Explore our leading sleep research by experts in psychology, science, engineering or medicine.
The Adelaide Institute for Sleep Health and Flinders University are an integral part of a national Federal Government funded Cooperative Research Centre (CRC) for Alertness, Safety and Productivity. The CRC aims to develop a range of innovative strategies to reduce fatigue and sleepiness and related injuries, enhance workplace performance and improve sleep-related health and quality of life. The CRC includes an extensive education and training program to support PhD students and postdoctoral research fellows involved in the seven-year CRC program.
We also partner with clinicians within the Southern Adelaide Local Health Network (SALHN), primarily at the Flinders Medical Centre. Our leading research includes multimillion-dollar National Health and Medical Research Council (NHMRC) funded projects.
Muscle Training
Obstructive Sleep Apnoea (OSA) is a disorder that is marked by the airway closing/narrowing to prevent air flow during sleep. This may result in stoppage of breathing during sleep, resulting in tiredness, poor concentration and other health risks. One of the causes of this, is poor functioning of the upper airway muscles. It is theorized that mechanically improving the muscles in this area will improve the function of the airway during sleep. Dr. Emma Wallace’s study works on these muscles, attempting to train them over a 12-week period through in-person and phone sessions, to improve their function and reduce the severity of OSA. Her study evaluates participant’s OSA before and after the therapy to compare the function of the muscle and its effect on obstructive sleep apnoea.
Interested participants are encouraged to click on “Volunteer for our research” and complete our pre-screening survey to register their interest.
Lead researcher
Dr. Emma Wallace
emma.wallace@flinders.edu.au
OVN-MAS
Common methods of treating obstructive sleep apnea (OSA) disorder include the use of CPAP machines, which present a pressure difference in the airway which forces air into the lungs, but they are intolerable to many prospective users, leading to the need for better options. Professor Danny Eckert’s study works on the jaw muscles by using a device called a “mandibular advancement splint (MAS)”, which works by opening the upper airway and increasing air flow. We aim to further understand the physiology mechanisms behind OSA.
This study will involve at least 2 dental visits to assess your eligibility into the clinical trial and a device fitting before you commence the acclimatising to the device. Those who do not see any improvements with the MAS device will be offered the chance to combine therapies with the addition of CPAP over a short period to treat their OSA.
Interested participants are encouraged to click on “Volunteer for our research” and complete our pre-screening survey to register their interest.
Lead researcher
Dr. Amal Osman
amal.osman@flinders.edu.au
A new clinical tool to assess fitness-to-drive in obstructive sleep apnoea
Obstructive sleep apnoea (OSA) is a common sleep disorder linked with increased daytime sleepiness, impaired driving performance and a more than two-fold increased motor vehicle accident risk. However, not all patients are impaired by OSA and identifying which patients are affected is a daily clinical challenge for sleep specialists.
There is an urgent need for new, simple and cost-effective clinical tools that can be used routinely in all patients to assist clinicians and policy makers to assess alertness failure and accident risk in OSA. Clinicians cannot rely on patient self-report or standard sleep study metrics to assess accident risk, and it is impractical to send every driver or transport worker with OSA for a day-long MWT assessment. This project provides a unique and much-needed opportunity to change the approach to driving risk assessment in OSA.
This National Health and Medical Research Council of Australia (NHMRC) funded project will test the performance of biomarkers to predict driving impairment in OSA, compare performance biomarkers with the current standard (the maintenance of wakefulness test), and explore the utility additional biological (blood and saliva) biomarkers to further improve the prediction of driving impairment in OSA.
Honours projects are available.
Lead researcher
Dr Andrew Vakulin
andrew.vakulin@flinders.edu.au
08 7221 8308
Investigation of falls risk in obstructive sleep apnoea
In 2017, over 6000 patients were admitted to hospital due to falls-related injuries in the Southern Adelaide area. Current risk factors for falls include age, gender, low muscle strength, and poor visual acuity. Recently, obstructive sleep apnoea (OSA), which is characterised by a frequent decrease and/or cessation of breathing during sleep, has been proposed as a further risk factor for falls, independent of other risk factors.
This project will use gold-standard measures of both falls risk (FallScreen©) and sleep (polysomnography) to provide insight to the relationship between OSA and falls risk. Furthermore, this project will attempt to address whether treatment of OSA, by continuous positive airway pressure, reduces falls risk.
This project is in collaboration with the falls researchers at the College of Nursing and Health Sciences and falls specialists at the 4th Generation Rehabilitation Clinic, Flinders Medical Centre.
Honours projects are available. This project would be ideal for those seeking to undertake further research in this area or pursue a career in medicine or allied health.
