Sleep Disorders Research Advisory Board (SDRAB) Meeting - April 1, 2021

BOARD MEMBERS PRESENT

Dr. Gabriel Haddad, Chair Designate
Dr. Si Baker-Goodwin
Dr. Mariana Figueiro
Dr. Judette Louis

BOARD MEMBERS ABSENT

Dr. Wendy Troxel

EX OFFICIO MEMBERS PRESENT

Dr. Marishka Brown, NHLBI, Executive Secretary
Dr. Janet He, NINDS, NIH
Dr. Karen Lee, NICHD, NIH
Dr. Mack Mackiewicz, NIA, NIH

Members of the Public Attending

The total number of public attendees watching online as reported by Zoom was 90.

Federal Employees Attending

Thirty Federal employees were in attendance via Zoom.

CALL TO ORDER, Dr. Marishka Brown

• The meeting was called into session at 12:00 PM ET on April 1st, 2021, as announced in the Federal Register on March 5th, 2021 [FR Doc. 2021-04524]. This meeting was fully open to the public according to provisions of US code and Federal Advisory Committee Act as amended. The Chair, Dr. Haddad introduced members of the Sleep Disorders Research Advisory Board (SDRAB) and the Ex Officio members.

WELCOME REMARKS, Dr. James Kiley

• Reviewed the role of SDRAB and how the board is essential for the work of NCSDR and NIH with regards to sleep and circadian science research.
• SDRAB has a bi-directional role, taking knowledge and insights to the community and from the community to NIH.
• Expressed his appreciation for the new NCSDR director Dr. Marishka Brown, explained the transition to the new director has been seamless .

NATIONAL HEART, LUNG & BLOOD INSTITUTE RESEARCH PRIORITIES, Dr. Dina Paltoo

• Overview of the current NHLBI budget and Strategic Vision was given.
• Review of current efforts including sleep and the health of women, and efforts for understanding sleep and circadian rhythm and COVID-19.
• Description of NHLBI’s strategic approach to address COVID-19 pandemic was explained and advancing a comprehensive understanding of post-acute sequelae of Covid-19 (PASC).
• Discussion of setting the sleep and circadian biology research agenda including the areas of sleep, pregnancy, and maternal health; sleep, society, environment, and health; and implementation research.
• Furthermore, the power of data, including NHLBI-supported National Sleep Research Resource and its planned integration with NHLBI BioData Catalyst was highlighted.
• In addition, realizing the promise of evidence-based solutions was detailed, and vision of partnering for maximal public health impact was described.

DIRECTOR’S REPORT FROM THE NATIONAL CENTER ON SLEEP DISORDERS RESEARCH, Dr. Marishka Brown

• Summarized the purpose and mission of the NCSDR, demonstrated support across the NIH for sleep and circadian research with over $3 billion in support since NCSDR’s inception, and with nearly $450 million in anticipated support in 2021.
• Coordination activities of the NCSDR across the government were also reviewed.
• Summarized first 100 days as NCSDR Director:
  • Described short- and long-term goals,
  • Introduced new Program Officials at NCSDR,
  • Summarized listening and engagement tour of NCSDR with many public and federal stakeholders.
• Described NHLBI-specific activities to promote sleep and circadian science and outreach initiatives.
• Described the current plan for publishing the Sleep Research Plan Revision for 2021.
• Lastly, described current critical and timely opportunities, current funding opportunities and highlighted other pertinent activities.

TRANS-NIH SLEEP RESEARCH COORDINATING COMMITTEE ACTIVITIES AND UPDATES

NINDS: described mission of the institute and highlighted current funding opportunity announcements.

NIMH: described support for sleep research across various divisions at the institute, highlighted upcoming workshops related to sleep, and described current funding opportunity announcements.

NCI (Extended Programmatic Focus): provided an overview of sleep and circadian NCI activities: the Provocative Questions Initiative, Epidemiology and Genomics Research Program, Behavioral Research Program, ASA24 research program and the addition of a sleep module, Strategic Plan for NIH Nutrition Research, and Nutrition for Precision Health current program. NCIs activities on Circadian and Chronomedicine was also discussed.

The group answered questions about the ASA24 research program.

UPDATES FROM STAKEHOLDER SOCIETIES

Sleep Research Society (SRS), Dr. Craig Heller

• Reviewed the SRS strategic plan including overall mission, various membership recruitment/engagement/retention activities, various career development programs and services, various scientific offerings, advocacy and outreach, strategic national and international partnerships, and fundraising practices. 
• SDRAB discussed grant success rate, and how the board may collaborate with SRS to continue to fill the pipeline of sleep and circadian researchers.

