beth israel deaconess medical center a harvard medical school teaching hospital

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Sleep and Sleep Disordered Breathing

The principal area of research relates to disorders of breathing and sleep. Research projects seek to better understand the mechanisms of sleepiness and sleep-disordered breathing. Studies include the use of therapeutic agents to improve the quality of sleep, productivity and quality of life in persons with sleep disorders.

One study on the functional neurobiology of sleepiness seeks to evaluate the role of specific brain centers and neurocircuitry following sleep deprivation, auditory sleep fragmentation and exposure to nocturnal hypoxia in healthy individuals. Functional assessments are made by sophisticated magnetic resonance imaging (fMRI) and magnetoencephalography (MEG). A major focus of the project is an evaluation of different intensities of treatment of obstructive sleep apnea and its impact on working memory assessed by fMRI. Another study seeks to evaluate carbon dioxide as a treatment for complex sleep-disordered breathing, especially that associated with congestive heart failure.

A research clinic is being established to provide a system of care for the management of sleep-disordered breathing in patients with heart failure. The principal focus of this research clinic is to establish an identity, a process, a clinical and polysomnographic protocol and measure clinical outcomes for patients with congestive cardiac failure and sleep-disordered breathing. Outcomes studied include cognitive, quality of life, and hemodynamic. Routine and specialized management protocols for sleep apnea will be evaluated, including positive airway pressure therapy, gas modulation (oxygen and carbon dioxide), and pharmacological sleep modulation (using GABA ergics-benzodiazepines, Tiagabine, zolpidem).