Lead researcher
Dr David Stevens
david.stevens@flinders.edu.au
08 7221 8306
Surgery of the upper airway trial for patients with moderate-severe obstructive sleep apnoea
Our researchers are leading a multi-centre, randomised controlled trial of airway surgery for moderate-severe symptomatic obstructive sleep apnoea (OSA). It aims to establish (for the first time) whether or not upper airway surgery is clinically effective, safe and cost-effective for those who have failed medical management.
Upper airway reconstructive surgery for OSA is widely used and reported in observational studies, but there are few rigorous randomised clinical trials to provide and validate these observational studies. The posterior tongue is a major site of upper airway collapse and minimally invasive and safe surgery to that region could be a very effective surgical approach to OSA management. This project looks into an exciting new option for a surgical approach which could reduce the volume of the tongue (i.e. coblation channelling of the tongue). Our researchers have pilot data to suggest that these surgical procedures are effective and safe.
Lead researcher
Professor Doug McEvoy
doug.mcevoy@flinders.edu.au
08 7221 8319
Health impacts of sleep apnoea in Australian men—a longitudinal population study
Obstructive sleep apnoea (OSA) is very common, seen in 60-70% of men over 40 years old. The condition is linked to a number of serious conditions, including heart disease and diabetes. However, we don't know which men are at risk of long-term complications from OSA. This three-year project seeks to follow-up men from a community sample of 1000 men who had sleep studies in 2010 to help identify who is at risk of poor health from OSA.
Lead researchers
Professor Robert Adams
robert.adams@flinders.edu.au
08 7421 9751
Dr Sarah Appleton
sarah.appleton@flinders.edu.au
08 7421 9755
Defence
Shift work wreaks havoc on our body clocks. Adjusting one’s body clock is dependent on multiple factors, including light. Intense, blue-enriched light at the right time naturally allow our bodies to adapt to and maintain a sleep-work-rest schedule. Advancements in technology have presented us with the opportunity to study smart lighting and its effects on the body clock, sleep and performance.
This study funded by the Australian Government Research Network for Undersea Decision Superiority, aims to assess the effects of very low light levels found on a submarine versus optimal lighting on body clocks, sleep, and work performance. Prof. Peter Catcheside’s study will compare the effects of traditional versus ‘smart’ lighting during an extended 8-day laboratory protocol mimicking the life of a submariner. Participants will live in a simulated night shift work environment governed by pre-determined work schedules and will partake in standardised medical, psychological and cognitive tests under both traditional as well as ‘smart’ lighting.
Interested participants are encouraged to click on “Volunteer for our research” and complete our pre-screening survey to register their interest.
Lead researcher
Dr. Hannah Scott
hannah.scott@flinders.edu.au
Drug Combination Therapy for Sleep Apnoea
Studies in animals have shown the link between the muscles of the upper airway and certain naturally occurring chemicals, or neurotransmitters, in the central nervous system. These studies have shown that specific types of drugs (and their combination) that target some regions of the brain may be responsible for the control of the upper airway during sleep, by interacting with these neurotransmitters. This mechanism may be a possibility, to avoid the collapse of the upper airway, responsible for obstructive sleep apnoea (OSA). OSA is a condition where the upper airway muscles narrow/close during sleep, causing stoppages in breathing, excessive snoring and frequent waking from sleep, and, in the long term, increased mortality risk. To date, the only effective treatment for OSA is CPAP (continuous positive airway pressure), a machine that blows pressure in the upper airway and keep it open during sleep, however many people find it to be restrictive and uncomfortable.
Our study involves the administration of a combination of drugs that target the brain regions responsible for the upper airway control and thus provide a potential alternative treatment option for OSA, especially for those who cannot tolerate CPAP. Dr. Ludovico Messineo’s study aims to assess the efficacy and safety of these drugs in combination in people affected by OSA.
Interested participants are encouraged to click on “Volunteer for our research” and complete our pre-screening survey to register their interest.
Lead researcher
Dr. Ludovico Messineo
ludovico.messineo@flinders.edu.au
A $2.5 million hub putting sleep disorders to rest
Sleep disorders have a significant impact on the health, productivity and safety of people around the world. The two most common disorders (obstructive sleep apnoea and insomnia) alone cost Australia—by conservative estimates—over $5 billion per year.
Disturbingly, current health services and policy fail to manage these disorders cost-effectively through over-reliance on too complex and costly sleep apnea tests, unregulated industry practices often failing to deliver good outcomes for patients, and poor treatment selection and access in primary care.
