AISH is recognised around the world as a leading centre for clinical and basic research, with special emphasis on sleep breathing disorders and insomnia.
Our projects are funded by the Australia's National Health and Medical Research Council, Flinders University, Industry and Foundation Daw Park.
Current NHMRC funded research programs
Sleep Apnoea Cardiovascular Endpoints Study (SAVE)
Save is a multi-centre, randomised, controlled trial to determine the effects of nasal continuous positive airway pressure (CPAP) in preventing cardiovascular (CV) disease in high risk patients with moderate-severe obstructive sleep apnoea (OSA). To find out more about SAVE, please click here.
Overlap between insomnia and OSA (COMISA Study)
Insomnia and OSA occur together much more than expected for 2 separate conditions overlapping purely by chance. OSA could worsen insomnia by making the transition into established sleep much more difficult than normal, and insomnia could worsen OSA by promoting more light sleep where OSA events occur particularly frequently.
In addition, patients with insomnia and OSA may find normal treatments more difficult to tolerate than most OSA patients. Flinders University and AISH are investigating potential links between OSA and insomnia and methods for improving treatments.
Contact Amanda O'Grady for further information.
New supine-avoidance therapy for posture dependent obstructive sleep apnoea (SUPA-OSA Trial) or snoring (SUPA-Snorer Study)
Many heavy snorers could be effectively treated by simply avoiding sleeping on their back. Classic supine-discomfort based treatments are remarkably effective, but most patients cease treatment within a few months due to the inherent discomfort of this approach.
AISH helped to develop and test a simple vibration alarm device to monitor and record sleep posture and discourage supine sleep (BuzzPOD), without discomfort and with minimal sleep disturbance to the bed partner. We have already shown the device accurately and reliably records body position almost completely abolishes supine sleep and appears to be highly effective in treating supine OSA. However, long-term acceptance and use of this therapy in OSA patients, and effectiveness in snorers remain to be established. Two separate projects are investigating treatment effectiveness and outcomes in in patients with supine-mainly OSA (SUPA-OSA study) and supine-mainly snoring (SUPA-Snorer study).
To find out if you are eligible for the SUPA-Snorer study, select aishresearch and complete the online screening questionnaire. Recruitment for the SUPA-OSA study has been finalised.
To be eligible for the SUPA-Snorer study you would need to;
- Ideally have had a sleep study (that we can check) or discussed your sleep problems with your GP to rule out OSA.
- Regularly sleep on your back and have problem snoring mainly on your back.
If you are a student interested in Honours or PhD opportunities within this project please visit the Prospective Students page for more information.
Surgery of the upper airway trial for patients with moderate-severe Obstructive Sleep Apnoea (OSA)
This is a multi-centre, randomized controlled trial of airway surgery for moderate-severe symptomatic OSA 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 randomized clinical trials to provide and validate these observational studies. The clinical effectiveness, post-operative complications and incremental cost effectiveness are uncertain.
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. A very exciting new option for a surgical approach to reducing the volume of the tongue is coblation channelling of the tongue. Combined with modified uvulopalatopharyngoplasty and tonsillectomy where indicated, these surgical procedures are designed to minimize morbidity while addressing two common sites of sleep apnea obstruction, the palate and the tongue base. We have pilot data to suggest these surgical procedures are very effective and safe.
Investigators include: A/Professor Nick Antic, Professor A. Simon Carney, Professor Doug McEvoy, A/Professor Peter Catcheside, Dr Ching Li Chai-Coetzer, Professor Edward Weaver, Professor Peter Cistulli, A/Professor Stuart MacKay, Dr Charmaine Woods, Dr Eng Ooi, Dr Michael Chia, Dr Aeneas Yeo, Dr Andrew Jones, Mr John-Charles Hodge, Professor Julie Ratcliffe, Dr Stephen Quinn, Dr Guy Rees, Dr Billingsley Kaambwa, Dr Terry Sands.
Cooperative Research Centre (CRC) for Alertness Safety and Productivity
The Adelaide Institute for Sleep Health and Flinders University are an integral part of a national Federal Government funded 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.
AISH in involved in 4 main themes of the CRC research program;
- Improving personalised sleep medicine through ‘phenotyping’ and targeting treatments to underlying causes of abnormal breathing in sleep.
- Identifying biomarkers of sleepiness and performance deficits to help reduce accident and adverse health outcome risks.
