The newsletter of the Australian Sleep Trials Network www.sleeptrials.net
JUNE 2009
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he Institute for Breathing and Sleep (IBAS) at Austin Health, based in Melbourne, has obtained $4.99 million from the Victorian Neurotrauma Initiative for Sleep Health in Quadriplegia research.
The research program aims to improve the sleep health, functional outcomes and quality of life of people with quadriplegia, and consists of six projects to be completed within five years. Two of the six projects will commence data collection in 2009.
Sleep Health in Quadriplegia (SHiQ) Progress Report
The largest project, the COSAQ study, is a prospective, randomised controlled trial of auto-titrating continuous positive airway pressure treatment for obstructive sleep apnea after acute quadriplegia. IBAS aims to establish whether the burden of using CPAP is outweighed by the benefit, and as such, if the primary outcome measure is improvement in neurocognitive function. This multi-centre, multinational trial will recruit participants from within Australia (Melbourne, Sydney and Brisbane), and overseas in hospitals in New Zealand (Christchurch), Canada (Vancouver) and the United Kingdom (Stoke Mandeville & Sheffield). Ethics approval for COSAQ has been obtained by Austin Health and recruitment has commenced. The remaining sites will be recruiting by the end of the year. Another study “Sleep disruption in quadriplegia, its hormonal basis and a randomised controlled trial of melatonin supplementation” aims to investigate whether exogenous melatonin supplementation improves sleep and function in quadriplegia. People with complete quadriplegia have essentially no circulating melatonin or diurnal rhythm. IBAS is currently awaiting ethics approval and expects to commence recruitment to the study in July. Three projects investigating the mechanisms of obstructive sleep apnoea in quadriplegia were also funded within the SHiQ program. Currently IBAS is recruiting staff and post-doctoral students to these projects, and expects to commence data collection in 2010. A key goal of the SHiQ research program is to translate research findings into improved identification and management of sleep disorders in people with quadriplegia. A Research Translation committee has been formed, and will commence drafting guidelines for the management of respiratory sleep disorders in quadriplegia this year. A new team of project staff has recently been employed by IBAS to manage and coordinate the SHiQ research program, and staff have commenced their new roles. The new staff are: Susan Delaney – Program Manager, SHiQ Elizabeth Hammond – Administrative Assistant, SHiQ For more information contact Marnie Graco – Project Manager, COSAQ E. Marnie.GRACO@austin.org.au
A key goal of the SHiQ research program is to translate research findings into improved identification and management of sleep disorders in people with quadriplegia.
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ASTN Open Forum
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ver 40 delegates attended the ASTN’s Open Forum on the 2nd May at the Woolcock Institute of Medical Research in Sydney. After introductions and updates on current studies, the group workshops began with the morning sessions dedicated to obstructive sleep apnea and shiftwork. The afternoon sessions included workshops on insomnia, non-invasive ventilation, non-REM parasomnias (sleep walking), and a presentation on sleep in autism. With delegates from Australia and New Zealand participating, the ‘Open Forum’ format provided a great opportunity for researchers to discuss areas of research need, the status of current proposals and opportunities for collaboration. The contribution of all those attending was greatly appreciated and provided direction and focus in these important areas of sleep research. The ASTN will be hosting another Open Forum meeting in October in Melbourne on Wednesday 7th October (from 3pm-6pm) as part of the Australasian Sleep Association Annual Meeting and invite all researchers with an interest in sleep research to attend.
