Insomnia, Shift Work And Body Clock Disruption - FHMRI Sleep Health

Insomnia and sleep disruption is common and affects people of all ages. There are many different reasons for insomnia. We are developing and improving a range of therapies to help solve these issues.

Work, environmental noise, sleep habits, mistimed body clocks, conditioned or habitual insomnia, medications and underlying medical disorders are among the most common causes.

Shift work can also impact our health and wellbeing. Trying to fit our social, work and other lifestyle responsibilities around a schedule which is not 9am- 5pm has implications for how we feel in ourselves, and our safety on the road and at work.

OUR RESEARCH

Our research is developing a range of improved, easy to access therapies including advanced programs and services in CBTi - Cognitive Behaviour Therapy for Insomnia, Stimulus Control, Sleep Restriction, Intensive Sleep Re-training, and Bright Light Therapies to treat insomnia, shift work disorder and body clock disruption.

Innovations in technology have presented us with the opportunity to investigate circadian core body temperature cycles and study smart lighting and its effects on the body clock, sleep and performance.

For example, Co-Morbid Insomnia and Sleep Apnoea (COMISA) is a highly prevalent and debilitating condition that can be more complex to treat effectively compared to either insomnia alone or sleep apnoea alone.

In addition, using these emerging technologies and improved therapies to support shift worker health, together with a deeper understanding of the patient experience of living with sleep disorders, is a priority for our group.

This research is also aligned with our Sleep Health Treatment Clinic.

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^{Photo credit: FHMRI Sleep Health - Nick Antic Sleep laboratory bedroom (courtesy of Cheeseman Architects)}

Current research projects include:

National Health and Medical Research Council funded Centre for Research Excellence investigation of the non-pharmacological management of insomnia in primary care.
Circadian optimised submariner performance through smart LED lighting - a project to investigate a strategy to help maximise human cognitive effectiveness in an encapsulated work environment through evidence based LED lighting design interventions.
Increasing the Australian cohort of psychologists capable of administering cognitive/behavioural therapy for insomnia.
Understanding the clinical characteristics and treatment efficacy for insomnia phenotypes.
Understanding the underlying causes of Co-Morbid Insomnia and Sleep Apnoea (COMISA), to develop more effective treatment approaches, and implement these treatments throughout the healthcare system.
A large three-year grant funded by the American Association of Sleep Medicine for the treatment of insomnia. This randomised controlled trial will test the effectiveness of the new THIM wearable device to administer the brief Intensive Sleep Re-training treatment of insomnia in comparison with a commercially available on-line therapy and the combination of the two together.
Understanding the patient experiences and perspectives of shift workers with clinical sleep disorders.
Flinders Foundation funded research into early intervention to identify and treat sleep disorders before young shift workers enter the workforce.
Safework SA funded research to understand the experiences of paramedics with shift work, sleep loss and fatigue, with a targeted approach to improve early education and support for our young paramedics.
In depth assessments of the relationships between insomnia and daytime functioning.
Exploring the interactions between insomnia, age, and longevity.
Understanding the effects of noise on sleep.

Featured publications

Cognitive behavioural therapy for insomnia reduces sleep apnoea severity: a randomised controlled trial Sweetman, A., Lack, L., McEvoy, R. D., Antic, N. A., Smith, S., Chai-Coetzer, C. L., Douglas, J., O'Grady, A., Dunn, N., Robinson, J., Paul, D., Eckert, D. & Catcheside, P. G., Apr 2020, In: ERJ Open Research. 6, 2, 9 p., 00161-2020.

Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA) Sweetman, A., Lack, L., McEvoy, R. D., Smith, S., Eckert, D. J., Osman, A., Carberry, J. C., Wallace, D., Nguyen, P. D. & Catcheside, P., Dec 2021, In: Sleep Medicine Reviews. 60, 14 p., 101519.

The effect of wind turbine noise on polysomnographically measured and self-reported sleep latency in wind turbine noise naïve participants Liebich, T., Lack, L., Micic, G., Hansen, K., Zajamšek, B., Dunbar, C., Lechat, B., Scott, H., Lovato, N., Decup, F., Nguyen, D. P. & Catcheside, P., 1 Jan 2022, In: SLEEP. 45, 1, 11 p., zsab283.

