Science from the Field: Sleep Insights with Dr. Jennifer Walsh and Dr. Kathleen Maddison

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Welcome to the first of hopefully of many Science from the Field podcast episodes, where we shine a light on the amazing work in the fields of sleep and respiratory medicine being done in our own backyard. We are excited to kick off our 2024 series with the powerhouse duo of Dr. Jennifer Walsh and Dr. Kathleen Maddison from the University of Western Australia. 

Sarah Hull: Welcome, and thank you both for joining us today. Can you share a little bit about your background and what drew you to specialise in sleep research? 

Dr. Jennifer Walsh: I got into sleep at the end of my PhD. I actually got a job working in a sleep lab and I needed some money because I was a poor broke student. I got a job in the sleep lab and I thought it was really interesting. My PhD was in cardiovascular physiology so sleep was a little bit of a sideways shift, but I thought there’s so much overlap between sleep and cardiovascular disease that it’s really interesting and then I landed into working with such an amazing team at Sir Charles Gardner Hospital. Sleep is such a fascinating field, so I’ve stayed in the area.  

Dr. Kathleen Maddison: My story is similar to Jen’s, although it started a little bit earlier when I’d finished my honours; my honours was in exercise and sports science and I followed the team at St Charles Gardner Hospital and landed in sleep. Thinking, rather naively, that I’m quite a good sleeper and therefore sleep research would be quite lovely. I hadn’t put all the dots together in my youth that I would be spending countless nights not sleeping, and instead watching other people sleep. The team that we work with, and kind of fell into, was amazing. And the research area is phenomenal.

Sarah Hull: It’s funny, isn’t it? How so many people fluke into sleep, fall in love and then stay forever. It’s a very common story. Can you share a little bit about the projects or research that you’re working on right now? 

Dr. Kathleen Maddison: Jen and I work on similar projects, because we fortunately work together. One of our big projects that we’re working on is looking at shift work in the aviation industry. And, how different sleep patterns and shift work present in the aviation industry.

I’m also working on a really interesting project that Jen was involved in. The underpinning of the project, which looks at sleep in First Nations people. And it’s with a fantastic group led by Fatima, out of Queensland University, and that project’s looking at diagnosing obstructive sleep apnoea and managing obstructive sleep apnoea in the rural communities. So, there’s a sleep education component educating the nurses and the Aboriginal healthcare workers as well. It’s a fascinating project. 

I will let Jen share the other interesting ones. 

Dr. Jennifer Walsh: We do a lot of education at UWA, at the Centre for Sleep Science, so that’s how we got involved with the project with Fatima and her team. We are doing a lot in terms of education, so it’s not specifically research, but it’s relating to sleep. We are about to develop an undergraduate unit for students at UWA which is going to focus solely on sleep and will be part of the UWA curriculum. 

Some of the other research that we’re doing, we’ve been doing for quite a few years now looking at medicinal cannabis and treating different sleep disorders. We’ve got plans to do a study where we want to look at the effects of different cannabinoids on the OSA endotypes. We look at these cannabinoids, which of those mechanisms of OSA Disease pathophysiology, and which ones are potentially going to be able to treat obstructive sleep apnoea. That’s really exciting.

Sarah Hull: Very interesting. In your opinion what are some of the most pressing sleep related health concerns? And, and how do you think we could address those? Obviously, that’s a massive question, but we’re doing lots in the research space. How do you think we translate some of that important research into the mainstream? 

Dr. Jennifer Walsh: I think one of the biggest issues is that we’re living in this 24/7 world where we’re constantly accessible to people, which means that we’re not having that downtime, and we’re not giving ourselves the opportunity to rest outside of work and then also allow enough time for sleep.

So I think that is a big problem, alongside shift work patterns. There are a lot of industries and different workforces where we need shift workers. And 16 percent of the Australian population is shift workers, and allowing people to work such long hours is just unhealthy for people, and for their sleep. 

They’re not getting enough opportunity to sleep.  And I think that businesses are struggling because they can’t change the rosters or work hours because employees are used to earning good money because they are working these long hours and they don’t want to stop working those long hours. So I actually think that the government needs to step in, and there needs to be some legislation around the number of hours that people can work consecutively.  

Dr. Kathleen Maddison: I’d agree with you, Jen, on that. I think shift work is a must if we want to keep the world moving, but some of the the knowledge around how to manage that shift work is probably where I think the challenges are, like sleep literacy, how can you make changes?

Let’s say government takes a while to legislate, or gives people some of the tools around how to improve their sleep with science backed research. Or gives people the proper tools so they can manage their own sleep, this is really important. And I do know this World Sleep Day, which is coming up in March, that the topic is sleep equality because of the detrimental effects poor sleep has on individuals. 

