Waking up to the need for sleep research

We do it all the time, yet its very essence is wreathed in mystery, old wives’ tales and misunderstanding, writes Danny Buckland

As a topic of conversation, it is probably only outdone by the weather and house prices, but it is the most fundamental part of our existence that remains under-researched. Our conception of sleep has been influenced by handed-me-down advice on counting sheep and nightcaps, and reinforced by the examples of world leaders who celebrated an ability to function on as little as four hours’ sleep a night.

But all that is changing as an alliance of neuroscience, psychiatry and bio-engineering probes deeper into the complex corners of the brain and learns more about the 24-hour circadian rhythms that drive the body clock. The tangle of neurotransmitter pathways and hormones is being unravelled and with this comes the power to help beat conditions from diabetes to depression as well as ensuring we get a good night’s sleep.

The science of sleep is emerging as a critical clinical discipline and the recently established Sleep and Circadian Neuroscience Institute (SCNi) at the University of Oxford is the first of its kind worldwide dedicated to the neuroscience of sleep, and advancing our understanding of how sleep and circadian rhythm disruption impacts health.

The Wellcome Trust propelled the institute into life with a £5-million grant programme, which has just completed its first year, and its pioneering work is attracting other supporters who are considering awarding substantial funding. The prize is not just the analysis of the mechanics of sleep, but solutions to a range of conditions and diseases that cause untold misery, and drain billions of pounds in healthcare resources.

“It is a hugely important area of science and medicine. It has implications for all areas, although our focus for the moment is psychiatric disorders,” says SCNi research co-ordinator Eleanor Waite. “There is scope for research across a whole breadth of medicine, and we hope that it will lead to early and better treatments for a range of conditions.”

The prize is solutions to conditions and diseases that cause untold misery, and drain billions of pounds in healthcare resources

John Williams, head of clinical activities for the Wellcome Trust, says: “Sleep is fundamental to our ability to function and lead normal, healthy lives. The study of sleep hasn’t had the necessary visibility, and it is only in the last ten years or so that we have been able to develop the tools and technique to genuinely understand what is going on. We now need to understand the very rhythms – the circadian rhythms – that underpin and drive our sleep-wake states.

“It is a very exciting time because a collaboration of world-class researchers, who sit in different domains such as psychiatry and physiology, has been assembled at Oxford to unravel and employ all the latest technologies and techniques that are going to unpack these problems and make the work transformative.”

Dr Williams adds that new research in sleep could help with optimising shift work in roles from the flight decks of jumbo jets to the factory floor and also potential restructuring of the school day to fit in with radical sleep-pattern changes in adolescents.

The grant-funded work, led by the Nuffield Department of Clinical Neurosciences and based at Oxford’s John Radcliffe Hospital, will report over a five-year period, and such is sleep’s move from a relatively obscure branch of science that the SCNi is starting a programme of summer schools this year for post-graduate students and early-career scientists.

The SCNi also hopes to produce a range of educational tools so that its critical findings will be shared across the health spectrum with the first advice dealing with mental health. It may seem an obvious step, but for sleep it is a giant bound forward.

The need to address sleep on a more scientific and condition-specific focus is being recognised across healthcare. The charity Rethink Mental Illness launched a Christmas appeal to fund £3 sleep packs, containing lavender oil, ear plugs, a hot malted drink and a sleep tips booklet, to help people with mental health issues during what can be a challenging time of year for them.

And Arthritis Research UK has highlighted the sleep problems of people in chronic pain. It advocates greater awareness about good practice and smashing the myths that entrench poor behaviour. For those involved at the sharp end of science and illness, it is clear that sleep is a potent force that can be easily mishandled.

We have tended to sit back and admire the examples of legendary short-sleepers, such as Margaret Thatcher and Bill Clinton, but now we are developing the science to understand with greater certainty what makes the brain tick at night.

Over the next decade, sleep will consign its myths and homely advice to folklore as advances in science and healthcare make sure that sleep does not remain in the dark ages.