ProfessorRon Grunstein

Project Opportunities

Title: Melatonin as a treatment for Delayed Sleep Phase Disorder

Summary of opportunity:

The project will characterise the behavioural and physiological phenotype of DSPD and examine the efficacy of melatonin as a treatment for DSPD.

Opportunity synopsis:

Delayed Sleep Phase Disorder (DSPD) is a circadian rhythm disorder defined as a sleep schedule occurring substantially later than the conventional or desired time. Individuals which suffer from DSPD not only habitually rise later but also fall asleep later than they choose. 10-16% of individuals that suffer from DSPD are misclassified with insomnia and therefore, may be treated inappropriately. This study hopes to conduct a definitive study of melatonin for DSPD, with accurate diagnosis methods, optimal treatment timing and a pragmatic treatment approach. Through physiological phenotyping of DSPD we hope to provide an evidence-base to inform pharmacogenetic approaches to treating DSPD.

Project Opportunities

Title: High Density EEG measurement in sleep disorders

Summary of opportunity:

Study the electroencephalography during sleep and wake to phenotype patients with sleep disorders, and neurodegenerative or psychiatric disorders with sleep disturbance.

Opportunity synopsis:

High density electroencephalography (hdEEG), by the use of multiple recording leads, allows for investigation of the activity of the brain with high spatial and temporal resolution. Potential projects include:

1. The use of hdEEG to phenotype patients with sleep disorders, as a potential marker of vulnerability to sleep loss, or a marker of treatment responsiveness.
2. Using hdEEG characterise sleep spindle structure, in patients with psychiatric or neurodegenerative disorders.
3. Using hdEEG to investigate the effects of pharmacological agents (including hypnotics) on sleep.

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Project Opportunities

Title: Novel diagnostic methods and treatment in insomnia disorder

Summary of opportunity:

This project will develop clinically deployable methods for insomnia phenotyping and test treatments tailored to these phenotypes.

Opportunity synopsis:

Insomnia is the most prevalent sleep disorder with around one-third of adults reporting symptoms consist with insomnia. Medical and societal costs related to the disorder are high and evidence suggests that the incidence is increasing. The diagnosis of insomnia is patient self-report and to date there are a lack of clinically valid objective measures to determine disorder severity and clinical subtypes. Therefore, methods to diagnose insomnia more effectively and target treatments that reduce insomnia severity are required. This project will develop new clinically deployable objective measures and tools for phenotyping insomnia and test the efficacy of new treatments tailored to insomnia patients based on their phenotype.

----------Current Research Projects----------

Sleep Neurobiology

· How high-density EEG provides insights into sleepiness, sleep apnea, insomnia and parasomnias and brain function (NHMRC)

· The effect of agingand dementias on sleep architecture using high density EEG, EEG power spectral analysis and neuroimaging (NHMRC)

· Sleep spindles in neurodegeneration and sleep-breathing disorders (NHMRC)

- the impact of "local sleep" on sleepiness in sleep apnea

- how do sleep disorders impact severe mental illness?

Sleep Apnea

· Weight loss and impact on health in sleep apnea (various grants)

· Use of digital health techniques in diagnosis of sleep apnea (Alertness CRC)

· effect of hypogossal nerve stimulation in sleep apnea (sponsored)

· use of simple and methods to predict crash risk in patients with OSA (NHMRC)

· screening and management of sleep apnea in schizophrenia (MRFF)

· wakefulness promoters in management of sleep apnea

· treating obesity-hypoventilation syndrome (NHMRC)

- drugs for weight loss in sleep apnea (sponsored)

· effects of opiates, anti-depressants and hypno-sedatives on sleep and breathing

Insomnia

· measuring insomnia phenotypes and use of digital health technologies to treat insomnia (Alertness CRC)

· understanding hyperarousal and sleep misperception in insomnia (Alertness CRC)

·· do novel cannabinoids alter sleep in chronic insomnia ? (Lambert Initiative)

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Chronobiology/Chronomedicine

· diagnosing and treating shift work sleep disorders (Alertness CRC)

· managing delayed sleep phase syndrome

· new oral delivery systems for time release of melatonin (with Macquarie University)

· sleep and circadian issues in long haul flight crew (Alertness CRC)

· light and circadian influences on cognition in aging (Perpetual Trustees)

Other Clinical Trials

· Clinical trials to determine the influence of sleep disorders on brain aging and pre-dementia (NHMRC)

· Treating REM sleep behaviour disorder (dream enacting behaviours)

· managing treatment-resistant restless legs syndrome

· Use of long acting oxybate and other novel treatments in narcolepsy (Avadel)

- orexin agonists in narcolepsy