To advance understanding of the prevalence and consequences of common sleep disorders.
Humans spend approximately one-third of their lives asleep, although the study of sleep disorders remains a relatively young discipline. During the past two decades there has been a dramatic increase in the recognition of obstructive sleep apnea as a highly prevalent disorder with important neurobehavioral and cardiovascular consequences. The widely cited prevalence of 2% of adult women and 4% of adult men reflects only those with severe daytime sleepiness; the prevalence of less severely symptomatic obstructive sleep apnea is 4-5 times greater. In conjunction with the Framingham Heart Study, we are currently involved in the Sleep Heart Health Study, a multi-center, prospective epidemiologic study of the cardiovascular consequences of obstructive sleep apnea in adults. The final outcomes of this study are now being analyzed and the study has become a major source of insight into the neurobehavioral, metabolic, and cardiovascular consequences and natural history of sleep-disordered breathing and other common sleep disorders. For example, recent studies have demonstrated that both obstructive sleep apnea and voluntary sleep restriction are associated with impaired glucose metabolism.
The reversibility of the neurobehavioral consequences of obstructive sleep apnea/hypopnea remains a source of controversy. In conjunction with the Brigham and Women’s Hospital and several sites nationally, we are participating in a randomized clinical trial of CPAP therapy for obstructive sleep apnea/hypopnea to assess the impact of therapy on a range of neurobehavioral domains, including sleepiness, attention, working memory, mood and quality of life.
It has long been recognized that many sleep habits and disorders, including the timing and duration of sleep, insomnia, sleepiness and sleep apnea are heritable traits. The genetic mechanisms underlying these traits are largely unknown. In conjunction with the Framingham Heart Study and other epidemiologic cohort studies, we are currently investigating the genetic mechanisms underlying these traits.
Summary of Current Research Focus:
- Cardiovascular consequences of sleep apnea
- Clinical trials of sleep apnea theory
- Genetic mechanisms of common sleep disorders
- Daniel J. Gottlieb, MD, MPH
- George T. O’Connor, MD, MSc
- David Sparrow, DSc
- Hassan Chami, MD, MSc
- Ting-Hsu Chen, MD
- Ann Marie Hibbert, RPSGT (VA Boston)
- Kapur VK, Resnick HE, Gottlieb DJ. Sleep disordered breathing and hypertension: Does self-reported sleepiness modify the association? Sleep (in press).
- Wang W, Tretriluxana S, Redline S, Surovec S, Gottlieb DJ, Khoo MCK. Association of Cardiac Autonomic Function Measures with Severity of Sleep-Disordered Breathing in a Community-Based Sample. J Sleep Res 2008 June 6 [Epub ahead of print].
- Chami HA, Devereux RB, Gottdiener JS, Mehra R, Roman MJ, Benjamin EJ, Gottlieb DJ. Left ventricular morphology and systolic function in sleep-disordered breathing: the sleep heart health study. Circulation. 2008 May 20;117(20):2599-2607.
- Gottlieb DJ, Redline S, Nieto FJ, Baldwin CM, Newman AB, Resnick HE, Punjabi NM. Association of usual sleep duration with hypertension: The Sleep Heart Health Study. Sleep 2006; 29:1009-1014
- Winkelman JW, Shahar E, Sharief I, Gottlieb DJ. Association of Restless Legs Syndrome and Cardiovascular Disease in the Sleep Heart Health Study. Neurology 2008;70:35-42.
- Thomas RJ, Mietus JE, Peng C-K, Gilmartin G, Daly RW, Goldberger AL, Gottlieb DJ. Differentiating obstructive from central and complex sleep apnea using an automated electrocardiogram-based method. Sleep 2007;30:1756-1769.
- Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol 2006; 164:947-954.
- Gottlieb DJ, O’Connor GT, Wilk JB: Genome-wide association of sleep and circadian phenotypes. BMC Med Genet 2007; 8(Suppl 1):S9. doi:10.1186/1471-2350-8-S1-S9.
- Kushida CA, Nichols DA, Quan SF, Goodwin JL, White DP, Gottlieb DJ, Walsh JK, Schweitzer PK, Guilleminault C, Simon RD, Leary EB, Hyde PR, Holmes TH, Bloch DA, Green S, McEvoy LK, Gevins A, Dement WC. The Apnea Positive Pressure Long-term Efficacy Study (APPLES): Rationale, Design, Methods, and Procedures. J Clin Sleep Med 2006; 2:288-300.
- Gottlieb DJ. Can sleep apnea be treated without modifying anatomy? [editorial]. N. Engl. J. Med. 2005.
- Gottlieb DJ, Punjabi NM, Newman AB, Resnick HE, Redline S, Baldwin CM, Nieto FJ. Association of Sleep Time with Diabetes Mellitus and Impaired Glucose Tolerance. Arch Intern Med; 2005; 165:863-868.