Insomnia Workshop – Friday 31st July, 2009 – Sydney
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he Australasian Sleep Trials Network is hosting an insomnia research workshop where researchers can work together to identify key research questions, discuss ongoing and proposed trials and establish new investigator relationships. The ‘Strengthening Insomnia Research’ workshop will be held at the Woolcock Institute of Medical Research in Glebe, Sydney on Friday 31st July, 2009. The workshop will be held from 10am to 3pm and will be facilitated by Professor Dan Buysse from the School of Medicine at the University of Pittsburgh, USA. Professor Buysse’s research interests focus on insomnia, sleep in ageing, and sleep in psychiatric disorders, particularly sleep in depression. His work includes the assessment, diagnostic reliability, and pharmacologic treatment of insomnia, circadian aspects of age-related sleep changes, and sleep correlations of treatment outcome in depression. Join Professor Buysse and other sleep specialists in discussions on : • Insomnia literacy • The burden of disease • Measuring sleep disturbance • Risk factors, interventions and outcomes • Quality use of medicines • Insomnia and depression • The role of pharmacy All interested researchers are welcome. Registration is free and a travel subsidy is available to all interstate attendees – $300 for attendees from Western Australia and $150 for attendees from other states. The Australasian Sleep Trials Network is funded by the NHMRC to facilitate multicentre clinical trials in sleep-health. To register contact Anthony Williams at: info@sleeptrials.net
Sleep Apnea Cardiovascular Endpoints Study (SAVE)
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AVE is an investigator initiated and conducted collaborative, multi-centre, open label randomised control trial of CPAP for the treatment of obstructive sleep apnea to prevent cardiovascular disease. SAVE is the world’s only trial sufficiently powered to demonstrate the cardiovascular morbidity and mortality benefits of CPAP . SAVE currently has 31 sites in China and 13 sites in Australia. In India there are 27 sites that have registered their interest in participating in the study. We have invited these investigators and their research coordinators to join us for the trial launch in Hyderabad, India in June of this year. SAVE is aiming to have four sites in New Zealand by late 2009. So far, 85 patients have been randomised into the study – 15 of these are from Australia and 70 are from China. For more information about the study please contact: Dr Samantha Mead SAVE Senior Executive Officer E. Samantha.mead@health.sa.gov.au T. (08) 8275 2879
www.sleeptrials.net
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Practical Approach to Common Sleep Problems Across the Life Span
Wednesday 7th October • Sofitel Melbourne on Collins
Clinical Epidemiology & Biostatistics for Sleep
Wednesday, 7 October, 2009 Sofitel Melbourne on Collins
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his course is rich in data and methodology, and is perfect for researchers and supervisors interested in, or practising in, the field of sleep research and medicine. Clinical Epidemiology and Biostatistics for Sleep is a one-day, postgraduate course that provides practical instruction on methodological and statistical issues by the use of examples that are specific to sleep research. These seminars will be presented by researchers who have published sleep research using that methodology and/or regularly teach these methods. Level of knowledge required: We assume that you have completed at least a 100 level statistics course in the past and that you require a level of knowledge refreshment. Course suitable for: Graduate students, sleep physicians and surgeons, nurses, sleep technologists, and allied health professionals including physiotherapists. Course Goals: To improve your understanding of the practical problems in study design and analysis of sleep related data. We aim to improve beyond 100 level your ability to understand, critique and produce study designs and statistical analyses. This course is held on behalf of the Australasian Sleep Trial Network (ASTN) biostatistics group. The course is sponsored by Australasian Sleep Trials Network and student registration fees are heavily subsidised.
his course aims to provide a background to normal sleep in infants, children, adolescents and adults, and outlines the different sleep patterns and problems that may occur at different life stages. It will focus on understanding the effects of sleep disturbance in different age groups, and will provide strategies for identification and management of common sleep problems. For further information: www.sleep.org.au T. 9920 1968 E. conference@sleep.org.au
Professor Rob Pierce
15.1.1947- 7.2.2009
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olleagues and friends of Professor Robert John Pierce were saddened by his recent tragic death in the Black Saturday firestorm on 7 February 2009. Professor Pierce graduated in Medicine from the University of Melbourne in 1970 and completed his residency at St Vincent’s Hospital and Repatriation General Hospital, Heidelberg, Melbourne. During the 1970s, Rob was one of a cohort of young Australian physicians who pursued their training in the United Kingdom, and it was here that he made his initial mark in respiratory health. Eventually returning to Australia, Rob worked extensively in the field of pulmonary physiology, asthma, chronic obstructive pulmonary disease and lung cancer. He was a pioneer in the field of research into the importance of sleep and the impact he made in this field is unable to be measured. In 2000 he founded the Institute for Breathing and Sleep in order to promote not only research, but also education and public advocacy in respiratory and sleep medicine. He enjoyed collaborative multi-centre research, and with interstate colleagues he developed clinical trials in ventilation in COPD (AVCAL) and treatment of mild sleep apnea (mOSA). He was also a founding investigator of the Australasian Sleep Trials Network. His abiding interest in respiratory and sleep health in Indigenous Australians was greatly deepened during a sabbatical in 2006 which he spent travelling and working in northern Australia. Rob always maintained his clinical skills and was loved by his patients, many of whom became his friends. A true mentor and international leader in the field of sleep and respiratory orders, Rob is survived by his wife Jan, their children Chris, Lucy, Nick and Tristan and their families and his parents. Taken from us all so suddenly, he will be sadly missed.
