Q&A: NIH researchers hope to reduce significant burden of sleep disorders

A new sleep research plan from the NIH aims to ensure that everyone gets a good night’s sleep and reduce the economic impact of sleep-related disorders.

According to the NIH, 30% to 40% of adults in the U.S. and 65% to 80% of teenagers report experiencing a sleep problem, such as insufficient sleep, irregular timing of sleep and poor quality of sleep. Data cited by NIH indicate that the health costs of sleep deficiency, including disease burden, accidents and lost productivity, totals almost $411 billion each year.

The Sleep Research Plan recently developed by the NIH-affiliated National Center on Sleep Disorders Research is the fourth such endeavor since Congress mandated in 1993 that a sleep research center and a comprehensive sleep research plan be created, Marishka K. Brown, PhD, the center’s director, told Healio.

“As the science progresses, and new and exciting scientific findings materialize, we essentially try to capture the growth of the field and future research opportunities,” she said in an interview. “The Sleep Research Plan primarily provides a vision of where the research is going.”

The Sleep Research Plan’s goals are to:

• “elucidate the sleep and circadian mechanisms underlying health and disease;”
• “improve the treatment of sleep and circadian disorders and reduce the risk associated with sleep deficiency and circadian misalignment;”
• “identify gaps and opportunities to accelerate the clinical implementation of sleep and circadian research and protect public health;”
• “advance the scientific understanding of sleep and circadian contributions to health disparities in diverse populations and their different impacts on the public safety of these populations;” and
• “foster the development of a strong and diverse workforce for sleep and circadian research.”

The Sleep Research Plan also describes several critical opportunities to help reach these goals. These include the creation of “chronotherapeutic approaches to prevent and treat chronic diseases,” identification of sleep and circadian biomarkers to ascertain the severity of sleep-related conditions and the effectiveness of interventions and finding “people-driven approaches” to enhance the public’s awareness of sleep and circadian rhythms.

In the interview, Brown discussed how sleep medicine has evolved since the last research plan was published in 2011, how the findings may impact clinical practice and more.

Healio: What are some of the most important breakthroughs that were recently made in sleep medicine?

Brown: Research findings have provided a better understanding of the underlying biological processes that work together and how interconnected they are to sleep and circadian research. This has enabled sleep and circadian biology to advance at a rapid, exciting pace, even outside of their respective fields.

A major step in that understanding occurred in 2017, when the Nobel Prize in Physiology or Medicine was awarded for the discovery of a molecular mechanism controlling circadian rhythms, or the circadian block in our brain that works with all the other clocks in the entire body. Additional research findings have since discovered that if the timing of the brain clock and/or the peripheral clocks are off, this is associated with health challenges and problems such as cardiovascular disease, obesity and diabetes. This discovery allows researchers to better understand how the relationships between sleep, circadian biology, health and disease work. Understanding these processes has really been exciting.

Healio: How will the Sleep Research Plan build on that discovery?

Brown: Researchers recently looked at individuals working a shift outside the traditional work hours of 9 a.m. to 5 p.m. Building on years of research, this group discovered that the time the individuals ate affected their health. This study revealed new opportunities that have not been investigated in real-world settings, and these findings could lead to the development of interventions that can protect the health of shift workers. It adds more evidence to the concept that sleep is a critical part of health by advancing the line of research that links metabolic health to sleep. The study is one example that could lead to future breakthroughs and one of many studies the plan will use to advance its goals.

Healio: What other questions do you hope these research efforts will answer, and how could the answers potentially change clinical practice?

Brown: The opportunities outlined in the plan will advance our understanding that sleep is a necessary requirement for overall health and well-being and is equally as important as nutrition and physical activity when it comes to preventing disease.

Primary care physicians and their teams are the frontline of health care, have the regular interactions with patients and are in the position to evaluate patients in the context of their overall medical conditions. They are on the frontline of the public health agenda, and now is the time to build the awareness of the importance of the relationship between sleep and health. In the past 2 decades, there have been hundreds of epidemiological studies, as well as studies that have physiology and mechanisms that have defined how sleep health is influencing patient outcomes in virtually every dimension of the of the medical system. For primary care physicians, this plan could highlight the consideration of how sleep can be incorporated to enhance patient experience and satisfaction.

Healio: Is there anything you wish to add?

Brown: Patients whose poor sleep is interfering with their quality of life should be encouraged to discuss it with their health care provider, because the sleep problems could be indicative of some underlying pathology that could impact their overall health.

References:

National Institutes of Health Sleep Research Plan. https://www.nhlbi.nih.gov/sleep-research-plan. Accessed Dec. 20, 2021.

New NIH sleep research plan released. https://www.nhlbi.nih.gov/news/2021/new-nih-sleep research-plan-released. Published Dec. 13, 2021. Accessed Dec. 20, 2021.

Request for Information: Response to proposed NIH Sleep Disorders Research Plan Critical Opportunities and Strategic Goals. https://grants.nih.gov/grants/guide/notice-files/NOT-HL-21-011.html. Accessed Dec. 20, 2021.