Science from the Field: Sleep Insights with Dr. Tracey Sletten

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Welcome back to BMedical’s Science from the Field podcast, where we shed light on some of the amazing work being done in our own backyard of Australia to further the fields of sleep and respiratory medicine. We are excited to continue our 2024 series with a bright light from the field of circadian research. From Monash University in Victoria, Dr. Tracy Sletten.

Sarah Hull: Can you share a little bit about your background and what drew you to specialise in sleep research?

Tracey Sletten: I think the pathway for me was biology in my final year of university. I was really fascinated by cardiology, and so I sort of started to follow that area through my university degree. And because I wanted to get involved in cardiology, there was a project running in a sleep lab that was looking at the impacts of sleep deprivation on the heart, so I volunteered for that in one of my undergrad units so I could get experience around cardiology, thinking I was going to go off and be a cardiac technician or something like that. And the wonderful colleagues at the University of South Australia at that time in that sleep lab convinced me I would be bored doing it within six months. They encouraged me to stay on and do an honours degree with them and then a PhD with the different projects looking at sleep deprivation, sleep loss, circadian misalignment, shift work etc. I’ve not stopped since then. It’s just carried over to multiple opportunities. So a very different pathway led me to sleep, but very, very happy that it did.

Sarah Hull: It’s always interesting to see where people find that passion because I don’t think anyone comes to sleep from sleep. We always come from somewhere else.

Tracey Sletten: Absolutely. We talk about it quite a lot within our program; that we’ve all come from different directions to find ourselves working in a similar field. And I love sleep as a field for that. You get into it accidentally, in many cases, and find a real passion for it.

Sarah Hull: Can you share a little bit about the projects and research you’re working on right now?

Tracey Sletten: Sure, as you mentioned, my focus is around circadian misalignment, particularly in shift work. So really understanding the implications of shift work and working against our body clock and working at regular hours or non-standard hours. What those implications are for sleep, alertness, safety and health, and then focusing on the various interventions we can create to help shift workers really adapt to their lifestyle as much as possible.
I think it’s really an area that’s understudied, but we’ve got a lot of scope to really help. Many shift workers just accept that it’s a lifestyle that works against them, basically, and they don’t think there’s a lot they can do about it. So I think it’s a really important area for us to try and find other ways to support them.
And some of the work that I do looks at interventions at the system level. Can we look at optimising rostering? For individuals, for example, can we make sure that rostering systems aren’t just about what works operationally for an organisation, but consider the biology of the workforce. Secondly, there’s sort of a system-level idea around the light exposure and the conditions of the environment that they’re working under, if we can consider their biology in that case. And then thinking about the individual level for intervention.
So 40% of shift workers have other sleep disorders that really don’t get acknowledged because shift workers so often feel so tired. And so they don’t consider that there could be other reasons for that tiredness. But also a big focus on the individual level differences. There’s so much variation in what shift workers need to do as far as their work hours go, but also individual variability in their own home circumstances and their biology. So we have a real interest in looking at those individual level interventions and what recommendations we can give to people around when they sleep, when they can get light and how napping might work and, and other countermeasures to try, I guess, and package all of these interventions together to give them the best opportunity to cope with that shift working lifestyle.

Sarah Hull: It’s such an interesting one, isn’t it? Because you can make recommendations, but then you’ve got the policy level in terms of legislation, and then you’ve got the individual businesses that are making decisions based on profitability and things like that as well. What do you think is needed to help take the learning from sleep research into the mainstream?

Tracey Sletten: That’s a really good point, and that’s part of why I love it. This area of work is extremely complex for some of those reasons that you say, but it also means we’ve got a lot we can be doing to help. I think one of the biggest things we need to consider is the context in which these individuals are working and the reality of what it is. We can come up with these wonderful randomised control trials that are set up in a perfect way in a laboratory setting in many cases, or even sometimes out in their real life. But quite often those interventions are very structured, they’re short term, and it’s not something they’re going to be able to continue to maintain themselves.
Where we find that balance between the science and the biology versus what is practical for an individual. We need to really step back up to that next level of the workplace and what can actually be implemented that is operationally relevant and allows them to keep the job happening. They still need to be productive in their role and successfully do their job. The regulation that is required for that industry, but also the requirements for that organisation.
That’s a lot of what I spend my time doing, really considering all of those different levels. One example of project we’re doing right now is very individual level interventions with digital sleep health management tools for shift workers. A lot of our initial work has been in working out how to make it as effective as possible for the individual, and then to actually roll it out and make change – to translate this to an effective benefit to the community.
We need to also consider how workplaces might actually support or embrace a tool like this. And then what is needed, as well as the required regulatory piece. I think it’s really important for us to make that change and think about the whole package. That’s what I’m really excited about, to just make sure we do actually see that translation to the real world.

