Brienne Miner, MD, MHS, assistant professor of medicine (geriatrics) recently received the National Institutes of Health/National Institute on Aging’s Early Medical and Surgical Subspecialists Transitioning to Aging Research award - a grant that provides funding for physicians early in their aging research career. The funding from the award will go towards investigating the way that sleep problems are evaluated in older adults and evaluating potential ideas on improving that methodology.
Miner became interested in research at the intersection of sleep and aging while working as a clinical and research fellow at the Dorothy Adler Geriatric Assessment Center. There, she came across two major problems when evaluating sleep problems in a lab-based environment: first, that clinicians are only seeing one night of sleep, and second, that the patients aren’t sleeping in their home environment. “I'm looking at improving subjective reports or subjective instruments that we might use, but also looking at the ways we can evaluate things objectively at home so that people don't have to come into a sleep lab, and so we get more of a sense of what their habitual patterns of sleep are like.”
Currently, the gold standard for sleep study is polysomnography, which can be cumbersome for patients to set up at home. Miner will be comparing home-based polysomnography against a new technology, an electroencephalography (EEG)-measuring headband that uses an algorithm to detect when participants are sleeping and what stage of sleep they are in. This new technology has the potential to attain information about patients’ sleep cycles with less physician evaluation and provide data across more than just one night of sleep.
The second part of Miner’s project involves actigraphy, which measures periods of rest and activity to determine when the person is actually sleeping. Instead of looking just at patients’ sleep characteristics, Miner will be investigating their circadian patterns. “There's so much overlap between sleep and circadian mechanisms, and a lot of times, we think about sleep without integrating the circadian piece. Let's actually assess that."
The final piece of her grant will focus on creating a more nuanced approach to assessing older people's sleep with self-report measures. Here, Miner wants to know the specific problems that older people report related to their sleep. And with traditional questionnaires, she wonders if researchers are asking the right questions. “Maybe we shouldn't treat them like young adults and middle-aged adults. Maybe there are unique issues, unique ways of reporting sleep that we should be capturing.”
Inspired by the importance of sleeping for health and the way that sleep medication isn’t recommended for older adults, Miner says, “I feel really lucky to have discovered that and to continue to work on it. And to always feel like, ‘Okay, at the end of the day, this problem that I'm working on is really important.’"
Miner is mentored by Thomas M. Gill, MD; Henry (Klar) Yaggi, MD, MPH, BA; and Melissa Knauert, MD, PhD.
Yale’s Section of Geriatrics strives to improve the health of older adults by providing exceptional patient care, training future leaders and innovators in aging, and engaging in cutting-edge research. To learn more about their mission, visit Geriatrics.