Despite the large amount of time we humans devote to sleeping, much remains unexplained about the science behind sleep. Now, Stuti Jaiswal, MD, PhD, an assistant professor and sleep researcher at the Scripps Research Digital Trials Center, is working to demystify this field with help from wireless sensor technologies that are making it easier for scientists to gather sleep-related data from people in the comfort of their own homes.
Jaiswal recently sat down for an interview for the Science Changing Life podcast to discuss her research. Here are some of the key takeaways from that conversation.
I can’t remember a time when I didn’t love science. Even as a little kid, I was fascinated by things like earth science and how the human body worked, and that fascination only grew stronger through high school and college. I remember taking one neuroscience class and being completely addicted.
I got into a PhD program in neuroscience, and at the same time was accepted into medical school. So, I ended up doing basic science research while undertaking my medical studies. I initially thought I wouldn’t practice medicine clinically, but as my medical training progressed, I discovered that I loved taking care of patients. I wanted to find a way of combining my passion for science and research with my love of caring for patients.
As a hospitalist, I see patients with a variety of medical conditions who have been admitted for inpatient care. I’m also a nocturnist, so my hospital shifts are primarily at nighttime. Poor sleep is a very common thread across the patients I treat. Too many people have a hard time sleeping while in the hospital given that it’s such a busy environment with care being delivered at odd hours.
Similarly, I see the effects of poor sleep on my colleagues–the nurses, medical students, residents, and other physicians. By focusing my research on sleep medicine, I’m able to link back to some of those core neuroscience principles that sparked my initial interest in science.
Sleep is related to so many different aspects of our health, but there’s so much we don’t know about it.
As people, we generally know when we’re not getting enough sleep. We can’t think clearly, we start to feel sluggish, we might have more aches and pains than normal, and maybe we even feel like metabolically we’re not functioning well because we put on weight.
Studies have shown that lack of sleep impacts our heart health and blood vessels. Untreated obstructive sleep apnea–a form of sleep disorder where a person stops breathing many times during the night–increases our cardiac risk whether through arrhythmias or coronary artery disease. It may also increase our risk of dementia down the line, though researchers are still investigating this.
Up until recently, much of our knowledge of sleep was based on subjective data such as patients’ personal sleep diaries. Objectively, we’ve traditionally only been able to measure sleep in a clinical setting at a sleep lab. There, a person is hooked up to all kinds of wires and cannulas, they have tubes inserted into their nose–it’s quite elaborate.
The integration of accelerometry technology into the devices we use, such as fitness trackers, smartwatches and even smartphones, has allowed us to start gathering more non-invasive, objective measurements of sleep. This allows us to get a better picture of how much people are actually sleeping at night, how many times they are waking up and what their sleep patterns are. And while the data that you are able to collect through fitness trackers is not polysomnography, the gold standard of sleep measurement, it gives us a general view of how a person is sleeping.
We’re trying to harness this information on a large scale to answer clinical questions, including those that have been previously answered with subjectively reported data and new questions like how sleep impacts heart health or obesity outcomes.
We recently launched our first remote digital sleep study—REFRESH. The goal is to learn more about the various physical and psychological dimensions of sleep by recruiting a large cohort of participants, with an emphasis on groups that have historically been underrepresented in biomedical research. By surveying a large group of participants, we can address a variety of questions and run targeted surveys on different sub-sets of the participant population, such as those who suffer from insomnia, sleep apnea or obesity.
The study is 100% remote, so there’s no need for participants to visit a clinic or conduct in-person consultations. Instead, the study is run through an app-based research platform which participants access via their smartphone or a web browser. Once they sync their fitness tracker or smartwatch with the study app, they begin to share their behavioral and physiological metrics with us passively. No identifiable data is shared with the scientists.
By using this digital trial model, anyone anywhere in the United States, who has a wrist-worn wearable, can participate and contribute to this research.
The team at the Scripps Research Translational Institute and the Digital Trials Center are really paving the way for the use of wireless sensors and other digital tools, both in the practice of medicine and in the management of health. They’ve developed a site-less clinical trial model that can be applied to a range of disease areas and health conditions, and they are constantly innovating.
I originally joined the Translational Institute as a KL2 clinical scholar in 2015. The KL2 program is for early career clinicians who are interested in combining their clinical work with translational research. After completing the program, I stayed on to lead the group’s sleep medicine initiative.
I’m part of a women’s tennis league here in San Diego, so I play a lot of tennis. I also have a seven-year-old, who keeps me busy. Otherwise, I enjoy reading. Recently, it has been Regency-era romance novels, which is a genre I just discovered last year. Also the classics, like old Russian literature and Jane Austen. Most recently I’ve been revisiting “Anna Karenina.”
Listen to the full interview on the Science Changing Life podcast and visit refresh.scripps.edu to learn more about the REFRESH sleep study.