New NIH-funded research projects investigate sleep apnea diabetes link

October 29, 2019

The University of Chicago has long been known as a leading institution for sleep research, ever since rapid eye movement (REM) sleep was discovered here in 1953. More recently, pioneering research at UChicago’s Sleep Research Center has identified sleep disturbances as contributing factors to the epidemics of obesity and diabetes. Esra Tasali MD, Associate Professor and Director of the Sleep Research Center, was recently awarded two five-year Research Project Grants (R01s) by the National Institutes of Health (NIH). Tasali’s research focuses on the impact sleep and sleep disorders have on glucose (sugar) metabolism, energy balance, weight regulation, and cardiometabolic diseases, particularly diabetes.

"Our research has shown that if healthy people are sleep-deprived, their blood sugar increases in as few as four to seven days, putting them at risk for diabetes over time," Tasali said. "These sleep-deprived people also reported that they were hungrier and eating more calories, particularly high carbohydrate, as compared to when they received enough sleep." More recent studies suggest that extending sleep in real-life settings in those who habitually sleep less than 6.5 hours per night can have beneficial effects on energy balance. 

Tasali also studies sleep apnea, the most common sleep disorder with serious public health concerns. Sleep apnea occurs when a person’s breathing stops repeatedly at night, leading to oxygen drops and sleep disruption. "We know that sleep apnea is strongly associated with diabetes and heart disease, and up to a striking 70% of patients with prediabetes or diabetes have sleep apnea," she said. Her research has shown that the severity of a person’s sleep apnea can predict the worsening of blood sugar levels. 

Tasali’s newly funded studies focus on the link between sleep apnea and prediabetic states. The first study, Mechanisms of Prediabetic States in Sleep Apnea, will examine how sleep apnea impacts diabetes and cardiovascular disease. Participants will undergo detailed glucose and lipid monitoring, and muscle biopsies will be taken to investigate how disruption in mitochondria, the powerhouse of the cell, affects sleep apnea. 

"This is very unique because it’s the first study that will look at the role of mitochondrial function in sleep apnea," Tasali explained.

In the second study, Technology-supported Treatment of Sleep Apnea in Prediabetes, patients with sleep apnea and prediabetes will engage in a six-month randomized controlled clinical trial that combines continuous positive airway pressure (CPAP) treatment of sleep apnea with lifestyle interventions using mobile technology.

"We are excited to implement a new smartphone app to help patients self-monitor, and we will also monitor their progress via the app to enhance adherence to treatment," Tasali said.

The custom-made app is the first of its kind to combine lifestyle intervention with CPAP treatment. Patients will install the app on their phones and have one week to test it prior to the start of the study. Participants will also wear wrist monitors that track information about activity patterns and monitor their dietary intake and weight through the app. Many patients struggle with using their CPAP treatment, and Tasali hopes the app integration will help improve CPAP adherence. 
 
"This is team science, and our research projects are in collaboration with leading investigators in the US," Tasali said.

The Sleep Research Center is currently in the process of recruiting patients for these studies. For more information, contact sleepstudy@uchicago.edu.

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