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Sleep, Circadian Rhythms, And Cardiometabolic Risk In Retired Shift Workers
R01 AG047139 (PI: Buysse/Hall)
Sleep and circadian rhythms are increasingly recognized as important determinants of health and functioning. Poor sleep health and misaligned circadian rhythms increase the risk of adverse health outcomes such as depression, cognitive impairment, cardiovascular disease, diabetes, and even mortality. However, we know very little about how sleep and circadian disruption lead to health risks later in life. We will study retired night shift workers (RNSW) and retired day workers (RDW) >60 years of age as a model to understand the effects of repeated sleep and circadian disruption on sleep, circadian, and cardiometabolic health in later life. Approximately 15% of the US population are retired shiftworkers. In previous studies we have shown that, compared to RDW, RNSW have worse subjective sleep quality; worse polysomnographic sleep; evidence of circadian rhythm abnormalities; and increased rates of diabetes and obesity. Additional new preliminary data with an independent sample suggest that, compared to day workers, older shift workers also have worse outcomes on cardiometabolic risk factors including endothelial dysfunction, poor glucose control, and increased prevalence of the metabolic syndrome. The study will advance these preliminary findings in several important ways: First, we will measure not only PSG sleep, but also the homeostatic regulation of sleep following sleep deprivation; second, we will characterize circadian phase, amplitude, and phase angles using a constant routine laboratory protocol; third, we will use a multi-dimensional approach to assess intermediate markers of cardiometabolic health including metabolic syndrome, brachial artery flow- mediated dilation, and carotid intima-media thickness. This study is significant because of the prevalence and known health consequences of shift work, coupled with an aging population. This study will impact our understanding of the health consequences of shift work, which may point to future intervention and rehabilitation strategies.
Circadian Misalignment and Reward Function: A Novel Pathway to Substance Use (ACRES study)
K01 DA032557 (PI: Hasler)
Adolescence is a time of particular vulnerability to substance use disorders; initiation of substance use often occurs during this developmental period, and the progression from first use to substance dependence occurs more rapidly in adolescents than in adults. This project is investigating whether substance-related vulnerabilities may be explained by adolescent changes in circadian rhythms, sleep, and reward function. In a sample of healthy adolescents aged 13-17 years old, we are testing whether experimentally-imposed circadian misalignment alters the neural processing of reward (monetary and social). Findings may have important implications for developing more effective preventive programs to delay substance use initiation and reduce risks for adolescent substance use disorders.
Circadian Alignment, Reward Function, and Alcohol Use During Late Adolescence (SCARAB study)
R21 AA023209 (PI: Hasler)
Abundant evidence indicates that disturbances in sleep and circadian rhythms are associated with alcohol involvement, suggesting that developmental changes in sleep and circadian rhythms may contribute to the increased risk for alcohol use disorders during adolescence. The aims of this research are to examine the short-term dynamics between sleep/circadian factors and alcohol use under naturalistic conditions, and to investigate one putative mechanism explaining these associations: alterations in reward function. We are recruiting a sample of late adolescents/emerging adults aged 18-22 years old who regularly drink alcohol. The study design capitalizes on the weekend as a “natural experiment”, examining how pre-weekend circadian alignment and reward-related brain function predict weekend alcohol use, as well as how that alcohol use predicts post-weekend circadian alignment and reward-related brain function. Demonstration of a sleep/circadian influence on alcohol use would provide scientific justification for testing the application of empirically-supported sleep/circadian interventions to alcohol use disorder prevention.
Collaborative Research: A Statistical Framework for the Spectral Analysis of Nocturnal Electrophysiological Time Series
R01 GM113243 (Site PI: Hall)
A large number of studies use polysomnography to continuously and non-invasively record electrophysiological signals during sleep with the goal of using these data to elucidate the biological pathways through which sleep affects health and functioning. Polysomnographic signals such as electroencenphograms and heart rate variability measure complex and dynamic processes whose frequency domain properties provided valuable and interpretable information. A dearth of tractable statistical models and methods for quantifying associations between frequency domain properties of collections of nonstationary time series with other study variables, such as clinical outcomes and experimental conditions,has limited the scope of questions that can be accurately addressed by analyzing polysomographic data. The goal of this research project is to develop a framework based on stochastic semiparametric evolutionary transfer functions for the spectral analysis of electrophysiological time series collected during sleep studies. Three specific aspects of this framework will be explored: (1) A time-varying spectral analogue of mixed effects models that will allow for the semiparametric analysis of the association between evolutionary power spectra and other variables while accounting for dependencies among correlated signals; (2) A procedure for discriminating between populations of nonstationary time series, such as between participants that respond positively to a treatment from those who do not; (3) A time-frequency canonical correlation analysis for obtaining low-dimensional measures of association between high-dimensional time series and processes measured by large collections of correlated variables. For each aspect of the framework, estimators will be developed, theoretical and empirical properties will be established, and efficient algorithms and computer programs will be created. These new methods will be used to analyze data from existing studies.
We are not recruiting participants for this study.
Effects of Dose-Dependent Sleep Disruption on Fear and Reward (SFeRe study)
Research has shown that sleep disruption affects psychological health following stressful experiences. This study seeks to examine how short term sleep loss affects the brain and emotional responses in healthy individuals ages 18 – 30 who may or may not have served in the military. Understanding how sleep loss affects the brain and emotional responses could lead researchers to develop more effective strategies to improve psychological health after stressful events.
