We will test our hypothesis that wearable morning bright light therapy will improve postpartum depression through a circadian mechanism in an open trial of 5 weeks of wearable morning bright light therapy in 10 postpartum women with depression who will complete in-home dim light melatonin onset assessments. Findings from the study will strengthen an R01 resubmission and inform future larger-scale research.
2019 Strategic Research Grant Recipients
Essential to addressing the epidemic of obstructive sleep apnea (OSA) is an efficient process for diagnosing OSA through either a home sleep apnea test (HSAT) or attended polysomnogram (PSG). The goal of this project is to leverage machine learning to optimize the diagnosis of OSA by creating a predictive model for identifying which patients with suspected OSA should be directly referred to PSG due to high likelihood of a non-diagnostic HSAT.
Achieving proper positive airway pressure (PAP) therapy adherence in the treatment of obstructive sleep apnea (OSA) is a significant challenge. Developing artificial intelligence mechanisms to predict likelihood of PAP adherence at multiple time-points and timing of non-adherence has the potential to improve OSA management. Machine learning will be applied to a large diverse patient dataset with the goal of implementing the developed prediction algorithms as clinician decision support tools to assist sleep medicine clinicians and enhance personalization of patient care.
There is no agreed upon method to measure sleep quality. Conventional metrics are limited by simplistic electroencephalogram features and ignore other sleep signals. Deep learning (DL) algorithms can extract rich information from signals to predict specified outcomes. This project will use >29,000 polysomnograms and DL algorithms to develop measures of sleep quality that reflect cognitive and cardiovascular risks of disrupted sleep, which are named data driven sleep quality biomarkers.
Obstructive sleep apnea (OSA) is a highly prevalent disorder that can have serious health risks if left untreated. The aim of this project is to develop a deep neural network model to automatically detect apneas and hypopneas from the electrocardiogram signal and apply this technique to the scoring of out-of-center sleep tests (OCSTs) . This technique will improve the accuracy of OCST for the diagnosis of OSA and result in more patients being identified and treated.
2019 Focused Projects Grant for Junior Investigators Recipients
Current insomnia treatments do not improve cognition in older adults. Computerized cognitive brain training may improve specific sleep and cognitive outcomes, but underlying mechanisms are unknown. In this pilot study, we will evaluate post-intervention and 6-week follow-up effects of a 6-week brain training program (Nintendo DS Big Brain Academy) on behavioral/physiological sleep, arousal, cognition, and mood in older adults with insomnia. Results may facilitate development of targeted, easily disseminable cognitive interventions for older adults with insomnia.
In this grant, we are interested in asking how obstructive sleep apnea (OSA) impacts one’s risk for developing early stages of neurodegeneration and Alzheimer’s disease. By testing for noninvasive and novel biomarkers in human blood, we aim to understand the relationship between OSA and the proteins tau and neurofilament light chain (NfL). We hypothesize that both tau and NfL will increase following acute continuous positive airway pressure (CPAP) withdrawal compared to a night of adherent CPAP usage in participants with OSA.
Veterans are a population with unique vulnerabilities and needs regarding sleep-disordered breathing (SDB) treatment. The proposed project will develop and pilot a combined face-to-face and telehealth positive airway pressure (PAP) use program within a Veterans Affairs sleep disorders center as an adjunct to routine clinical care. Focus group feedback will be used to refine the program for future pragmatic research. We anticipate this program will improve PAP acceptance and adherence in Veterans with SDB.
A significant void exists in the clinical practice of screening for and managing suspected obstructive sleep apnea (OSA) in perioperative patients. Increasingly, care is provided by various front-line providers. In collaboration with the Society of Anesthesia and Sleep Medicine, a multi-site, multidisciplinary survey will explore the perceptions of perioperative OSA management amongst medical residents and advance practice providers. Identifying variability in these perceptions will allow for targeted educational opportunities, improving understanding and patient care.
Sleep testing using wearable ambulatory devices is prolific in the clinical and consumer market. However, the stability of sleep electroencephalography and electrocardiography measures between in-lab and at-home environments is not well established. To investigate this and the influence of a bed-partner on sleep oscillations, this study will acquire concurrent at-home polysomnography (PSG) in 20 co-sleeping couples where at least one of the pair has been referred clinically for an in-lab PSG to investigate obstructive sleep apnea.
Insufficient sleep or sleep restriction (SR), is associated with endothelial dysfunction, a marker of cardiovascular risk. SR increases endothelial oxidative stress, however, the appropriate antioxidant response to increased oxidative stress is lacking in women after SR. To understand the underlying phenomenon for lack of antioxidant response after SR, we will investigate endothelial cells for regulators of antioxidant response. The proposed research questions may advance our understanding of underlying molecular mechanism that impair endothelial antioxidant response after SR despite increased oxidative stress.
2019 ABSM Junior Faculty Grant Recipient
Hypoglossal nerve stimulation (HNS) dilates the airway in obstructive sleep apnea (OSA) by pulling soft tissue structures ventrally, but the pharynx can also be stretched caudally by the sternothyroid muscle, which is innervated by the ansa cervicalis (AC). We hypothesized that stimulating the AC can improve airway patency better than HNS alone. We are evaluating percutaneous HNS and AC stimulation in OSA patients. If successful, it may lead to new neurostimulation treatments for OSA.
2019 Community Sleep Health Grant Recipients
This study will investigate whether bed provision combined with community provider-delivered sleep health education improves sleep in children living in poverty, in partnership with the Beds for Kids program, which provides beds and bedding to low-income families. This randomized control trial will assess sleep outcomes (sleep duration, sleep quality) and child sleep health behaviors (bedtime routine consistency, sleep schedule regularity, nighttime electronics usage). We will also examine intervention acceptability and feasibility to inform large-scale dissemination.
Approximately 43,000 adolescents reside in U.S. juvenile justice facilities. With adolescence a time of significant neurocognitive, sleep, and emotional development, it is important to understand the consequences of detention on sleep and behavioral well-being. This collaboration with Maryland Department of Juvenile Services (DJS) will ultimately enhance the sleep-environment/schedules for youth residing in DJS. Building on a study of the sleep-wake environment, this project will assess the youth’s sleep quality, patterns, and behavioral well-being. The team will develop sleep health recommendations/education with DJS.