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NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Sleep Disorders Research Advisory Board Meeting Minutes
December 4, 2007
Attendees
Introduction
Adoption Of Minutes From The June 19, 2007 SDRAB Meeting
Remarks: Director, Division of Lung Diseases, NHLBI: James Kiley, PhD
NCSDR Director's Report: Michael Twery, PhD
2008 Sleep Disorders Research Plan
Perspectives on Epidemiology and Prevention Research: Michael Lauer, MD, FACC, FAHA - Director, Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute
Public Reports
CDC Public Awareness Activities and Initiatives; Daniel Chapman, PhD, Epidemiologist National Center for Chronic Disease Prevention and Health Promotion, Centers For Disease Control and Prevention (via Teleconference)
Sleep and Circadian Research at the National Institute of Mental Health: William Riley, PhD, Deputy Director Division of AIDS and Health & Behavior Research; Aleksandra Vicentic, PhD, Program Chief Circadian Rhythms, Sleep, and Regulation of Behavior Program
Next Meeting
Certification
Sleep Disorders Research Advisory Board Page
Dr. Phyllis Zee, Chair
Dr. Sonia Ancoli-Israel
Dr. Estelle Gauda
Dr. F. Javier Nieto
Dr. Stuart Quan
Dr. Howard Roffwarg
Dr. Michael Smolensky
BOARD MEMBERS ABSENT
Ms. Elizabeth Johns
EX OFFICIO MEMBERS PRESENT
Dr. Thomas Balkin, DoD
Dr. Merrill M. Mitler, NINDS
Dr. Andrew Monjan, NIA
Dr. Alexsandra Vicentic, NIMH
Dr. William Riley, NIMH
Dr. Michael Twery, NHLBI, Executive Secretary
LIAISON MEMBERS PRESENT
Dr. Daniel Chapman, CDC (via teleconference)
Dr. Harold Gordon, NIDA
Dr. Ellen Witt, NIAAA
FEDERAL EMPLOYEES PRESENT
Mr. Al Golden, National Heart, Lung, and Blood Institute, NIH
MEMBERS OF THE PUBLIC PRESENT
Mr. Robert Balkam, Restless Legs Foundation
Mr. Edward Grandi, American Sleep Apnea Association
- Dr Zee called the meeting to order. Dr. Twery welcomed the Board members, others present and outlined the materials provided in the Briefing Books and handouts. He indicated that the meeting was being videocast and welcomed those viewing the videocast.
- Conflict of interest issues and responsibilities associated with NIH Advisory Board membership were identified for members to review.
- Those in attendance introduced themselves.
ADOPTION OF MINUTES FROM THE JUNE 19, 2007 SDRAB MEETING
- Dr. Ancoli-Israel made a motion that the June 2007 meeting minutes be adopted without amendment, and Dr. Smolensky seconded the motion. The motion carried unanimously.
REMARKS: DIRECTOR, DIVISION OF LUNG DISEASES, NHLBI: James Kiley, PhD
- Dr. Kiley provided an update since he last spoke to the SDRAB in December 2006. He emphasized that the reorganization of NHLBI is ongoing, including new leadership of the Divisions of Prevention and Population Sciences (DPPS) and Cardiovascular Diseases (DCVD).
- Benefits to the sleep research program resulting from the DLD reorganization were emphasized including improved administration and grants coordination.
- Board members were encouraged to submit suggestions for filling open Health Scientist Administrator (HSA) positions within DLD.
- Opportunities for future collaboration with the sleep community were discussed within the framework of the revision of the Sleep Disorders Research Plan and the recently released NHLBI Strategic plan.
NCSDR DIRECTOR'S REPORT: Michael Twery, PhD
- Dr. Twery briefly described how the NCSDR interacts with the Trans-NIH Sleep Research Coordinating Committee (SRCC), the SDRAB, the research community, and other constituencies. He identified new members of the Trans-NIH Sleep Research Coordinating Committee (SRCC) representing the National Institute of Diabetes and Digestive and Kidney Diseases.
- NIH sleep research grant and funding data presented previously to the Board were updated to include FY 2006 and 2007. There was discussion regarding the search variables used to derive these data. Options to expand search criteria to better reflect the range of sleep research will be considered in the context of the NIH Research Disease Coding implementation.
- A conference on Sleepiness and Health Related Quality of Life is in the early planning stages and tentatively scheduled for November 2008.
2008 SLEEP DISORDERS RESEARCH PLAN
- Dr. Twery outlined the concomitant process and primary recommendations of the 1996 and 2003 Sleep Disorders Research Plans. Since the legislation establishing the NCSDR includes a provision that this Research Plan be revised every 5 years, an update needs to be completed in 2008.
- A general description of common strategic planning elements and concepts was introduced as a starting point to stimulate discussion.
- An approximate timetable for development of the 2008 Plan including specific milestones was suggested, with the final Plan projected for release in December 2008.
- Board discussion included the following suggestions:
- The 2008 Plan should be more focused and specific than prior Plans;
- Specific progress since release of the 2003 plan should be included;
- Input from the Sleep Research Coordinating Committee (SRCC) Member Institutes and Centers is an important component;
- Implementation issues and identifying specific stakeholder groups should be considered and identified at the start of the process.
- Board members interested in serving on the Research Plan Subcommittee should contact Dr. Zee. The first meeting will be in January or February 2008 via teleconference.