Feasibility and Refinement of the Interactive Resilience Enhancing Sleep Tactics Mobile App (iRest study)
This research study seeks to assess the feasibility, usability and acceptability of a mobile phone app designed to be used by military service members and veterans with chronic sleep disturbances in order to support self-help efforts to improve sleep. We will also explore whether using the iREST app over a period of 4 weeks improves sleep related behaviors and sleep quality.
Interested in learning more about the study? Contact Rebecca Campbell at 412-383-2131 or fill out this form.
A Novel Risk Factor for Cardiovascular Disease: The Insomnia-Short Sleep Phenotype (KINETICS study)
K23 HL118318 (PI: Kline)
Emerging evidence suggests that a specific insomnia phenotype, insomnia with short sleep duration, is associated with heightened risk for cardiovascular and metabolic disease. This project will examine the association between this insomnia phenotype and cardiovascular (CVD) risk using a well-characterized diagnosed insomnia sample, objective markers of subclinical CVD, and measurement of nocturnal physiological arousal. We will also develop, refine and assess the feasibility and safety of a novel behavioral intervention—traditional cognitive-behavioral therapy for insomnia augmented with exercise training—for this phenotype. The proposed research has significant public health relevance due to the high prevalence of insomnia with short sleep duration and the possibility that its increased CVD risk may be modifiable via a behavioral approach.
Restorative Power of Sleep (RePoS study)
The purpose of this study is to identify the links between sleep, daytime sleepiness and functioning, and stress in post 9/11 military service members and veterans with and without sleep difficulties.
Study of Women's Health Across the Nation (SWAN Study)
U01 AG012546 (Co-I: Hall)
The Study of Women's Health Across the Nation (SWAN) is a 7-site longitudinal cohort study initiated in 1996 in response to RFA AG-94-002. It is mandated “to characterize the chronology of the biological and psychosocial antecedents and sequelae of the menopausal transition (MT) and the effect of this transition on subsequent health and risk factors for age-related disease”, and to extend this information from White women to “…the range of peri-menopausal experiences in women of other racial/ethnic background(s).” A total of 3302 Black, Chinese, Japanese, Hispanic and White women were enrolled, completing up to 13 visits spanning the premenopause to early post-menopause (PM). Thus far, SWAN has described the natural history of the MT -- its timing, patterns of hormonal changes, and symptoms – and its relation to disease risk indicators. During SWAN V, we will extend observations through the late PM, a necessary step to assess the impact of the MT on age-related diseases. The specific aims for this renewal are to: 1) complete the characterization of the natural history of reproductive aging through the late PM; 2) evaluate the impact of reproductive aging through the late PM on health outcomes clinically relevant to women in their 60s, including: cognitive and physical function and psychological well-being, sleep, bone and cardiometabolic health, and urogenital symptoms, sexual function and vaginal health; and 3) identify potential underlying mechanisms linking reproductive aging and health by assessing the relation of inflammation, hemostasis and adipokines to the occurrence and progression of biological, functional and clinical outcomes and delineating the interrelationships of body size and composition, race/ethnicity and socioeconomic status with these outcomes. The SWAN V Core protocol will be completed at the 7 study sites, with bone and cardiovascular studies at 4 sites and actigraphy sleep studies in a subset of women at all sites. Targeted longitudinal specimens from the SWAN Repository will enable characterization of skeletal markers and adrenal hormones, hemostasis, inflammation, and adipokines across the MT into PM. SWAN is uniquely positioned to fill important scientific gaps in understanding of the impact of the MT on women's health in their 60s and 70s. With 1.5 decades of both calendar time and “menopause time”, SWAN V can disaggregate the contributions of aging and the MT to women's health, address difficult questions about the temporal nature of MT-disease associations, investigate associations by race/ethnicity, and provide insights into modifiable factors related to health outcomes, a first step in the design of innovative, individualized approaches to prevention and treatment for aging women.
We are not recruiting participants for this study.
Pragmatic Trial of Behavioral Interventions for Insomnia in Hypertensive Patients (HUSH trial)
UH2/UH3 HL125103 (PI: Buysse)
Insomnia is a prevalent and inadequately-treated chronic medical condition. Insomnia is associated with comorbid conditions such as hypertension, and with a range of adverse health outcomes. Hypnotic medications are efficacious and widely available, but they have potentially serious adverse effects. Patients and providers prefer non-drug treatments such as Cognitive-Behavioral Treatment of Insomnia (CBT-I), which is safe, efficacious, and durable—but not widely available.
This randomized controlled trial compares two CBT-I-based interventions in people with insomnia and hypertension to enhanced usual care from their primary care physicians. We are recruiting participants 18 – 75 years of age from their University of Pittsburgh Medical Center (UPMC) primary care physician practices. We will be examining self-reported sleep and health symptoms, and blood pressure measurements at 9 weeks, 6 months, and 12 months.
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Slow-Wave Sleep and Executive Network Function In Older Adults
K01 AG049879/ADRC (PI: Wilckens)
Sleep and cognition both tend to decline with advancing age. There is increasing evidence that age-related changes in sleep depth and sleep continuity contribute to cognitive changes in older adulthood. This study seeks to examine how age-related sleep difficulties contribute to a range of cognitive functions in adults ages 55-80. Understanding the aspects of sleep most critical for cognitive function may allow us to identify more effective behavioral methods for mitigating cognitive decline.