MTSU center forms partnership to conduct intensive sleep research

Middle Tennessee State University’s Center for Health and Human Services has formed a research partnership to highlight the importance of sleep quality in the overall health of Tennesseans and that of the nation.

The university’s new Sleep Research Consortium was formed this past year to perform research and increase public awareness of how important sleep is to human existence, health and well-being.

An academic partnership between MTSU, the Sleep Centers of Middle Tennessee and a growing group of community partners, the SRC is the brainchild of Cynthia Chafin, associate director of the Center for Health and Human Services.

“Our center has conducted numerous studies, programs, and projects aimed at improving the health of both children and adults, but we have never before addressed the role of sleep in health,” Chafin said.

“When I go to national meetings, my peers present research on heart disease, obesity, diabetes, decreased school and work performance, etc., but sleep disorders are never addressed as a cause.”

Dr. William Noah, medical director of Sleep Centers of Middle Tennessee, serves as the first chairperson of the SRC. Noah and Dr. Timothy Hoelscher started practicing sleep medicine over 25 years ago right down the street from the MTSU campus.

The two board-certified sleep specialists later formed Sleep Centers of Middle Tennessee, which has grown to having more than 5,000 patient encounters per year. Its new main office building sits off Medical Center Parkway in Murfreesboro, with other offices located in Cool Springs, Clarksville, and recently opening in Chattanooga.

“We began some sleep research with MTSU over 10 years ago, but it was sporadic,” Noah said. “What Ms. Chafin has formed in the Sleep Research Consortium is a consolidated, ongoing effort involving faculty members and graduate students from multiple departments with research interest in sleep. And she has already produced results.”

In just over a year the SRC has had several research projects get approval by the Institutional Review Board (required for investigations with human subjects), and four projects are already in the writing phase preparing for publication.

The SRC has just completed a one-year study investigating the role of sleep in obesity in fourth-grade children across four rural Tennessee counties. The Consortium is collecting data this spring to complete a 10-year study on the progression of obstructive sleep apnea, or OSA, in collegiate football players. Yet, most of the initial focus of the SRC will be on the treatment of OSA, which is usually continuous positive airway pressure, also known as CPAP.

OSA, particularly severe cases, has proven to be a major health hazard. Such sleep apnea is associated with numerous medical problems including increased cardiovascular events, stroke, diabetes, high blood pressure, accidents, and decreased quality of life. OSA is also a major cause of shortened life span.

“Snoring isn’t something to laugh at anymore,” Noah said. “It’s the sign of an obstructed airway and possible future heart disease, stroke, diabetes, high blood pressure, shortened life span, and just not feeling your best each day.”

Treatment of sleep apnea with CPAP has been shown to improve a myriad of medical problems and possibly preventing others. However, the problem with CPAP is that a patient has to wear the mask daily during their sleep period to obtain this benefit.

“Part of our interest in partnering with the Sleep Centers of Middle Tennessee was their outcomes,” Chafin said. “They get many more of their patients to wear (CPAP masks) as our analysis shows – up to 25 percent more than the national average. Our initial research interest is finding out why.”

The Sleep Centers of Middle Tennessee was the first medical practice in the U.S. to widely use modems inside CPAP machines to monitor usage. Since 2006 they have collected daily usage data on over 16,000 consecutive patients treated with CPAP. This data along with corresponding data from the electronic medical records has been de-identified to remove any patient identities to form an enormous data set.

“This may be the largest existing data set combining CPAP usage with health records in the United States,” said Gabriel Toban, a Ph.D. candidate in Computational Science at MTSU. “We are already using the data set to better understand how patients use CPAP. We are writing three papers now, and the questions we can ask the data set seem endless.”

Consortium partners believe the results of the first two studies may affect national policy and guidelines. The first provides strong evidence that CPAP should be removed from federal laws that prohibit physicians from dispensing CPAP equipment to their patients. The results of the second study suggest that the current national guidelines for CPAP compliance need to be changed.

“It’s exciting that our data is being used to improve care outside of our sleep centers,” Noah said. “This would have never been possible without MTSU and [Chafin’s] vision. The Sleep Centers of Middle Tennessee will always be grateful.”