- Developing new technologies to assess alertness impairment
- Individualising sleep and alertness management in safety critical occupations
The CRC provides for exciting opportunities for high-calibre individuals with a strong interest in the translational science-industry interface, to undertake PhD research projects or work as post-doctoral fellows. Individuals would need to work closely with industry partners and related translational research programs at the forefront of sleep medicine, diagnostic devices and treatment management. Suitable candidates would also have the opportunity for involvement in other ongoing NHMRC funded research programs spanning areas including detailed human physiological measurements through to clinical translational research programs. AISH is leading several NHMRC funded comparative effectiveness trials in the areas of comorbid insomnia, supine-avoidance and surgical treatment for obstructive sleep apnoea where there is additional scope for allied projects (e.g. imaging analysis, device and algorithm development etc).
Current other research projects
Limited versus Full Testing for Obstructive Sleep Apnea (LIFT-OSA)
This is a national study funded by the Australasian Sleep Trials Network which will involve patients from seven sleep centres throughout Australia.
Patients suspected of having OSA usually undergo a full sleep study in a laboratory to confirm the diagnosis, which involves monitoring of sleep stages, breathing patterns, oxygen levels, heart rate and leg movements. Simplified sleep recording devices have been developed with fewer channels which record only breathing patterns and/or oxygen levels overnight, without recording of sleep stages. This study will assess whether patients who receive treatment from a sleep specialist on the basis of a simplified sleep study recording will do as well, in terms of improvement in symptoms, as patients who have had a full sleep study.
Unravelling the mechanisms of stabilised breathing in deep sleep
Breathing becomes much more stable in deep sleep, even in most patients with OSA, but the mechanisms underlying this effect are unknown. In a series of studies AISH is investigating factors that may help explain this effect; such as changes in arousal "threshold" and responses to arousal, and breathing effort and upper airway muscle control. Through a better understanding of these mechanisms AISH hopes to design and test new treatments for stabilising breathing throughout sleep.
A new device for stabilising respiratory control during sleep
AISH has developed a prototype device for preventing low carbon dioxide levels and low breathing conditions following periods of increased breathing such as occurs with brief arousal and some abnormal patterns of breathing. This study will examine the effect of this device in OSA.
Sleep disordered breathing in patients with Sjögren's syndrome
Sjögren's syndrome is an auto-immune disorder characterised by dry mouth, eyes and airways, and marked sleepiness and fatigue. AISH has previously found that OSA is common in patients with Sjögren's syndrome, suggesting that dry airways may help explain OSA and sleepiness in these patients. A current study is examining the effect of a surface tension lowering agent (surfactant) on OSA severity in Sjögren's syndrome patients with OSA.
Biological and Behavioural Rhythms of Delayed Sleep Phase Disorder
Delayed Sleep Phase Disorder (DSPD) makes it difficult to get to sleep and wake up at normal times causing loss of sleep. It impacts health, mood, daytime activity, social obligations, and occupational needs. DSPD is highly prevalent in the adolescent and young adult population and can impair the start to adult life.
Past theories of its cause based simply on a delay of circadian rhythms in DSPD and treatments based on these theories have not been supported by experimental evidence or clinical treatment success. We intend to use an innovative laboratory method to comprehensively study, for the first time world wide, the circadian rhythm causes of DSPD. The results will allow the development of effective treatments for this disabling sleep disorder. Initial results suggest that DSPD have rhythm cycle lengths (time taken to complete one cycle) that are abnormally long (over 25 hours) thus leading to an abnormally strong tendency to delay with respect to the 24-hour world. This suggests that aggressive and persistent treatments (morning bright light and evening melatonin) will be necessary to treat this condition. Supported by an ARC grant (2012-4). For more information visit Professor Leon Lack's web page, School of Psychology, Flinders Univerity of South Australia. Volunteers interested in participating in this project please contact Dr Nicole Lovato.
Randomised controlled trial of melatonin for Delayed Sleep Phase Disorder (DSPD)
Delayed Sleep Phase Disorder (DSPD) is a primary sleep disorder affecting 7-16% adolescents and young adults. Symptoms include markedly delayed sleep onset and inability to wake up for activities such as schooling and work with poor health outcomes in particular depression, impaired academic and social functioning.
We aim to conduct the pivotal study to test the efficacy of melatonin (0.5 mg) for DSPD. We predict that, compared to placebo, melatonin treatment will result in: (1) earlier sleep onset time; (2) improved sleep efficiency; and (3) reduced sleep-related daytime impairments. As secondary aims, we will examine the role of the Per3 gene in treatment response and assess clinician-rated change in severity of illness. These latter findings will inform pharmacogenetic approaches to the treatment of Circadian Rhythm Sleep Disorders. The study will establish a standardised treatment protocol for DSPD. We will also establish a diagnostic test for DSPD and identify whether polymorphisms in the circadian gene Per3 influence treatment response. Supported by an NHMRC grant (2012-4). For more information visit Professor Leon Lack's web page, School of Psychology, Flinders Univerity of South Australia. Volunteers interested in participating in this project please contact Dr. Helen Wright.