CANA Global CONNECT Vol. 1, Issue 2 – Research Highlights

Dr. Lichuan Ye’s Program of Research on Sleep

Sleep is underrated. In hospitals, on college campuses, and across our fast-paced society, sleep’s vital role in health is generally minimized and misunderstood. Obstructive sleep apnea (OSA), the most common sleep disorder, affects nearly one in five adults, making it a major public health problem on par with smoking. Yet much remains undiscovered about OSA and its effective management. I have made it my goal to research sleep and sleep disorders, spread awareness, and ultimately improve health outcomes. With the commitment to promoting health through better sleep and better management of sleep disorders, my program of research has progressed towards meeting this goal, with three major aims:

I: Improving understanding of OSA clinical presentations to facilitate earlier diagnosis

In my first study as the Principal Investigator (PI), I examined different symptom experiences and quality of life in patients with OSA. I was struck by how few female patients were enrolled in my study and represented in the scientific literature on OSA, and to hear how OSA was typically characterized as a “male” disease. Wondering if vast numbers of OSA cases among women were going clinically unrecognized, I examined gender differences in OSA clinical presentations for my dissertation. Building on this foundation, I have published several articles on the topic, including an integrative review in Sleep Medicine as well as an empirical study in the Journal of Clinical Sleep Medicine in 2009. This research was the first reported study to examine gender differences in response to continuous positive airway pressure (CPAP) treatment, and was chosen for inclusion in Best of Sleep Medicine 2011 by Lee-Chiong, Teofilo (Ed). Later on, I have partnered with researchers at the University of Pennsylvania School of Medicine and the National University Hospital of Iceland to identify clinical phenotypes of OSA using cluster analysis. We examined all diagnosed OSA patients throughout the entire population of Iceland. We identified three distinct patterns of clinical presentation, including “disturbed sleep group”, “minimally symptomatically group”, and “excessive daytime sleepiness group”. This is the first attempt to explore the heterogeneity of OSA clinical presentations with a data-driven approach, the goal being to identify symptoms earlier and target therapies more precisely. The article was published at the European Respiratory Journal in 2014, the official journal of the European Respiratory Society and a top journal in respiratory medicine. To increase the proportion of persons with symptoms of OSA who seek medical evaluation has been included as one important goal of Health People 2020. My passion is to reduce disparities in the clinical diagnosis of OSA, and hopefully would contribute to this goal.

ii). Improving OSA health outcomes by promoting treatment adherence

Poor adherence to CPAP treatment remains the major impediment to effective management of OSA. Through my dissertation work, I found that men and women may have different challenges, concerns, and/or motivations when it comes to using this treatment. Building on this finding, I was funded by 2010 Sigma Theta Tau International/Virginia Henderson Clinical Research Grant to examine gender differences in adherence to CPAP. The spouse plays a critical role in an OSA sufferer’s adherence to the CPAP treatment. My collaborators and I examined predictors of CPAP use during the first week of therapy, finding that concerns about intimacy influence a patient’s decision to use CPAP. This research was published in the Journal of Sleep Research in 2012. Funded by the National Institute of Nursing Research of the National Institutes of Health (R15NR013274, 06/2013–05/2016), we recently completed a study examining the role of spousal involvement in adherence to CPAP. In this study, we collected data from 136 newly diagnosed OSA patients and their partners, recruited from two hospitals affiliated with Harvard Medical School (Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center). Our findings confirm the spouse plays an important role in CPAP adherence. Spousal involvement in CPAP therapy could have both positive and negative impacts on patient CPAP use. Inspired by the findings, my team will design innovative interventions that effectively engage partners to optimize CPAP adherence.  

 iii). Improving sleep in acute care hospital settings and on college campuses

In 2010, I was honored to be named as a Haley Nurse Scientist at Brigham and Women’s Hospital in Boston. The Haley Nurse Scientist Program is an academic practice partnership between Boston College Connell School of Nursing and BWH. The position has afforded me excellent clinical resources and opportunities to expand my sleep research into the acute care hospital setting. My investigations of inpatient sleep led to a funded project, A Sleep Promotion Toolkit for Hospitalized Patients, with funding from the Agency for Healthcare Research and Quality (AHRQ, 1R21HS024330-01; 09/2015-09/2017) and Boston College Ignite Award. Working as the PI, I have led the development of the Sleep Promotion Toolkit (SLEEPkit), and get ready for the randomized control trial to test the SLEEPkit at BWH oncology and cardiovascular units. Upon completion of this project, my team, including expert in health informatics intervention, IT developers, and human interface designers, will continue to work on SLEEPkit for a multi-site RCT with the goal to integrate SLEEPkit into the electronic health system, and will expand the use of the SLEEPkit to community settings.

In addition, I have conducted studies to examine sleep habits and sleep quality in college students. This research informed the development of a 10-hour sleep education program for college nursing students funded by the American Sleep Medicine Foundation (2012 Educational Projects Award). I’m in the process to package this innovative program planning to disseminate it to other college campuses.

 

About Dr. Lichuan Ye

Lichuan Ye, Ph.D., RN, is a tenured associate professor at Boston College Connell School of Nursing. Dr. Ye’s research focuses on promoting health through better sleep and better management of sleep disorders. In particular, her work aims to improve understanding of obstructive sleep apnea (OSA) clinical presentations to facilitate earlier diagnosis, to improve OSA health outcomes by promoting treatment adherence, and to improve sleep in acute care hospital and on college campus. Dr. Ye’s work has been funded by the National Institutes of Health, Agency for Healthcare Research and Quality, American Sleep Medicine Foundation, Sigma Theta Tau International, and American Nurses Foundation. As an educator, Dr. Ye has had the opportunity to teach over 1000 students in several different undergraduate and graduate courses in both classroom and lab settings. She is a member of the Sleep Research Society, American Academy of Sleep Medicine, and Sigma Theta Tau Honor Society of Nursing, and has served in professional committees including the Sleep Research Society, American Thoracic Society, and Eastern Nurse Research Society. Dr. Ye received her Bachelorette degree in Nursing and Master’s degree in Geriatrics and Internal Medicine from West China School of Medicine Sichuan University in China, and her Ph.D. in nursing from the University of Pennsylvania.

 

Contact Information: lichuan.ye@bc.edu