There doesn't seem to be any sleeping on the job at the Rush Sleep Disorders Service and Research Center as it explores new ways to help people rest easier at night.
Led by director James Wyatt, PhD, a sleep disorder specialist, the center is conducting research that is changing the way sleep disorders are diagnosed and treated. The following are examples of some recent research performed at the center and how these studies may ultimately help people with sleep problems and the clinicians who treat them.
Perhaps the most groundbreaking study, published online in the Archives of General Psychiatry on June 6, questions the validity of currentcriteria for diagnosing insomnia. The five-year project, a collaborative effort between Rush and Duke University, comprised about 350 patients who were each interviewed by six different clinicians. Often, there were different diagnoses for the same patient.
Wyatt believes the findings will change how insomnia is diagnosed. Previous studies at Rush, along with nationwide research, found that insomnia usually occurs in combination with other factors: medical conditions, the use of certain medications, the environment, and psychiatric disturbances such as anxiety disorders and depression. Those factors need to play a more significant role in the diagnosis.
"In the future, patients will likely be diagnosed with something called insomnia disorder, and there may be specifications added to the diagnosis based on the factor that is making the condition worse," Wyatt said.
Wyatt was also part of a research team that looked into gender differences in the way the circadian clock — our 24-hour internal cycle — functions. The study found that women's internal clocks are more in line with the 24-hour day-night cycle than men's clocks are. Male clocks tend to drift later each day, and the cumulative effect makes it harder for them to have a consistent wakeup time and bedtime. Wyatt says the difference may suggest women can adapt quickerto factors that can affect sleeping, such as shift work and jet lag. The study was published online in the Proceedings of the National Academy of Sciences on May 2.
Rest for Caregivers
Margaret Park, MD, a sleep medicine specialist, and Wyatt recently completed a study analyzing the sleep patterns of people with Alzheimer's disease who also display mild symptoms of Parkinson disease, such as tremors and walking instability. The investigation found that patients suffered from significant daytimesleepiness and scored low on tests of daytime alertness. The findings, published in the April 2011 edition of Sleep Medicine, focus attention on sleep and daytime sleepiness, and the related burden faced by caregivers of people with Alzheimer's disease.
"There's increased caregiver stress when patients with Alzheimer's disease start sleeping more during the day and start having more cognitive problems during the day," Wyatt said. "The presence of the Parkinson-type symptoms would allow clinicians to predict earlier which patients are going to need more interventions, such as perhaps needing nursing home care earlier or more support at home."
Peace of Mind
Jason Ong, PhD, a behavioral sleep medicine specialist who runs the Behavioral Sleep Medicine Clinic at Rush, is wrapping up a National Institutes of Health-funded trial that’s examining mindfulness meditation — a keen awareness of thoughts — for the treatment of insomnia. Once the trial is complete, Ong will process the data to not only see if mindfulness-based stress reduction is effective, but also to uncover the underlying reason for the effectiveness.
"The concept of mindfulness is really catching on," Wyatt said. "Researchers are trying to apply it to all sorts of fields, from cardiology to psychiatry to gastroenterology."
Sleep research as a whole is crossing over into multiple disciplines, so there should be no shortage of avenues for Wyatt and the Rush Sleep Disorders Service and Research Center to pursue new remedies for sleep problems.
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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.
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