The Adelaide Institute for Sleep Health is leading a major five-year, $2.5 million project to establish a Centre of Research Excellence (CRE) National Centre for Sleep Health Services Research. The Centre brings together an extensive network of internationally recognised experts in sleep and respiratory medicine, general practice, nursing, pharmacy, health services and policy research, epidemiology, health economics and sleep health technologies. It will show how primary care can be placed at the centre of sleep disorders service delivery. The focus will be on the deployment of simplified, cost-effective and evidence-based methods for diagnosing and managing sleep problems in primary care. By designing specialist services in a 'hub and spoke' model, primary care practitioners will be better connected and supported.
PhD projects with the National Centre for Sleep Health Services Research
Embrace the chance to develop and test sleep health decision support (eHealth) systems for primary care to assist the GPs and other primary care professionals in screening and managing sleep disorders. We've developed a prototype, web-based sleep health decision support system for community use, but now it must be adapted for primary care and tested for effectiveness in a cluster randomised trial. The main aims of this Centre for Research Excellence project are to:
- Identify technology gaps and opportunities to assist primary care professionals with the screening and management of sleep disorders.
- Based on these qualitative research findings, revise and enhance the capability of the sleep health decision support (eHealth) tool for use in primary care.
- Test the effectiveness of the sleep health decision support system in primary care in a cluster randomised control trial.
We hope this trial will show increased patient self-management of asymptomatic obstructive sleep apnea, improved GP care of sleep apnea, decreased hypnotic drug prescriptions, and increased non-drug (behavioural) insomnia therapies.
This PhD project would suit an outstanding and enthusiastic candidate with an interest in health services research. Technical background in biomedical engineering, eHealth system, or web development would be an advantage.
Supervisor
Andrew Vakulin
andrew.vakulin@flinders.edu.au
08 7221 8308
Take the lead in developing guidelines for sleep health management in primary care. Primary care professionals need standardised, practical guidance on how to screen for and manage sleep disorders. The specific aims of this project are to:
- Review and adapt existing sleep specialist guidelines for use in primary care.
- Determine the best ways of implementing the sleep health guidelines in primary care, including format, uptake and usability.
- Test the impact of the introduction of sleep health guidelines on GP behaviour and patient outcomes.
This PhD project would suit an outstanding and enthusiastic candidate with an interest in translational health services research, health policy, education or public health.
Supervisors
Professor Doug McEvoy
doug.mcevoy@flinders.edu.au
08 7221 8319
Ching Li Chai-Coetzer
ChingLi.Chai-Coetzer@sa.gov.au
08 7221 8313
A new device for stabilising respiratory control during sleep
We have developed a prototype device for preventing low carbon dioxide levels and low breathing conditions following periods of increased breathing—as occurs with brief arousal and some abnormal patterns of breathing. This study will examine the effect of this device when used by people with obstructive sleep apnoea (OSA).
Improving breathing for people with motor neurone disease
Respiratory muscle weakness occurs commonly in patients with motor neurone disease (MND) and can develop at any stage of the disease. This weakness may result in shortness of breath, difficulty lying flat, unrefreshing sleep, morning headache, impaired quality of life and sleepiness.
We are hoping to better understand the nature of abnormal breathing patterns in MND patients so that we can best tailor treatments to improve patients’ breathing, sleep and quality of life. As part of our study, we are testing the usefulness of a new ‘smart’ form of mask ventilation and comparing it with one that is currently used.
Unravelling the mechanisms of stabilised breathing in deep sleep
Breathing becomes much more stable in deep sleep, even in most patients with obstructive sleep apnoea (OSA), but the mechanisms underlying this effect are unknown. In a series of studies, we are investigating factors that may help explain this effect—such as changes in arousal threshold and responses to arousal, as well as breathing effort and upper airway muscle control. Through a better understanding of these mechanisms, we hope to design and test new treatments for stabilising breathing throughout sleep.
Sleep disorders as a potential phenotype of fatigue in stroke patients
This project will profile the prevalence of sleep disorders in stroke patients and examine their contribution to post-stroke fatigue (PSF)—a significant post-stroke complaint 50% of patients. We hypothesise that sleep disorders, particularly obstructive sleep apnoea (OSA) and insomnia, will be highly prevalent and contribute to feelings of fatigue in those with stroke.
This study will identify the prevalence of sleep disorders in stroke patients and how they contribute to PSF. The results will highlight the potential importance of treating sleep disorders in this population and will guide future treatment intervention trials and clinical practice in stroke.
Sleep and respiratory problems
We collaborate with the Cooperative Research Centre for Alertness, Safety and Productivity, and other initiatives, to better understand the mechanisms underpinning sleep and respiratory problems, and develop new methods to improve outcomes for patients through personalised treatments tailored to individual variability in underlying problem causes and consequences.
Potential Honours projects could:
- use a new quantitative method for assessing breathing effort to better understand interactions between respiratory disturbances and fragmented sleep.
- examine physiological disturbances associated with noise exposure during sleep.