Sarah Hull: Definitely. When you start talking about tools as well, you start thinking about how could those be implemented within policies within the organisations too. If you’re looking at blue light glasses, blocking glasses, or actigraphy, things that are making people aware of how they’re sleeping; how do you then integrate that and make sure it has a positive effect and not a negative effect?

Tracey Sletten: Exactly right. That’s where it’s helpful to have a real understanding of the industries you’re working with. What are the fatigue management programs that different organisations are putting in place? And how can some of these tools and interventions be built into existing or evolving fatigue management plans? So I think it’s really important to consider all levels with this. And when we do, if we approach our science with a narrow focus, we’re not going to get the same level of translation that is possible if we open up our perspective on that.

Sarah Hull: Yeah, that’s a fantastic point. Jumping off from there, what are some research papers that are getting you excited at the moment?

Tracey Sletten: I think there’s quite a few. I’m clearly passionate about this area and what we do. I think there’s some really important work that is happening around changing our health care related to sleep disruption and sleep disorders. It’s such a prevalent area and there’s so much of our population who are experiencing either sleep problems or diagnosed sleep disorders and people still don’t have an understanding of how much can actually be done for them. So I think there’s some fantastic work that looks at the public education around sleep disorders and accepting how common they are to encourage the public to come forward and get support for any problems they have.
But then there’s some work that’s starting to emerge, that’s looking at the models of care, the sleep disorders and what our healthcare system is doing to be able to put these interventions in place. I really am excited about the work that is starting to happen, but we definitely need a lot more of it. I’m jumping on any papers that show this is happening, but also look at opening up avenues to help the public with sleep challenges and disorders.

Sarah Hull: That’s so interesting. If we think about the different regions, I know you work a lot with the UK and the US, and obviously the implications for funding sources would change the story completely from area to area. So it’s a really interesting space to be looking at.

Tracey Sletten: Yes, and linked to that as well is what capacity we have to expand our research. We’ve got some fantastic technologies allowing for rapid expansion of our research. We can look at wearables for real-time and long-term monitoring of behaviour, and the background of education is that sleep duration is important – you must get eight hours, etc. I think it’s been damaging when now we’ve got this amazing opening up of the field that’s looking at the sleep timing variability and all of the health implications for that. It’s really starting to get traction now so we can start to show those long-term health implications of small things that people could be doing in their sleep behaviour to avoid some of those nasty adverse health consequences. And then our interventions are becoming much more targeted with some of those behaviours to improve sleep as a whole for the community.

Sarah Hull: Where do you think the studies on big data will play a role in this? Helping us understand some of the misunderstandings in sleep and sleep hygiene that have impacted the way people interact with sleep and sleep time.

Tracey Sletten: Great question. I think it’s absolutely key for the direction we’re heading. We’ve been limited for such a long time trying to do this kind of controlled study of small groups. But the fact we have big data now of tens of thousands of people, the individual differences are key and we need big data to be able to understand and do accurate analysis on understanding, how when you group people by different types of behaviours, what we’re learning that we couldn’t have learned before.
We’ve known light exposure at the wrong time of day has a huge adverse effect. The public can benefit from the furthering of research data to to really feed that in. And so now we’ve got some amazing stuff coming out of the UK Biobank and other big data sets that can really look at tens of thousands, even more examples of people with long-term light monitoring and time of day that they’re getting light. And that’s actually leading directly into new recommendations that are now coming out around what is the level of lighting that’s actually problematic, which is what people need to be able to actually change their behavior. We, who work in this field know what level of lux means, but the public doesn’t. And so we can now start to sort of put some of those sorts of criteria out there for people to make practical change. And that can’t happen without the big data sets that we’re starting to see now.

Sarah Hull: Yeah, excellent. Thanks so much for that. So I do want to change directions a little bit. So I guess on the eve of International Women’s Day, I have to ask, as an inspiring female researcher, mentor and a leader in your field, how do you support and encourage other women that are trying to pursue careers in sleep research or related disciplines?

