This year’s British Sleep Society (BSS) conference, held in Brighton at the Hilton Metropole, featured an invited presentation from Prof Niro Siriwardena, director of CaHRU, entitled ‘Tribulations and trials in primary care insomnia’.
After a welcome to the conference by Professor Mary Morell, President of the BSS, the opening keynote was given by Professor Franco Cappuccio, from the University of Warwick on the topic of ‘Healthy sleep’. This was followed by the opening session of the conference on ‘Sleep and health’ chaired by Professor Graham Law, secretary of the BSS and a member of CaHRU. This session included three presentations. The first was on ‘Sleep and chronic pain: moving from association to causation?’ give by Dr John McBeth, Reader at the University of Manchester. He described the bidirectional relationship between chronic pain and sleep, with pain giving rise to insomnia and sleep disturbance exacerbating or even causing pain. Studies had shown that treating insomnia in people with chronic pain, for example due to fibromyalgia led to improvements in wellbeing and quality of life but no improvement in pain.
Prof Siriwardena next talked about how he had initially developed an interest in the problem of insomnia through initial research into use of sleeping tablets by general practitioners. ‘Tribulations and trials in primary care insomnia’ went on to describe the studies that showed that hypnotic drugs like benzodiazepines and z-drugs though often prescribed for insomnia did more harm than good, and that primary care trials of cognitive behavioural therapy for insomnia (CBT-I) showed positive effects. He went on to describe the work on the Resources for Effective Sleep Treatment (REST) project, a quality improvement project which successfully implemented CBT-I in general practice which led to reduced hypnotic prescribing in those practices. Because of the low uptake of CBT-I in primary care, there was increasing evidence that online or self-help CBT-I was effective with similar effect sizes to face-to-face individual or group therapy. Finally he presented the evidence on short behavioural therapies such as sleep restriction therapy including a forthcoming HTA funded trial led by Oxford University’s Simon Kyle and involving the Universities of Manchester (Peter Bower) and Lincoln (Niro Siriwardena).
The final talk in the session was Dr Eleanor Scott, Senior Lecturer at Leeds University and Consultant Diabetologist at Leeds Teaching Hospitals, who spoke on Sleep and metabolic health, describing the relationship between insomnia and diabetes, obesity and cardiovascular disease. This was followed by Dr Jason Rihel,of University College London discussing his work on sleep in zebrafish and Dr Claire Sexton of Oxford University on her work on sleep related to dementia. Brighton was an excellent setting for a well-attended BSS conference.
By Niro Siriwardena
I have been working on sleep and health for around 7 years now. When I first started there was very little interest. A clinician, on a national funding committee, said to me “why are you worried? Sleep is natural…” I think this attitude is finally changing.
You may have seen an increased interest in the media in relation to sleep. There are news articles, nearly daily, about the new research and the ‘dangers’ of bad sleep. I suppose they need to sell papers. I was recently part of a BBC1 programme (‘The truth about…sleep’) with Michael Mosely. They approached us to conduct some sort of experiment. Working with my colleague (Dr Eleanor Scott) we recorded the blood glucose in 6 participants for a week. During this time, they were required to reduce their time asleep by 3 hours on 2 consecutive nights.
The results took us by surprise. We know that this should have some sort of impact, but all six participants had raised glucose the days after their sleep restriction. And the rise was around 0,5mmol/L which, as well as being statistically significant, is clinically significant. I am busy writing this up for a journal.
Hopefully, we are going to carry on this idea by looking at shift-workers. That is the plan….
By Prof Graham Law
HAVING TROUBLE SLEEPING?
WOULD YOU LIKE TO SLEEP BETTER?
The Oxford Access for Students Improving Sleep (OASIS) study offers an effective state of the art sleep improvement programme to all students who take part. This involves a 6 week course and keeping a sleep diary. The course is delivered via the web and mobile phone. In addition you’d be required to complete online assessments. There are no face to face appointments.
We are offering this as part of a research study to find out if improving students sleep also improves their emotional wellbeing.
To find out if you’re eligible to take part, please register your interest on the study website and you will receive a link to a short sleep test (2 minutes).
The OASIS study is run by Oxford University’s world-leading Sleep and Circadian Neuroscience Institute (SCNi) in collaboration with Lincoln University’s Community and Health Research Unit (CaHRU).
The Resources for Effective Sleep Treatment (REST) project featured in the Health Foundation’s recent newsletter, ‘Stories of outstanding impact in primary care‘. The REST project is an ongoing area of research within the Quality and Outcomes in Primary Healthcare group at CaHRU led by Prof Niro Siriwardena and involving other members of the team including Fiona Togher, Viet-Hai Phung, Dr Coral Sirdifield, Dr Jo Middlemass and Dr Zowie Davy. The project was initially funded by the Health Foundation under their Engaging with Quality in Primary Care scheme to improve primary care for people with insomnia. Subsequent work has been funded by the Research Investment Fund at the University of Lincoln, the EPSRC and the East Midlands Health Innovation and Educational Cluster.
The research seeks to improve treatment for people suffering with sleep problems by promoting a range of treatment options beyond just sleeping tablets and has led to a series of peer-reviewed and highly cited publications in journals such as the British Journal of General Practice, Health Expectations, Sleep, Biomed Central Family Practice, and the British Medical Journal. Subsequent research has also been undertaken in collaboration with other institutions including Universities of Glasgow, Connecticut and Ghent and also Harvard and Oxford Universities.
The project led to its own REST project website (http://restproject.org.uk/) in 2011 and a REST e-learning programme for primary care professionals on how to manage insomnia using non-drug therapy which has been accessed almost 12,000 times by 10,000 users in over 150 countries with over 5,000 users in the UK alone. REST was showcased as one of three impact case studies submitted from CaHRU to REF2014.
CaHRU members, Viet-Hai Phung, Ana Godoy and Dr Jo Middlemass all presented posters at the recent College of Social Science Summer Conference, held at the University of Lincoln Business School on Thursday 2nd July. The purpose of the Conference was to showcase a range of work from across the College of Social Science that had been funded by its small grants scheme.
Ana was busiest as she presented four posters: Resources for Effective Sleep Treatment utilising Community Pharmacists (REST-UP), bisphosphonates and stroke and two for Quality and Costs of Primary Care in Europe (QUALICOPC)! Jo and Viet-Hai presented their work on dementia and ethnic inequalities in prehospital care respectively. All six posters generated considerable interest from attendees. Research from the wider School of Health and Social Care was also very well represented. Alongside the poster sessions were three sessions with 20 oral presentations from PhD students and staff. As with the posters, the oral presentations captured the diversity of the College’s work: from the work of the Red Cross to the future of Christmas markets; from gender identities and football through to the psychology of decision-making; from empathy in nursing to branding cities.
It is sometimes felt that students and academics rarely know what research colleagues in other parts of a School or College do. If the university is serious about raising awareness about the work of different departments, schools and colleges, then events such as this should become a permanent fixture in the academic calendar.