Evaluating Sleep Deficiency in Aging Populations

PROJECT SUMMARY/ABSTRACT Candidate: My career goal is to become an independent clinician-investigator focused on improving sleep- wake disturbances and preventing their adverse outcomes in older persons. My clinical training as a Geriatrics and Sleep Medicine physician and research training in Geriatric Clinical Epidemiology form the foundation on which I will build to reach this goal. My track record of success is evidenced by the publication of high-impact original reports and the receipt of 3 grants. I have distinguished myself as a national leader and received awards for my research from the Sleep Research Society, the American Academy of Sleep Medicine (AASM), and the American Geriatrics Society (AGS), including the AGS New Investigator Award and a career development award from the AASM Foundation. Mentors and Environment: I have an outstanding team of mentors and advisors, including my primary mentor, Dr. Thomas Gill (Geriatrics), an internationally recognized thought leader in aging research, and co- mentor Dr. Klar Yaggi (Sleep Medicine), an expert in conducting epidemiologic studies aimed at understanding the health outcomes of sleep disorders. I also have a team of advisors, selected based on their expertise in aging, sleep, qualitative and mixed-methods research, circadian biology and analysis, and instrument development. I have outlined a rigorous program of training that draws upon the wealth of resources across Yale University, including the Program on Aging/Claude D. Pepper Older Americans Independence Center, as well as national training opportunities in mixed methods research and leadership development. These resources, and the support of the Sections of Geriatrics and Sleep Medicine at the Yale School of Medicine, provide an ideal environment for my career development and execution of the proposed research. Mentored Research Project: Sleep-wake disturbances are associated with important adverse outcomes in older persons, including cognitive and functional decline. Our prior work has demonstrated that these disturbances are under-diagnosed in older persons, which may be due to the poor sensitivity of existing sleep questionnaires, the frequent co-occurrence of multiple sleep-wake disturbances, and the burdensome nature of objective sleep testing. We propose to develop and test age-appropriate, comprehensive subjective and objective sleep assessment tools to facilitate identification of older persons with sleep-wake disturbances. To accomplish this, we will assess sleep-wake disturbances using a broader construct termed, “sleep deficiency”, which is a condition causing functional impairment as a result of a deficit in sleep quality, sleep duration, and/or sleep that is out-of-sync with the body's natural clock (i.e., non-circadian sleep). The overall objective is to develop and pilot test tools to identify sleep deficiency in older persons. Future work will validate these tools, which can be used to target interventions to improve sleep health and prevent adverse outcomes.