Pulmonary, Critical Care & Sleep Medicine Research

The Interventional Pulmonology/Complicated Airway Center conducts studies focused on early recognition of lung cancer, diagnosis and staging of chest lesions using minimally invasive techniques, and treatment of airway lesions. The Center also works closely with the Center for Lung Injury Research. All patients are considered for appropriate investigations, but participation is completely voluntary.

Our current studies and protocols include:

• Comparison of Photodynamic Therapy to other treatment modalities, e.g. YAG laser therapy
• Autofluorescense bronchoscopy for early cancer detection
• Endobronchial ultrasound for minimally invasive cancer staging
• CT-fluoroscopic bronchoscopic needle aspiration of mediastinal lesions
• Virtual bronchoscopy and three dimensional airway imaging as an adjunct to bronchoscopy in the evaluation and follow-up of patients with impaired airways
• Physiologic assessment of airway collapsibility
• Endoscopic lung volume reduction

The Institute for Personalized Sleep Medicine develops and evaluates innovative methods to enhance the precision of sleep disorder diagnosis and treatment. Through the use of precision medicine, we aim to pinpoint the specific causes of sleep disturbances and tailor treatments accordingly. Our goal is to ensure that optimal sleep — a fundamental necessity for health and well-being — is achievable for everyone. 

The Institute is working to expand and grow existing facets of our Pulmonary Division’s Sleep Program in a number of areas, including:

• High loop gain apnea (HLGSA). This relatively new concept has an increasing amount of supportive data. In this condition, unstable breathing control contributes significantly to sleep apnea, and does not respond well to treatment such as positive airway pressure which targets upper airway obstruction. BIDMC’s work provides the conceptual framework for a new disease category (treatment-emergent central sleep apnea), FDA-approved therapies for "Complex Sleep Apnea," a commonly used name for HLGSA, FDA approved software to identify HLGSA and novel multi-modal therapy approaches for management. However, the vast majority of patients in the U.S. and elsewhere remain poorly treated and do not have access to our methods. Building on our prior work, the Institute will design and implement studies to generate data for new approaches to the treatment of high loop gain sleep apnea.
• Collaborations with cardiovascular medicine. The Institute can drive critical collaborations to address sleep physiology and its relationship to heart failure and atrial fibrillation.
• Optimal sleep. Several dimensions of sleep have been individually associated with health outcomes. These include sleep duration, daytime sleepiness, insomnia, sleep apnea, stability of sleep, sleep blood pressure, sleep timing and resilience of sleep. We aim to measure multi-component sleep physiology and improve the quality of sleep in an integrated balanced approach.
• Innovative technology. The Pulmonary Sleep Program has developed the ECG-spectrogram and its variants for sleep and sleep apnea phenotyping (wearable devices and stand-alone software as medical device, FDA approved), an auto continuous positive airway pressure algorithm (FDA approved) and the Positive Airway Pressure Gas Modulator (PAPGAM) device to treat central sleep apnea.
• Innovative clinical concepts. Novel approaches to diagnosis and treatment of hypersomnia and circadian rhythm disorders are in active development.

About the Personalized Sleep Institute

The goal of this program is to accelerate the translation of best scientific research around normal and pathological states of sleep. The mission of the Institute of Personalized Sleep Health (IPSH) is to ensure that optimal sleep — a fundamental necessity for health and well-being — can be achieved by everyone.

The IPSH is the research arm of the Sleep Disorders Center with a special focus on utilizing novel sleep research tools to improve sleep health in the clinic. The Institute aims to enhance clinical and translational research by fostering innovation, discovery, education and collaborative networks among disciplines relevant to sleep science.

Within the Sleep Disorders Center, the Institute utilizes a personalized "accelerated bench-to-bedside" approach to optimize sleep health. This Institute aims to provide personalized care for disorders of breathing control during sleep and stimulate the development of innovative technology, especially wearable devices, that allow for personalization of sleep health. Further, this Institute expands the concept of measuring and enabling "optimal sleep health," large scale data analytics and genetic foundations of rare sleep disorders to meet its goal of achieving precision sleep medicine.