Cost
Student Members of ASA/ASTN: $50 Members of ASA/ASTA: $350.00 Non-Members: $400
For further information:
www.sleep.org.au T. 9920 1968 E. conference@sleep.org.au
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National Ethics Application Form
www.sleeptrials.net
ASA Conference
8–10 October, 2009 – Sofitel Melbourne on Collins
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he National Ethics Application Form (NEAF 2) is a webbased tool that has been developed for all research applicants completing submissions to the Human Research Ethics Committees (HREC). Using the one application to standardise the procedure on a national level, while still meeting the requirements of Good Clinical Practice (GCP) and all ethical standards, the aim of a national system is to increase efficiency while still maintaining quality review of proposed research. The main body is the National Health and Medical Research Centre (NHMRC). The NHMRC has developed policies and a national strategy to co-ordinate this approach for all areas of research. The principles for a national approach are: • Efficiency – improve timelines to allow quicker start-up • Collaboration • Verifiable • Compliance – national standards • Competent ethical review for the research subject safety The national approach will offer common policies and procedures for all states to utilise and allow trust building, better understanding and information-sharing. For more information visit: www.neaf.gov.au
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he 21st Annual Scientific Meeting of Australasian Sleep Association (ASA) and Australasian Sleep Technologists Association (ASTA), ‘Visions of the Night: Sleep Science and Research on the World Stage’ will be held at the Sofitel Melbourne on Collins from Thursday 8 October to Saturday 10 October, 2009. This year’s meeting will explore the importance of sleep for good health and function, as well as the impact of disease and lifestyle factors. A panel of world-renown speakers will discuss the latest developments in cardiovascular health and sleep disorders, the use of melatonin for treating circadian rhythm sleep disorders, and the physiology of the upper airway. In addition, a special plenary session will closely examine the contentious issue of driver fatigue and the scientific basis and practical considerations for managing this within the transport industry and wider community. The line-up of international guest speakers at this year’s meeting is impressive, and includes Professor Anna WirzJustice, Emeritus Professor at the Centre for Chronobiology, Psychiatric University Clinics Basel, Switzerland. Professor Wirz-Justice is highly regarded in sleep medicine circles for her research into the effects of light and melatonin on mood, alertness, performance and thermoregulation. She will be joined at the meeting by Associate Professor David Rapoport, Director of the New York University Sleep Medicine Program and Associate Director of the Bellevue Hospital Pulmonary Function Laboratory. Professor Rapoport has been involved in the development of nasal CPAP since its origin. He has developed modifications for its delivery and is currently working on using this tool to help understanding in the pathophysiology of the syndrome. Professor Claudio Bassetti, an eminent neurologist and current President of the European Sleep Research Society will also take centre stage to discuss the neurobiology of REM sleep behaviour disorder, and the clinical and etiological developments in the understanding and management of narcolepsy-cataplexy. Professor Nick Hill is Chief of the Pulmonary, Critical Care and Sleep Division at Tufts-New England Medical Center, and a Professor of Medicine at Tufts University School of Medicine, Massachusetts. For further information: www.sleep.org.au, T. + 61 2 9920 1968 • E. conference@sleep.org.au
The Australasian Sleep Trials Network is funded by an NHMRC Enabling Grant For further information or to be added to the mailing list contact: Anthony Williams National Research Manager T. (02) 6687 9185 F. (02) 6687 8305 M. 0411 895 226 E. info@sleeptrials.net www.sleeptrials.net Mail: ASTN c/o Woolcock Institute of Medical Research, PO Box M77 , Missenden Road, NSW 2050 The mission of the Australasian Sleep Trials Network is to conduct and facilitate clinical trials of national and international significance that will have a major impact on sleep health. It will achieve this mission principally through investigator driven trials, funded by government or industry. The ASTN is funded by an NHMRC Enabling Grant to facilitate investigator-initiated multicentre clinical trials in sleep health. It covers the full range of sleep disorders, including insomnia, circadian disturbances and neurological disorders as well as sleep breathing disorders. Visit the Australasian Sleep Trials Network website at www.sleeptrials.net to see: • assistance provided by the ASTN including biostatistics, study design, health economics, genetics and protocol development • what to do to discuss a study idea with the ASTN • how the ASTN is managed • reports from ASTN Open Forums • ASTN newsletters • news about upcoming ASTN events