Having a platform and offering opportunity to people so they too can have good sleep periods. It’s universal and across socioeconomic groups, regions, financial commitments, and conflict and safety are a big one as well. What are the patterns you need to adhere to, to maintain your life?

Sarah Hull: Absolutely. And we’re starting to see, for example, if you’re working in the aviation space and a shift worker, how those two can interact. But what takes it to another level is we’re working with people that can’t change their circadian rhythms. Can you give some insights into where you think wearables, or some of the new consumer technology, could play a role in that? 

Dr. Jennifer Walsh: I think that’s such an exciting area. I guess, obviously, there are some people that the technology is proving to be detrimental for; people are getting concerned by looking at the numbers. But it is exciting that sleep literacy is actually improving because of these wearables.

It’s incredible that people know about light and deep sleep, REM sleep, and sleep cycles. The accuracy of their understanding is perhaps a little, a little off the mark, but you know, at least they are talking about it. Which is really quite new, only in the past five or 10 years since we’ve had personal sleep monitors. And the accuracy of those is variable. But you can imagine it’s only going to be improving, so I’m looking forward to seeing where it goes. 

Dr. Kathleen Maddison: I love these discussions. I think the light with shift work is a big one. You know, people are having those discussions around “how much sleep did you get” “what was your sleep score?”. Jen’s made a great point around the double edged sword around fixating on your sleep score.  If you do, and you think you are going to have a bad day before you have even started- maybe that device isn’t for you. But the research is super interesting, alongside the big data as well. Jen and I talk about this a bit, seeing what the big data looks like.

Sarah Hull: Well, that’s a great segue. What are some of the research or papers that are getting you excited at the moment? 

Dr. Jennifer Walsh: Personally I’m really interested in the big data. But I think what I find more interesting is the stuff that’s coming out about drug therapies for obstructive sleep apnoea. It’s only been in the last 10 or so years that we’ve really understood more about the mechanisms that are causing obstructive sleep apnoea and the different endotypes.

And I just love the way that we may be able to tailor it. Different therapies for different people, who’ve got different risk factors, or different physiological makeup and reasons for their sleep apnoea. That’s my number one interest in terms of the research that’s coming out. 

Sarah Hull: Are there any specific papers? I know there’s some really interesting stuff coming out of South Australia in that space right now. Is there anything that jumps to mind?

Dr. Kathleen Maddison: A lot of the translational stuff really interests me. It’s not in my specific area of research, but I do love reading it. I like everything really structured when we study, we’re going to bed at the same time, and we do our interventions in a really strict routine way, which is not real life. 

So I like seeing when people take information and apply it out to the real world; and I think the sporting community is a big one. There’s a lot of people that are looking at how sleep impacts their sporting performance and their mood, and then how the mood impacts how they perform on the field.

I think some of that research is fascinating and comes with a whole new set of difficulties, but it’s really interesting to see what happens in smaller research studies being passed out into the wider community.

Sarah Hull: We just heard recently that our light therapy device is being used by some big sporting figures and big sporting teams around the world. So that’s been really exciting to see and get some of their feedback about how that’s working in situ, and how it’s impacting their performance as they travel.

Dr. Jennifer Walsh: It’s so good that we have these technologies. It’s so great. 

Sarah Hull: Absolutely. Given that I’m talking to two powerhouse women on the eve of International Women’s Day, as leaders in the field, how do you support and encourage other women pursuing careers in sleep research and related disciplines? 

Dr. Jennifer Walsh: I think I probably have the same attitude regardless of gender. and I’m generally pretty honest about my own personal experiences throughout my, my career and how I’ve juggled work and family, sort of family life balance.

Then, then there’s obviously, career decisions as well. I think I just try and support everyone in terms of what they’re trying to get out of their life, when they’re making their own decisions, really. I wouldn’t say I specifically do something different for women versus men.

Dr. Kathleen Maddison: I agree. I think it’s across the board. Anyone that wants to enter into science or research, we would love to have them, but you want to have your eyes wide open in terms of what’s expected, and the challenges in the field and how to manage those challenges. A lot probably comes around to deciding what you want from both your life and career, and then trying to make the two merge. It doesn’t always work seamlessly, but supporting people where you can so that you can get the best out of both sides.

Dr. Jennifer Walsh: I’ve got five or six PhD students and they’re all, at the moment, they’re all female and at different stages in their life, and they’re all fabulous in their own way. We are not short of women who are interested in going into the sleep field, and obviously very clever women, so that’s great.  

Sarah Hull: I’m sure we could do a whole deep dive on on your tips for research, and working in research full stop. But do you have one takeaway? 

Dr. Kathleen Maddison: I think having a passion, like we discussed at the beginning. People who have fallen into sleep, but have stayed here. And we’ve stayed here because the field, the colleagues, the area, is really inclusive. The people across multiple disciplines, across the science, the engineers, the medical space, all collaborate really well. I think being in a really collegiate environment makes for quite a happy working line, and the field is so new and there’s so much exciting stuff happening. 

