Vol. 7 No. 4
February/March 2005

Anatomy of a Lullaby
In Emory's growing sleep research program, scholars encounter mystery and paradox

Stealing breath and life
Sleep Apnea

We do have some very good people [in sleep research], and we’re gaining a critical mass to do this kind of work.
Donald L. Bliwise, Professor of Neurology, Program Director, Sleep, Aging and Chronobiology

I think there are valuable things we can learn about how plastic or mutable the circadian system is by looking at people who travel abroad and contend with jet lag, or people from different cultures.
Hillary Rodman, Associate Professor of Psychology

The Power of Sleep
Exploring disorder and disturbance
Kathy P. Parker, Edith F. Honeycutt Professor of Nursing

What’s A Few Drinks Between Friends?
Exploring the ancient drinking party with students
Peter Bing, Associate Professor of Classics

Transforming
and Transformative Knowledge
Practicing what we profess
Karen D. Scheib, Associate Professor of Pastoral Care and Pastoral Theology

Further reading

Endnotes

Return to Contents

Academic Exchange: What’s most important to know about the relationship between sleep and medicine?

Don Bliwise: There are three cardinal tenets of sleep medicine. First, diseases don’t disappear when patients go to sleep. The manifestations of a disease may change, but the diseases are still there (in some cases they may be worse), and for many years medicine has ignored that. Second, the treatment of any particular disease can have greater or lesser benefit depending on the time of day it is administered. And third, there are some diseases that are unique to sleep and occur only when a patient is asleep. These constitute the bulk of clinical practice in most sleep disorders centers.

AE: How do aging and sleep interact?

DB: There are predictable changes in the body clock with age. The timing of the minimum of the body temperature cycle is related to the age of a person, such that minimum temperature occurs earlier (relative to clock time) in an older person than in a younger one. That explains a lot about the chronobiologic changes we see as a function of age. For example, why do college students stay up until four in the morning? Yes, they’re socializing, but their biologic clock predisposes them to have a very delayed minimum body temperature nadir, and they don’t get sleepy until late into the night. By contrast, an older person’s body temperature minimum occurs much earlier in their twenty-four-hour day, and that compels them to go to bed earlier in the evening, wake up too early in the morning, and be unable to get back to sleep.

AE: How does Emory fit into the broader picture of sleep research?

DB: Emory has come a little late into the game. The University of Chicago and Stanford have long-standing histories in sleep research. rem sleep was discovered at the University of Chicago in 1953. Stanford pioneered the development of sleep disorders medicine as a subfield. There’s been phenomenal growth in
clinical sleep disorders medicine. Most major hospitals have a sleep disorders laboratory associated with them. It would be no different than having a pulmonary or electrocardiology lab.
We have unique situation: a four-bed lab dedicated only for research and a four-bed clinical lab for sleep disorders clinic patients. But even our eight beds combined is much smaller than other academic medical centers, and I would like to see that expand to sixteen or twenty beds to put us on par with other major academic medical centers like Pennsylvania, Harvard, and Stanford. We do have some very good people, and we’re gaining a critical mass to do this kind of work. There are so many potential avenues of research: basic science, animal and human models of disease, basic descriptive human research on sleep in normal subjects ranging from infants to children, adults, and geriatrics, even dementia. Intervention studies and clinical trials are also essential. We have people at Emory working in many of those areas. It’s just a smaller group than at some of the other academic centers.

AE: Do we know why we sleep?

DB: The definitive function and purpose of sleep remain uncertain. There are many clues, and they are all derive from different kinds of research. If you go down each experimental path, certain clues emerge. For example, sleep deprivation studies show that immune function may be compromised during long periods of sleep deprivation, implying that one of the functions of sleep is to preserve immune function. But it’s not as simple as that, because you can miss a night of sleep and not come down with the flu the next day.

Another line of research looks at sleep loss and the ability to regulate glucose. You can’t regulate glucose—which is the fundamental source of energy for the body—as well if you’re sleep deprived. Yet another line of research shows that if you deprive animals of sleep, their ability to regulate their body temperature decreases. After prolonged periods of time, the predominant effect of that kind of severe kind of sleep loss is to produce a hypermetabolic state, and the animal eats huge amounts of food but still cannot regulate its temperature. That implies that sleep loss is critical to regulation of body temperature. Also, when animals are then allowed to have recovery sleep and then given a choice of temperatures in which to sleep, they tend to choose warmer environments in direct proportion to the extent of their sleep loss. Sleep seems to be involved integrally in all of those processes, as well as many others, such as memory, learning, and mood. But exactly what constitutes the processes by which sleep routinely helps us maintain homeostasis and recover those many functions remains tantalizingly elusive.