The Sleep Medicine Program is involved in both clinical and translational research in sleep disorders. Please click on the headings below to be taken to recent publications.
Most people know they are either a natural (i.e. biological and genetic) night owl (“sleep-phase delayed”), or a natural morning lark (“sleep-phase advanced”), or just naturally fall asleep in the evening and wake up the next morning when most people do. Phase delay is most common in adolescents (especially males) but starts trending back to a conventional sleep time after their 20th birthday. However, some people are very phase-delayed from childhood, remain phase delayed well after their 20th birthday, and in that case often know that phase-delay runs in their family as a genetic trait. Despite the powerful genetic influence on our fall-asleep and wake-up times, there are behavioral strategies that can minimize bothersome phase advance or delay.
The University of Utah sleep center was the first to describe a kindred with advanced sleep phase syndrome with mutations in clock genes that confirmed the genetic basis of phase regulation by these genes.
Research by Dr. Christopher Jones has focused on recruiting and phenotyping phase-advanced, phase-delayed, and short-sleeping kindreds in collaboration with geneticists. Dr. Jones on-going research, based on data previously collected from the University of Utah Sleep-Wake Center, will probably support an estimate of the prevalence of familial phase-advance in patients presenting with Obstructive Sleep Apnea.
Current clinical and translational collaborations between Drs. Krishna Sundar, Josef Prchal and Jihyun Song at the University of Utah Prchal Lab have demonstrated a role for intermittent hypoxia-driven generation of mitochondrial reactive oxygen species in the prevention of polycythemia in patients with obstructive sleep apnea. Based on prior understanding of Dr. Song’s work on neocytolysis, this work has elaborated a role for hypoxia-inducible factor driven generation of microRNAs and other mediators that limit antioxidant defenses and further oxidant stress. This work is being expanded to understand effects of untreated OSA in both humans and animal models.
Following demonstrations of central apneas and ataxic breathing in patients on chronic opioids including suboxone, Dr. Robert Farney’s current work aims to determine optimal monitoring technologies to accurately identify and provide insight into the mechanistic bases of opioid induced sleep-related breathing abnormalities.
Current efforts to improve outcomes and processes for patients with obstructive sleep apnea have included the creation of a stable CPAP clinic – a program run by sleep coordinators at multiple locations within the University of Utah clinics to monitor compliance and efficacy of PAP therapy in established sleep apnea patients. In addition to this program which is tracked by a software interface developed with the University of Utah Information Technology software professionals, there is also research to understand outcomes from sleep interventions on overall outcomes using large datasets.
A direct effect of sleep-disordered breathing is on the human airways. A relationship between untreated OSA and chronic cough was first shown in a community based retrospective study and a subsequent prospective study by Dr. Sundar. Currently a double-blind placebo-controlled study of CPAP intervention for chronic cough is being conducted to understand the impact of OSA treatment on the course of comorbid cough.
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