It really keeps you motivated. If you didn’t love it, you would struggle to stay in the space. Finding something that is actually your passion is not always possible, but finding something that excites you and having discussions like this, it’ll make it for an easier work life balance. 

Dr. Jennifer Walsh: My tip would be that everyone needs to have a Kath at their workplace. So I’m sorry for those people who don’t because there is only one of her. But I think the team makes or breaks it, don’t they? It’s definitely important. 

Sarah Hull: Looking ahead, what do you envision for the future of sleep research, particularly regarding its impact on overall wellbeing and healthcare? 

Dr. Jennifer Walsh: I believe we are so close to everyone recognising that sleep is the magic bullet. I think we’re on the cusp. There’s a lot of groundswell. Hopefully in the next few years it’s just going to be widely recognised how important sleep is across the board. 

Dr. Kathleen Maddison: I couldn’t agree more, Jen. I think we are on the precipice. I can feel that nutrition and exercise has long been spoken about, but I feel like people are just getting on board to the sleep side of things, and it might not be the last piece, but it will be a really integral piece of the puzzle to help with overall wellbeing.  

Sarah Hull: I think it’s so interesting. We’re starting to hear it talked about in so many different fields now. So it’s not just the sleep research people talking about sleep. It features in neurodegeneration, in ICU, and all the different disciplines. They are starting to come together to recognise that if sleep isn’t right, then the other stuff isn’t going to be either. It’s such an exciting time – obviously coming from a room full of sleep nerds. 

Dr. Kathleen Maddison: No bias here at all!

Sarah Hull: To finish off, what books or resources would you recommend for our listeners? And they don’t have to be sleep; it can be anything that’s getting you excited or that you’re into at the moment. 

Dr. Kathleen Maddison: Well some really good resources on the sleep side of things. The Sleep Health Foundation has excellent fact sheets. I really like the Matthew Walker book around sleep; it is a little bit like ‘you are going to die if you don’t sleep well’ but he’s softened that scare message side of it over the years. But the facts that are in there, there’s good references. As scientists I’m always biased to a good solid reference to just to open people’s eyes to the complexity and variability of sleep and how it changes over the course of your life. I think it’s a nice starting point. 

Dr. Jennifer Walsh: I agree. And I haven’t read it yet, but I’ve heard good reviews about Russell Foster’s book, Life Time as well. I’m looking forward to reading that. Obviously there’s our courses that we have at the Centre for Sleep Science, and I think the ASA are getting a lot of quality resources out to GPs, psychologists, pharmacists. It’s great that our professional association is coming on board to translate the knowledge that’s out there to the general public.

Sarah Hull: What are your favourite podcasts? Hit us with them. 

Dr. Kathleen Maddison: Ooh, I chop and change. I’m listening to a science backed podcast with Peter Attia at the moment. It runs a full spectrum of different topics, not just sleep. I was learning about back pain this morning on my drive in. 

Dr. Jennifer Walsh: In terms of sleep, I would say the AASM podcast, Talking Sleep is quite informative. I think they’re monthly podcasts and it all relates to sleep. A general one that I really like is The Imperfects. You may have heard of that as well. It’s really broad, and more about mental health, but I’ve learned a fair bit from that too.

Sarah Hull: Excellent. There’s some good ones to add to our list. Thank you guys. 

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Dr. Jennifer Walsh
Director of the Centre for Sleep Science, UWA

Dr Jen Walsh is the Director of the Centre for Sleep Science at the University of Western Australia also leads the sleep physiology research team at the West Australian Sleep Disorders Institute at Sir Charles Gairdner Hospital. Jen’s research focuses on investigating the causes of, and novel treatments for, sleep disorders including obstructive sleep apnoea and insomnia. Her research includes investigating the use of medicinal cannabis for the treatment of sleep disorders. With the CSS team she is also dedicated to providing evidenced-based sleep education to health professionals and the general public.

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Dr. Kathleen Maddison
Research Fellow at the Centre for Sleep Science, UWA

Kathleen has worked in the area of sleep science since early 2003 with her research focusing on improving the understanding of upper airway collapsibility, the pathophysiology of obstructive sleep apnoea, identifying novel therapies in the area of sleep, insomnia and upper airway physiology. Kathleen has been fortunate to work with a number of world-leading scientists on novel research projects and has lead and co-designed projects investigating new treatment options for obstructive sleep apnoea and insomnia. In addition to her research, Kathleen has a passion for sleep education and regularly provides education sessions to schools, private companies and social/community groups.  She has a strong belief that together with nutrition and exercise sleep forms the third pillar of health.