Sleep apnea and insomnia have been on the rise for decades, but the COVID-19 pandemic has exacerbated both. University of Arizona Health Sciences and UArizona sleep researchers are working to help solve these problems.
In recognition of National Sleep Awareness Month, Sairam Parthasarathy, MD, chief of the Division of Pulmonary, Allergy, Critical Care and Sleep Medicine at the University of Arizona College of Medicine – Tucson, answered questions about the state of sleep health today and how UArizona Health Sciences and UArizona researchers are contributing to a future of better sleep.
Dr. Parthasarathy also is medical director of the Center for Sleep Disorders at Banner – University Medical Center Tucson, director of the UArizona Health Sciences Center for Sleep and Circadian Sciences, and a member of the BIO5 Institute.
What is the state of sleep for Americans today?
Modern-day insomnia and sleep apnea research began decades ago, and since then, both diseases have been becoming more prevalent. Now, pandemic anxiety is on the rise and as a result, there's a new term – “coronasomnia” – for the inability to sleep caused by pandemic stress. Sleep apnea is also on the rise, especially as people have become more likely to gain weight because they are not eating right and have been more sedentary over the past year.
Why is good sleep so important?
“So, when my daughters say, 'I need to get my beauty sleep,' there's actually science behind it.”Sairam Parthasarathy, MD, professor in the Department of Medicine
Sleep apnea (a disorder in which breathing repeatedly stops and starts during sleep) increases blood pressure and increases the risk for heart attack and stroke two to threefold. One thing our lab is doing is trying to get people to adhere to CPAP (continuous positive airway pressure) use. We're testing what's called peer-driven intervention, whereby patients with sleep apnea who are adherent to CPAP therapy share their experiences with individuals who are not adherent. The peer-to-peer support encourages them to adhere to CPAP therapy and, ultimately, both patients experience significant improvements in health-related quality of life during the course of their interactions.
Insomnia can also lead to inflammation, which puts people more at risk for heart attacks. Dr. Daniel Taylor of the UArizona Department of Psychology and I are part of a group of five universities funded by a $5 million grant from the Patient Centered Outcomes Research Institute, PCORI, to enroll rural patients with insomnia. Potential participants with insomnia will receive recommendations for their sleep through a well-studied internet-based software program, SHUTi, that enables them to modify their sleep pattern and other aspects regarding their sleep and thereby improves their insomnia.
Potential participants may alternatively receive Ambien prescribed by their doctor in this study, while others may receive both interventions. We are getting ready to start enrolling participants and are looking to collaborate with primary care physicians who serve rural residents with insomnia. The study aims to enroll over 2,000, making it one of the largest sleep research clinical trials.
Beyond sleep apnea and insomnia, sleep cuts across so many aspects of our health and touches each organ system and cell in the body. When the brain and body sleep, your cells are in a different state than in wakefulness. For example, skin cells multiply more at nighttime than during the day. So, when my daughters say, "I need to get my beauty sleep," there's actually science behind it.
When the skin cells multiply during the day, the DNA can be damaged as it is exposed to higher levels of inflammation and can potentially lead to mutations and, consequently, skin cancer in experimental conditions. Conceivably, to protect these cells from undergoing such cancerous transformation, it is better for them to multiply at night during sleep.
What is the state of sleep research today?
Sleep research is the new kid on the block compared to other fields, like cardiovascular or cancer research. Sleep came into being a major area of research with sleep laboratories and clinics popping up around the county because people were interested in receiving treatments for sleep apnea and insomnia. We are still learning a lot about both of these sleep disorders, but there are more questions that have emerged. Now, we're able to study what sleep is, how it works, the connections to circadian rhythms and the state of the body during wakefulness versus sleep, for example.
What is the University of Arizona Health Sciences doing to take care of patients and research sleep?
There are two sleep centers at the University of Arizona Health Sciences addressing many different aspects of sleep science. The Center for Sleep Disorders at Banner – University Medical Center Tucson, which addresses the clinical mission, sees patients with sleep disorders. The UArizona Health Sciences Center for Sleep and Circadian Sciences addresses the research mission.
You are also researching how astronauts might sleep in the unique conditions of space. Why is that important?
Many people are interested in the impact of space travel on the human body. The International Space Station rotates around the globe every few hours, which means astronauts go through night and day cycles every few hours. Imagine what that does to your circadian rhythm.
During missions to Mars, astronauts won't even have light and dark; they may just have a dark cycle. How will humankind fare with that? As long as you live on Earth, your body has a rhythm called the circadian rhythm, but as soon as you leave Earth, you're on your own. We have to find out what we can do to preserve sleep health and circadian rhythms for the long journey.