- investigate other aspects of sleep physiology.
Students interested in clinical sleep research, human respiratory or sleep physiology should contact:
Professor Peter Catcheside
peter.catcheside@flinders.edu.au
08 7221 8305
Wind farms and sleep
The expansion of wind farm facilities in Australia has led to widespread community complaints regarding noise, sleep disturbance and adverse health effects. This five-year collaborative study is looking into how the noise from wind turbines affects people's health. It also tests how much windfarm noise disturbs sleep compared to traffic noise.
Wind farm noise exposure, including audible and potentially inaudible low frequency components, clearly has the potential to adversely affect sleep, health and wellbeing through two main plausible and interrelated mechanisms: chronic sleep fragmentation from frequent physiological activation responses to sensory disturbances in sleep, and chronic insomnia which could potentially develop more gradually over time in sensitised individuals. However, data from well-designed studies using objective measures of sleep and sound are remarkably lacking and are clearly now needed to definitively establish the sleep disruption characteristics of wind farm noise compared to other noise disturbances in sleep.
Students involved with this research could assist with:
1. A survey of people exposed to wind farm or traffic noise. One of the aims of the survey is to compare responses about sleep disturbance from people exposed to wind farms and people who live in noisy night-time traffic conditions, which are already known to disturb sleep.
2. An in-home study of sleep and noise in people affected by noise. Self-reported and direct objective measures of sleep quality will be assessed in participants’ natural homes and noise environments to investigate the relationships between noise, sleep disturbances, and other factors.
3. A laboratory study to investigate noise effects on sleep in a controlled sleep and noise environment. Gold standard sleep and physiological activation responses to a range of noises will be used to carefully test noise impacts on sleep macro-structure (i.e. sleep stage distribution and wake time during the sleep period) and sleep micro-structure (i.e. brief arousal and physiological activation responses).
Lead researchers
Dr Gorica Micic
gorica.micic@flinders.edu.au
08 7221 2377
Dr Branko Zajamsek
branko.zajamsek@flinders.edu.au
08 7221 5081
Bright light glasses that can help us sleep
Circadian rhythms fundamentally determine the timing of sleep and wakefulness across the 24-hour day. An individual with a ‘normally’ timed circadian rhythm will typically fall asleep at approximately 11pm and wake around 7am. However chronic sleep difficulties can occur when the circadian rhythm is mistimed, leading to a sleep-wake rhythm that does not coincide with an individual’s preferred sleep-wake schedule. A late timed circadian rhythm can lead to difficulty falling asleep. Sleep onset insomnia is associated with delays of the circadian rhythm in the order of 2-3 hours. Later sleep onset times increase the tendency to sleep later into the morning in a bid to obtain sufficient sleep. However, when required to rise for work or social obligations (e.g. at 7am), an individual with a delayed circadian rhythm will experience extreme difficulty as they are attempting to rise at the time of maximum circadian sleepiness. The negative experience of this physiological difficulty, coupled with insufficient sleep, can amplify the negative consequences of difficulty falling asleep and reinforce the cycle of chronic insomnia.
Appropriately timed exposure to bright light can re-time (or phase shift) the circadian rhythm and consequently alleviate the associated sleep difficulties and daytime sequelae. Although the efficacy of bright morning light has been well established to advance (move earlier) the circadian phase, few studies have investigated its efficacy for the treatment of sleep onset insomnia associated with a delayed circadian phase. Bright light has traditionally been administered using a ‘light box’, which requires individuals to maintain a fixed position in front of the box. It's impractical and impacts significantly on treatment compliance. Since the development of light boxes, it has become well established that coloured blue/green light, as opposed to white light, produces a superior therapeutic response.
Based on extensive research into optical devices using small light emitting diodes, particularly using blue/green light, we've developed commercially available light therapy glasses.
These devices are now available to the public for a variety of beneficial effects including the treatment of circadian rhythm disorders contributing to insomnia, jet-lag, winter depression and shift work disorder. They have been shown to be effective at delaying the body clock timing when used in the evenings and advancing the body clock timing when used in the mornings.
These commercial devices based on this earlier research need to be validated for their effectiveness. We have previously shown that they are effective at delaying the body clock timing when used in the evenings, and advancing the body clock timing when used in the mornings.
Our initial research was conducted using individuals who experience typically good sleep. Now we need to show the effectiveness of the light therapy glasses in shifting the body clock when used in a clinical population with sleep onset insomnia. In doing so, our light therapy glasses will be the first presently on the market to have evidential support for their effectiveness.
Honours students can apply to work on this project.
Lead researcher
Dr Nicole Lovato
nicole.lovato@flinders.edu.au
08 7221 8307
Sturt Rd, Bedford Park
South Australia 5042
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