NIH – Research To Address Sleep Disorders in the Context of Medical Rehabilitation (R01)

February 20, 2017 by School of Medicine Webmaster

Patients with a wide range of diseases—cardiovascular disorders, cancer, diabetes, stroke, traumatic brain injury, neurodegenerative disorders, infections, arthritis—report problems sleeping. Rehabilitation strategies (whether psychological, OT or PT) require the patient to be alert, active, and to engage in some type of homework or lifestyle alteration. In order to comply and fully participate, the patient must be able to interact and understand the rehabilitation regimen. During both acute and chronic rehabilitation periods, conditions secondary to the primary event, will affect the patients’ abilities. Clinical descriptions of sleep problems exist in the literature surrounding many disabling conditions (e.g. stroke, heart attack, HIV, neurodegenerative disorders); however, research on how to approach sleep disruptions in the context of rehabilitation is less prevalent.

Sleep disorder is multifaceted: sleep apnea, insomnia, hypersomnia, restless legs, circadian disorders, parasomnias. Likewise, sleep is both affected by and affects broad physiological and behavioral parameters: depression, anxiety, pain, cardiovascular changes, immune function. Each one of the sleep disorders should be diagnosed and appropriately treated to maximize benefit. Research is needed on ways to best approach this complexity in the context of medical rehabilitation for a primary, non-sleep disorder.

Disturbed sleep has many manifestations and sleep disturbances are described as components of disabling conditions—neuromuscular, neurodenerative, and cardiovascular disorders; CNS trauma and stroke; neoplastic disease and its treatment; and primary sleep disorders are considered risk factors for many chronic diseases. These conditions relating to sleep disturbance likely affect the success or failure of rehabilitation in a variety of fields. To address these concerns for rehabilitation, research is needed in areas such as:

The National Center for Medical Rehabilitation Research at NICHD is particularly interested in research to:

  • Apply refined methods to diagnose sleep disturbances during rehabilitation for primary disabling conditions
  • Determine sleep patterns during acute vs chronic rehabilitation
  • Propose specific interventions (pharmacological or non-pharmacological) based on specific sleep disturbances linked to specific patient populations, whether based on timing of the primary disorder, patient characteristics, or rehabilitation setting
  • Determine tailored, non-pharmacological sleep interventions for specific stages of rehabilitation for various age groups
  • Test the timing/duration of pharmacological sleep interventions for specific stages of rehabilitation
  • Define the optimum outcomes for improved sleep vs improvements in other aspects of patient functioning/satisfaction in the context of medical rehabilitation

National Institute of Nursing Research (NINR) is particularly interested in studies that:

  • Address sleep disorders as a first-line defense for rehabilitation optimization
  • Assess non-pharmacologic treatments of sleep disorders that offer long-term effectiveness in rehabilitation patients faced with disability
  • Determine if non-pharmacological treatment of sleep disorders “cross-over,” and reduce the impact of other symptoms such as pain, depressive symptoms, and anxiety in patients undergoing physical rehabilitation
  • Determine biobehavioral markers of sleep disorders and improved sleep in rehabilitation patients
  • Assess the directional impact of improved sleep  on fatigue in relation to rehabilitation success/acceleration/sudden gains
  • Examine the physiological, psychological, social  and environmental factors that affect sleep and the rehabilitation process and its outcomes

Deadlines:  April 21, 2017, March 30, 2018, March 29, 2019 (letters of intent are due 30 days prior to the application deadline)


Filed Under: Funding Opportunities