Tracey Sletten: Yeah, great question. Look, I think there’s multiple ways and these are changing over time as our culture changes a little as well. So I’ve sort of been in the field for a couple of decades now and back when I was doing it because of the work that I do in the industry, I was one of very few women at that time. And so I really looked at the women that I did have around me to demonstrate to me that this is a field that that I can break into. So I love now that I’ve sort of have a background of physiology moving into psychology. There are many more women in this space than there were when I started. And so I think for me, I sort of have a big focus on making sure that women do have the opportunities to move forward in this area if they want to. And so for me, I think it’s really about exposure as much as possible. The way that we learn that we have capacity and we have opportunities is to be thrown into those opportunities. And so when I go out and talk to industry and do the different things that I do that are research related, I try to take as many people with me to expose them to that. Even if they’re starting just by sitting in a room and hearing the conversations, it’s the only way that we start to see opportunities. And I think it’s really important that we allow the younger voices to come through in the things that we do. So, you know, when you’ve done something for a really long time, you have a particular way of looking at it. And so some of the best ideas in the sorts of work that our group has done has come from the newer generation women that are coming through. So, for me, I think that a really important thing is to expose them to it as much as possible. And I think, get them out into environments that, you know, whether they’re male-dominated or not to give them that exposure and placing them in those workplaces and those environments to just give them a go. And give it a try. And then debriefing afterward around what opportunities are there and open those doors and let them through.

Sarah Hull: That’s so excellent. Giving people the opportunity to stand on the shoulders of giants, which is fantastic.

Tracey Sletten: Absolutely. And I might just add that I spent a couple of years in Europe. And I think you mentioned that. The European Sleep Research Society has for a very long time had a forum that is for women in sleep research in particular. And just so to spend time in those rooms with Jo Arendt and Debra Skene and the European giants in sleep research really showed me what capacity there is out there. So making sure we’re giving time to anyone that’s coming through so that they can see that there are opportunities, I think, is important. So where we can do a lot more of that, and the ASA is certainly starting to do that with early career researchers in general and just giving them exposure to more senior people I think is valuable.

Sarah Hull: Excellent. Thanks so much. So building on that, I guess, looking ahead, what do you envision for the future of sleep research, particularly, regarding its impact on overall well-being and health care?

Tracey Sletten: Yeah, so that’s what I’d really like to see is that rapid change around health care more than, more than anything. So there’s some fantastic work that many teams are doing in Australia and beyond that are trying to really make that community change and that acceptance for the importance of sleep in so many aspects of our lives. So, you know, for me, clearly, I have a huge focus on shift workers and workplaces coming to terms with the importance of sleep and how they can actually support their workforce. But it’s the same with any sort of community and public group. And so I think the sorts of things that we are able to demonstrate now exactly as we’ve talked about with big data, etcetera. So much of what we want to do- the success of that is going to be dictated by people’s understandings of education around the importance of sleep and the, and the impacts that it has on every aspect, of what we do. I am really excited to see, more people coming through this field and really being proactive around getting communities involved, getting their stakeholders and people with lived experience involved in this field of sleep research so that we can really push hard on improving well-being and health care. It is one of the three pillars of health, and I think it’s taken us a long time to get there, but I’m excited by the fact that I think we’re starting to make movements now. I hear a lot more people talking about sleep in the public arena than I used to 10 years ago.

Sarah Hull: Absolutely. I think the fact that it is being recognised as one of the three pillars of health is a massive change, even in the last five years. So it’s exciting to see that transition and see people talking about it.

Tracey Sletten: And then it’s only through that that we start getting governments and policymakers on board for us to really start to see those positive changes, I hope.

Sarah Hull: All right, to finish off, what books and resources would you recommend to our listeners? Now, this doesn’t have to be sleep-related, it can be just anything that you’re excited about at the moment that you’d love to share with us.

Tracey Sletten: Good question. I didn’t know that I could actually recommend anything outside of sleep. I’m too busy doing sleep-related things. But look, I think there’s some lovely books that have been coming out from experts in the field that are changing the way that people are looking at sleep. So Russell Foster is one example of somebody who really knows the field well and writes really well in his communication. So a book of his that came out, in 2022, I think ‘Lifetime’. It’s body clock related which is my passion. But yeah, that has a big focus on the new science of the body clock and how that can be used to revolutionise your sleep and health. And I think that’s really helpful for people in the field to look at different ways of writing about science and different ways of communicating, which is key for us to make positive change. A book that, because of the way it’s written, is out there and great for public education.

Sarah Hull: Beautiful. Thank you so much for taking the time to talk to us today. We really appreciate it. I’ll go ahead and close off there. This has been Science from the Field with Tracy Sletten from Monash University.


Dr. Tracey Sletten
Senior Lecturer, arc

Dr. Tracy Sletten is a senior lecturer at ARC, mid-career industry fellow with the Turner Institute for Brain and Mental Health, and the School of Psychological Sciences at Monash University. Tracy has previously completed postdoctoral work training at the University of Surrey in the UK, where some of the groundbreaking work in circadian photoreception has been conducted.At Monash University, Tracy is head of the Circadian Misalignment and Shiftwork Laboratory. She leads a research program on the impacts of sleep and circadian disruption in shift workers, including large-scale trials of sleep and circadian timing, alertness, and psychological health in multiple unique industry settings.