As part of our “Meet Yale Internal Medicine” series, today’s Q&A is with Brienne Miner, MD, MHS, instructor (geriatrics).
Q: What led you into medicine as a career?
A: I come from a family who believes in public service. My father is a physician and my mother is a nurse. I grew up hearing my parents talk at the dinner table about medical issues, and I always found it so interesting. They inspired me to give back in my own career.
Q: Why pursue geriatrics?
A: My father is a primary care physician so I have always viewed the internist as the consummate physician. I wanted to maintain a broad knowledge of medicine. It was being here at Yale that sparked my interest in geriatrics. During my residency training, I worked on the Cooney Service, now called the Center for Restorative Care. I really liked the patient population and the approach to care. It wasn’t a cookie-cutter type of medicine. We had to be more individualized in our approach for what was important for these patients. The approach has to be different.
Q: Why did you choose to come to Yale School of Medicine?
A: My husband and I decided to visit Yale based on the reputation and were both pleasantly surprised by how much we liked the program. During our visit, we met all these people who planned to be here for only three years but ended up staying in New Haven. It gave us a sense that people are invested in the program and want to give back. There was also such a personable approach. I remember meeting the program director, and he knew exactly who I was and what I was interested in. He made sure to introduce me to specific people. We knew that we would have resources and a great academic program, but the personalized approach set Yale apart from other programs. They encourage what is unique and special about each person and determine how these aspects can be fostered.
Q: Why focus on sleep medicine in the geriatric population?
A: My first passion is geriatrics, but I discovered during my training that sleep problems in this population were a major issue. I was working in the Adler Center, our geriatric assessment clinic, and saw that so many older people had sleep problems. These problems can be difficult to treat and are very stressful for the caregivers and family members we depend on to help care for our patients. For example, if you are taking care of a loved one with dementia and they can’t sleep through the night, that can become a problem for the caregiver, especially if they have work responsibilities the next day. Everyone knows that getting a good night sleep is important, but we know that cognition and behavior are negatively impacted by a bad night of sleep. I decided to do the sleep fellowship because I wanted to know more about how to help my patients with their sleep problems and to decrease the burden for family members helping to care for my patients.
Q: What research are you working on currently?
A: I have focused on two sleep symptoms: insomnia and hypersomnia. Insomnia is trouble sleeping during the night and hypersomnia is daytime drowsiness. My research is looking at the risk factors for these two conditions and identifying modifiable factors to help with these problems. I am looking at all older adults currently, but in the future I plan to look specifically in people with cognitive impairment and dementia.
I am looking at how conditions, such as social isolation and being on multiple different medications, can affect sleep because these are things that are especially important in older adults. The landscape looks different for older adults, and because of these differences, maybe there are specific modifiable risk factors that we can target to help their sleep.
My hope with my research in sleep is to give everyone better tools to help these people because I think it is a big frustration for caregivers, patients and care providers.