Intensive sleep retraining treatment for insomnia administered by smartphone in the home: an uncontrolled pilot study. Mair, A., Scott, H. & Lack, L., 1 Jun 2022, In: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. 18, 6, p. 1515-1522 8 p.
Longitudinal studies of sleep, physical activity and nutritional intake in shift workers: A scoping review. Crowther, ME, Ferguson, SA & Reynolds, AC (2022). Sleep Med Rev, 63, 101612
The management of insomnia by Australian psychologists: a qualitative study. Haycock, J., Hoon, E., Sweetman, A., Lack, L. & Lovato, N., 27 Jun 2022, (E-pub ahead of print) In: Australian Psychologist. 11 p.
Prevalence of common sleep disorders in a middle-aged community sample. McArdle, N, Reynolds, AC, Hillman, D, Moses, E, Maddison, K, Melton, P & Eastwood, P (2022). J Clin Sleep Med, 18(6), 1503-1514
An experimental investigation on the impact of wind turbine noise on polysomnography-measured and sleep diary-determined sleep outcomes. Liebich, T., Lack, L., Hansen, K., Zajamsek, B., Micic, G., Lechat, B., Dunbar, C., Nguyen, D. P., Scott, H. & Catcheside, P., 14 Apr 2022, (E-pub ahead of print) In: Sleep. 16 p.
Sleep's role in the development and resolution of adolescent depression. Gradisar, M., Kahn, M., Micic, G., Short, M., Reynolds, C., Orchard, F., Bauducco, S., Bartel, K., Richardson, C. 2022 Jun 20;1-12. Nat Rev Psychol. doi: 10.1038/s44159-022-00074-8. (Online ahead of print).
Comorbid insomnia and sleep apnoea is associated with all-cause mortality. Lechat, B., Appleton, S., Melaku, Y. A., Hansen, K., McEvoy, R. D., Adams, R., ... & Sweetman, A. (2022). European Respiratory Journal, 60(1).
Primary care management of chronic insomnia: a qualitative analysis of the attitudes and experiences of Australian general practitioners. Haycock, J., Grivell, N., Redman, A., Saini, B., Vakulin, A., Lack, L., Lovato, N., Sweetman, A., Zwar, N., Stocks, N., Frank, O., Mukherjee, S., Adams, R., McEvoy, R. D. & Hoon, E., 22 Jul 2021, In: BMC Family Practice. 22, 11 p., 158.
Prevalence of probable shift work disorder in non-standard work schedules and associations with sleep, health and safety outcomes: A cross-sectional analysis. Reynolds, AC, Ferguson, SA, Appleton, SL, Crowther, ME, Melaku, YA, Gill, TK, Rajaratnam, SMW, & Adams, RJ (2021) Nat Sci Sleep, 31, 683-693
Circadian tau differences and rhythm associations in Delayed Sleep-Wake Phase Disorder and sighted Non-24-Hour Sleep-Wake Rhythm Disorder. Micic, G., Lovato, N., Ferguson, S., Burgess, H. & Lack, L., Jan 2021, In: Sleep. 44, 1, 12 p., zsaa132.
Sleep misestimation among older adults suffering from insomnia with short and normal objective sleep duration and the effects of cognitive behavior therapy. Lovato, N., Micic, G. & Lack, L., 1 May 2021, In: SLEEP. 44, 5, 8 p., zsaa250.
The accuracy of the THIM wearable device for estimating sleep onset latency. Scott, H., Whitelaw, A., Canty, A., Lovato, N., Lack, L. (2021). Journal of Clinical Sleep Medicine, 17(5), 973-981. https://doi.org/10.5664/jcsm.9070.
Emerging Approaches to Better Define Sleep Disruption and Its Consequences. Lechat, B., Scott, H., Naik, G., Hansen, K., Nguyen, D. P., Vakulin, A., Catcheside, P., Eckert, D. J. (2021). New and Frontiers in Neuroscience, 15, [751730]. https://doi.org/10.3389/fnins.2021.751730
The development and accuracy of the THIM wearable device for estimating sleep and wakefulness. Scott, H., Lovato, N., Lack, L. (2021). Nature and Science of Sleep, 13, 39-53. https://doi.org/10.2147/NSS.S287048
Economic evaluation of cognitive behavioural therapy for insomnia (CBT-I) for improving health outcomes in adult populations: A systematic review. Natsky, A. N., Vakulin, A., Chai-Coetzer, C. L., Lack, L., McEvoy, R. D., Lovato, N., Sweetman, A., Gordon, C. J., Adams, R. J. & Kaambwa, B., Dec 2020, In: Sleep Medicine Reviews. 54, 101351.
The shift work and health research agenda: Considering changes in gut microbiota as a pathway linking shift work, sleep loss and circadian misalignment, and metabolic disease. Reynolds, AC, Paterson, JL, Ferguson, SA, Stanley, D, Wright, KP & Dawson, D (2017). Sleep Med Rev, 34, 3-9
A systematic review and meta-analysis of wind turbine noise effects on sleep using validated objective and subjective sleep assessments. Liebich, T., Lack, L., Hansen, K., Zajamšek, B., Lovato, N., Catcheside, P. & Micic, G., Aug 2021, In: Journal of Sleep Research. 30, 4, 24 p., e13228.
A systematic review of the accuracy of sleep wearable devices for estimating sleep onset. Scott, H., Lack, L., Lovato, N. (2020). Sleep Medicine Reviews, 49, [101227]. https://doi.org/10.1016/j.smrv.2019.101227
Sleep and circadian wearable technologies: considerations toward device validation and application. Scott, H. (2020). SLEEP, 43(12), [zsaa163]. https://doi.org/10.1093/sleep/zsaa163
The effect of cognitive and behavioral therapy for insomnia on week-to-week changes in sleepiness and sleep parameters in patients with comorbid insomnia and sleep apnea: A randomized controlled trial. Sweetman, A., McEvoy, R. D., Smith, S., Catcheside, P., Antic, N., Chai-Coetzer, C., Douglas, J., O'Grady, M., Dunn, N., Robinson, J., Paul, D., Williamson, P. & Lack, L., 13 Jul 2020, In: SLEEP. 43, 7, p. 1-13 13 p., ZSAA002.
Cognitive and behavioral therapy for insomnia increases the use of continuous positive airway pressure therapy in obstructive sleep apnea participants with comorbid insomnia: a randomized clinical trial. Sweetman, A., Lack, L., Catcheside, P. G., Antic, N. A., Smith, S., Chai-Coetzer, C. L., Douglas, J., O'Grady, A., Dunn, N., Robinson, J., Paul, D., Williamson, P. & McEvoy, R. D., 24 Dec 2019, In: SLEEP. 42, 12, 12 p., zsz178.
Insomnia and mortality: A meta-analysis. Lovato, N. & Lack, L., 1 Feb 2019, In: Sleep Medicine Reviews. 43, p. 71-83 13 p.
Sickness absenteeism is associated with sleep problems independent of sleep disorders: Results of the 2016 Sleep Health Foundation national survey. Reynolds, AC, Appleton, SL, Gill, TK, Taylor, AW, McEvoy, RD, Ferguson, SA & Adams, RJ (2017). Sleep Health, 3(5) 357-361.
Developing a successful treatment for co-morbid insomnia and sleep apnoea. Sweetman, A. M., Lack, L. C., Catcheside, P. G., Antic, N. A., Chai-Coetzer, C. L., Smith, S. S., ... & McEvoy, R. D. (2017). Sleep Medicine Reviews, 33, 28-38.
Does comorbid obstructive sleep apnea impair the effectiveness of cognitive and behavioral therapy for insomnia? Sweetman, A., Lack, L., Lambert, S., Gradisar, M., & Harris, J. (2017). Sleep medicine, 39, 38-46.

