8 Questions for Friso Postma, PhD, Senior Director of Clinical Programs and CVB’s Lead on Sleep Programs
As Senior Director of Clinical Programs at Cohen Veterans Bioscience, Dr. Friso Postma is dedicated to studying sleep in patients with neurological disorders, working with wearables such as Fitbits, Apple Watch and bedsensors to track sleep patterns in real time. Friso has a masters in Medical Biology from the University of Amsterdam, and a PhD from the Netherlands Cancer Institute. As a post-doc at Harvard Medical School, Friso used molecular and electrophysiological techniques to study the role of direct communication between brain cells in vision, learning and memory. He also worked on the development of treatments for Fragile X syndrome and Autism Spectrum Disorder.
Friso recently discussed his work on developing data-driven, objective sleep measures to help soldiers, veterans and others who have disturbing and life-impairing sleep disorders.
Why is the particular research you do for CVB so important or impactful?
Sleep is often disrupted in individuals with brain disorders. These disruptions include insomnia (problems with falling or staying asleep), nightmares, or wakefulness. It is a complicating factor that significantly affects the quality of life for people with brain conditions who are already contending with really tough issues. Sleep dysfunction is hugely problematic for the veteran population, and it is a hallmark feature of brain trauma and PTSD, which many veterans are struggling with.
What makes sleep so important for brain health?
Sleep is critically important for many brain functions and overall brain health. There is a complex interplay between different areas in the brain that govern sleep. Sleep is not binary, meaning parts of the brain can be awake while we are sleeping, and parts of the brain can be asleep while we are awake. In fact, there is a lot of brain activity while we sleep.
What do you enjoy most about researching sleep?
As a neurobiologist, studying the complexities of the interplay between neurons during sleep is very interesting, because they are not fully understood. Discoveries that improve our understanding of sleep and disrupted sleep in the brain are incredibly important. Improving sleep helps with disorders like Autism, brain trauma, post-traumatic stress disorder and many others. Sleep affects brain health and really every other aspect of our lives – cognition, performance, mood, endurance, resiliency, recovery and overall health. Working on sleep initiatives with soldiers and veterans is hugely important and means a lot to me. I have personally met with veterans who experienced a great deal of trauma and are so affected by disrupted sleep that their lives become even more difficult and they are anxious for new solutions. I am grateful we are working to provide them options.
What new technology in sleep research excites you the most?
Having worked in the sleep research and pre-clinical settings within biotech, I realized there were gaps that were preventing the industry from moving forward with innovative treatments. These gaps exist not only in scientific knowledge, but in how we analyze and assess sleep – there is little use of objective measures – and there were no truly effective standardized practices. Then, I met Dr. Daniela Brunner and when I learned what she was doing with wearables, trying to find more objective and accurate measures, I was excited.
With wearables and other new sensors, we can monitor sleep in a natural setting – people’s own homes. Sleeping labs are artificial and don’t resemble natural sleeping habitats, so the findings are not necessarily accurate.. Now we have wearables generating big data, which we analyze using machine learning and artificial intelligence. These data sets provide objective endpoints for assessing sleep and other aspects of brain disorders.
What new or existing sleep research is most relevant to those suffering from sleep disorders?
There’s research showing that Cognitive Behavioral Therapy for insomnia (CBT-i) can be as effective as medication, but CBT-i therapy is not accessible for some and others don’t always follow through with the treatment. What I think is going to be impactful are the studies that involve wearables for more accurate sleep analysis to assist the therapist with CBT-i and to make it accessible via telehealth. There’s Sleepwell, our digital health program based on a precision medicine approach to improving sleep after brain trauma. It help us better understand the methodology needed to measure sleep objectively and how to use it with CBT-i. The idea is to improve CBT-i, to make it more accessible, effective and reliable.
What are your views regarding sleep medication?
Sleep medications can knock you out and help you sleep, but many people wake up feeling tired and groggy the next morning. This happens because sleep medications don’t address the biological pathways governing sleep of the brain properly, so they don’t mimic the normal properties of sleep and your body is, scientifically speaking, tired.
What are some of the current challenges and obstacles in sleep science and treatment?
Probably the biggest challenge in sleep research is the fact that there are no replicable objective measures. Right now, we are relying on subjective measures that are either patient-reported or from a subjective scale used by the physician. We’d be in a better place in terms of treatment if we had objective measures for sleep in the home setting, which is something we are working on at CVB. Also, there is no unified standard approach for treating sleep disorders. Current treatment practices are inconsistent.
What is something you’ve recently learned about sleep that you found to be surprising or fascinating?
I’ve been studying sleep for years in a number of different settings. I talked about the complexities of sleep and the brain earlier and it’s fascinating. Right now, I’m intrigued by how a combination of approaches, such as the use of wearables and CBT in a telehealth setting with apps, can allow people to track their own sleep and provide data via a dashboard for doctors to enable precision therapy.