Circadian rhythm Sleep-Wake Disorders: Gaps and Opportunities Workshop Report, Dr. Jeanne F. Duffy

• Discussed background information of circadian rhythm sleep-wake disorders (CRSWD), described knowledge and research gaps, and described results of the workshop including opportunities presented.
• Research opportunities were discussed and recommendations for collaborative efforts to harmonize inclusion/exclusion criteria for human research, methods and data/sample sharing, adding questions about CRSWD to large cohort studies, new high-quality research on causes of CRSWD, and development and testing treatments appropriate to the underlying problem were discussed.
• SDRAB discussed: relationship between trauma and CRSWD, and whether there are differences globally (latitude North to South, immigration patterns, etc.)

American Academy of Sleep Medicine (AASM)/AASM Foundation Updates, Dr. Jennifer Martin

Described mission of AASM, their response to COVID-19, advocacy victories (sleep health caucus, school start times), recent and upcoming publications and position papers, and awards to young investigators including diversity supplement awards new for 2021. Other types of AASM Foundation strategic research awards were described, including partnership with AMA and Chest Foundation to design new research awards.

NIH INITIATIVES

• Opportunities for Sleep & Circadian Research in COVID-19, Dr. Josh Fessel
  • Described the current status of the COVID-19 pandemic and Post-Acute Sequelae of COVID-19 (PASC)
  • Multiple studies demonstrating high rates of sleep problems and issues in the long COVID population were reviewed and highlighted.
  • The NIH-wide Long COVID/PASC Initiative was described, and many upcoming additional initiatives from NIH in the future.
  • Lastly, availability of current Sleep and Circadian Common Data Elements (CDE) was highlighted.

SDRAB discussed relationship between severity of initial COVID-19 infection and long COVID condition and symptoms, long-term plans for CDEs at the NIH, and the upcoming workshops in this area and how they may help push the science forward.

• Community Engagement Alliance (CEAL) Against COVID-19 Disparities, Dr. Catherine Stoney and Dr. Sairam Parthasarathy
  • Described objectives and priorities of CEAL (research and outreach, inclusion of diverse racial and ethnic populations), current status of CEAL with support across 11 States, structure of CEAL across an executive committee and three work groups along with a community partner from each CEAL team.
  • Described NIH guiding principles to combat COVID-19 through community engagement.
  • Provided data about COVID-19 including hospitalizations by race and ethnicity, sleep health disparities, and the social determinants of health across various points (exposure, care access, care delivery, discharge care, long-term care).
  • Highlighted the partners and the broad community-based efforts.  
  • Overall mission of the Arizona CEAL and specific 30-, 60-, 90-, 180-, and 240-day milestones of the Arizona CEAL were demonstrated.
  • Lastly, vaccine hesitancy data were provided, and the topic was highlighted, vaccine inequities data were provided, and data on inequity in adherence to CPAP and its relevance to COVID-19 were described.

SCIENTIFIC FOCUS PRESENTATIONS

• Is Time Restricted Feeding Driven by the Microbiome? Dr. Amir Zarrinpar
  • Provided an overview of consequences of circadian desynchrony, and research showing importance of microbiome oscillations for circadian rhythms in the body and changes to the digestion machinery based on microbiome composition.
  • Summarized how the challenges of performing microbiome research in conventional mice were addressed.
  • Summary of Engineered Native Bacteria results and conclusions were provided.  

SDRAB discussed how microbiome entrainment of circadian rhythms may be occurring, potential underlying mechanism for obesity phenotype, possibility to study time-restricted feeding, and influence of gut microbiome on sleep.

• Sleep disruption and the Impact on the Gut Microbiota: CVD Outcomes Among African-origin Adults, Dr. Lara Dugas
  • Discussed background, data showing difference in gut microbiota by cardiometabolic disease risk, across participants from multiple African countries, and relationship of gut microbiota to short sleep.
  • Current and ongoing research directions were summarized.
  • An overall progression of the research studies over the last 10 years were summarized.

PUBLIC COMMENT

• Dr. Peter Mensbach (Circadian Sleep Disorders Network) thanked circadian researchers for the workshop they have planned and thanked them for hearing the CSDN’s views. The CSDN expressed concerns about the  recommendation of Cognitive Behavioral Therapy for Insomnia (CBT-I) for Non-24-hour sleep-wake disorder. SDRAB Chair invited Peter to send his complete comment for future actions.
• Phyllis Stein expressed that microbiome of babies is influenced by mode of birth (vaginal vs. c-section).
• SDRAB explained that the presentations are public and anyone wanting them should email NCSDR at ncsdr@nih.gov .
• Jay Pea (Save Standard Time) expressed views on Standard Time and thanked several professional groups for their statements on the topic.
• Phyllis Payne (Start School Later Healthy Hours) described the group’s membership and the expressed desire to see research knowledge in this area translated into practice across the lifespan, described benefits of later school start time, and encouraged inter-disciplinary research in this area.

CONCLUDING BOARD BUSINESS

Additional comments to be sent to Dr. Brown and Dr. Haddad and were encouraged to return to future meetings to provide further comments. SDRAB chair concluded the meeting and congratulated Dr. Brown on her first 100 days as NCSDR director, and thanked Dr. Dixit and Dr. Baizer for their help.  The meeting adjourned at 5PM on April 1st, 2021.