Resources

THIM Device website

Practice guide for GP Brief Behavioural Therapy for Insomnia

Online GP insomnia and obstructive sleep apnoea guideline

GROUP MEMBERS

Associate Professor Nicole Lovato
Research theme Co-lead

Dr Nicole Lovato is a senior clinical researcher focused on the basic and clinical aspects of sleep, circadian rhythms, and sleep disorders such as insomnia, and the translation of this knowledge to ensure best-practice sleep healthcare is accessible and cost-effective for the community. Dr Lovato has developed new innovative therapeutic interventions and models of care for the management of chronic insomnia and associated mental ill-health.

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Associate Professor Amy Reynolds
Research theme Co-lead

Dr Amy Reynolds is a clinical epidemiology with a particular research interest in work schedules, health and safety. She regularly works with industry partners to better understand the relationship between work schedules, sleep, health and safety. She has published extensively on the relationship between work, sleep, productivity and safety.

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Emeritus Professor, Leon Lack
Research theme Co-Lead

Emeritus Professor Leon Lack brings to this group a 45-year history of research, teaching, and clinical practice in the areas of sleep, circadian rhythms, insomnia, and clinical treatments for these disorders. This broad experience has also resulted in the development of new treatments of insomnia involving the use of wearable devices to make treatments readily available in the home environment to the large percentage of the population suffering from these disorders.

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Professor Peter Catcheside

Research Fellow Gorica Micic

Research Fellow Alexander Sweetman

Research Associate Hannah Scott

Alisha Guyett,
PhD Candidate

Brandon Brown,
PhD Candidate

Claire Dunbar,
PhD Candidate

Darah-Bree Bensen-Boakes,
PhD Candidate

Gizework Desalegn,
PhD Candidate

Jack Manners,
PhD Candidate

Jenny Haycock,
PhD Candidate

Kelsey Bickley,
PhD Candidate

Nikki Stuart,
PhD Candidate

Sian Wanstall,
PhD Candidate

WORK WITH US

We have strong collaborations with academic partners, government bodies and professional organisations. In addition, we work with a range of strategic industry partners to advance sleep health solutions.

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