PERSPECTIVES ON EPIDEMIOLOGY AND PREVENTION RESEARCH: Michael Lauer, MD, FACC, FAHA - Director, Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute
- Dr. Lauer outlined some of the history of epidemiological research at NHLBI, emphasizing the Framingham Study as one of the most successful examples.
- He briefly outlined several current NHLBI supported cohort studies in addition to Framingham, including the Cardiovascular Health Study (CHS), Coronary Artery Risk Development in Young Adults (CARDIA), Atherosclerosis Risk in Communities (ARIC), Multi-Ethnic Study of Atherosclerosis (MESA), the Strong Heart Study, and the Hispanic Health Study, and identified several of the associated datasets.
- NHLBI supported trials and health services research were discussed, including Action to Control Cardiovascular Risk in Diabetes (ACCORD), the Women’s Health Initiative, Heart Failure (HF) Action, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack (ALLHAT), and the Girls Health Enrichment Multi-Site Studies (GEMS).
- Several models of metrics for evaluating progress were identified in the conceptual frameworks of ‘retrospective’, ‘prospective’ and ‘planning’.
- Dr. Lauer introduced a conceptual model of Preventing and Managing Risk Factors for CVD in the context of ‘Policy Pathways’. There was brief discussion of where ‘sleep’ might fit into this model in further revisions. Dr. Lauer welcomed suggestions from individual Board members.
Representatives of organizations with an interest in sleep were invited to provide a brief verbal update on their organization’s activities since the last SDRAB meeting, and to highlight any upcoming events or items of interest. This was in addition to the written reports each organization was invited to provide to the Board included in the meeting binders.
CDC PUBLIC AWARENESS ACTIVITIES AND INITIATIVES; Daniel Chapman, PhD, Epidemiologist National Center for Chronic Disease Prevention and Health Promotion, Centers For Disease Control and Prevention (via Teleconference)
- Dr. Chapman provided information regarding recent sleep related efforts within the CDC including a website recently launched focusing on sleep and sleep disorders (http://www.cdc.gov/sleep/), and requested that Board members relay dates, locations, and weblinks of upcoming sleep meetings and events to dpc2@cdc.gov so that they can be included on the website as space permits.
- He briefly outlined some sources of epidemiological data on sleep, including recent publications of Morbidity and Mortality Weekly Report (MMWR), the Behavioral Risk Factor Surveillance System (BRFFS) and National Health and Nutrition Examination Survey (NHANES) datasets, and suggested there could be opportunities for exploring expansion of sleep related data in these and other surveys and instruments.
- The CDC National Center for Health Marketing (http://www.cdc.gov/healthmarketing/aboutnchm.htm) was described as one potential model and source of information on effective marketing of health related messages to the public and other targeted audiences.
SLEEP AND CIRCADIAN RESEARCH AT THE NATIONAL INSTITUTE OF MENTAL HEALTH: William Riley, PhD, Deputy Director Division of AIDS and Health & Behavior Research; Aleksandra Vicentic, PhD, Program Chief Circadian Rhythms, Sleep, and Regulation of Behavior Program
- Dr. Riley provided a brief overview of the organization of NIMH, its overall budget and allocations by NIMH Division, and historical NIMH funding support for sleep research.
- The National Advisory Mental Health Council (NAMHC) workgroup recommendations for priorities in sleep research in Basic Brain & Behavioral Science at NIMH include:
- Emphasize mechanistic studies of sleep and its relationship to waking behavior;
- Support studies of the neurocircuitry and molecular neurobiology of sleep, arousal and attentional states as well studies of sleep’s influence on emotion and cognitive function;
- Reduce investment in simple phenotyping of sleep problems in psychiatric disorders which has been largely accomplished.
- The National Advisory Mental Health Council (NAMHC) workgroup recommendations for priorities in sleep research in Circadian Biology Research for Basic Brain & Behavioral Science at NIMH include:
- Shift focus from studies examining only behavioral or sensory circadian phenomenon;
- Support research on molecular and neural systems basis of circadian phenomenon that relate to higher brain function, emotion, mood, motivation, attention, arousal and cognition.
- Dr. Vicentic provided a brief overview of the sleep and circadian research portfolios within the NIMH Division of Neuroscience and Basic Behavioral Science.
- Possible components of a future research agenda for sleep and circadian rhythms research at NIMH include:
- Further investigation of the molecular neurobiology and neural circuitry of sleep, arousal and attentional states;
- Targeted array analyses to test links between wakefulness and cellular states, sleep and glial function, sleep and synaptic function;
- Elucidation of the mechanisms of brain plasticity that underlie sleep-dependent memory processes;
- Molecular and neural systems basis of circadian phenomenon that relate to aspects of higher brain function and behaviors relevant to NIMH;
- Mechanisms responsible for the association of sleep disturbances and various major mental disorders;
- Intervention studies of sleep disturbance as a risk factor for the onset and/or maintenance of major mental disorders;
- Novel and innovative insomnia interventions, especially for comorbid insomnia in major mental disorders;
- Dissemination and services research to improve access to effective treatments for insomnia or other sleep disorders in those with mental disorders.
- The next scheduled SDRAB meeting is June, 2008. The exact date has yet to be determined. Details will be posted when available on the NCSDR website http://www.nhlbi.nih.gov/sleep
These Minutes will be presented to the full Board at its next regularly scheduled meeting for consideration, amendment as approved, and formal adoption.
I hereby certify that the foregoing minutes are accurate and complete.
Phyllis Zee, MD, PhD
Chair, Sleep Disorders Research Advisory Board
Michael Twery, PhD
Executive Secretary, Sleep Disorders Research Advisory Board
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