Sleep is a prerequisite for good brain health

This is according to Henning Kristian Olberg, neurologist, somnologist, and specialist in clinical neurophysiology at the Neurology Clinic at Haukeland University Hospital. He is the contact person for the newly established network for Sleep Disorders at NorTrials Brain Health.

Photo: Anne Sidsel Herdlevær

The center already has 11 other professional networks for other neurological diseases such as MS, stroke, headache, dementia and ALS. Kjell-Morten Myhr, head of NorTrials Brain Health collaboration, took the initiative to establish a 12th network, hoping to attract more sleep trials to Norway.

- Through these 12 networks, we will be able to collaborate to ensure rapid and good inclusion in studies with participation from Norwegian hospitals, says Myhr.

Broad Network

Henning Olberg has extensive experience with sleep disorders from both a diagnostic and treatment perspective. In addition to his work at Haukeland, he is also the outgoing leader of the Medical Association's Specialty Committee for Clinical Neurophysiology, a member of the working group at the National Center for Sleep Medicine (SOVno), and a board member of the Norwegian Association for Sleep Medicine (NOSM). He also collaborates extensively with the National Competence Center for Neurodevelopmental Disorders and Hypersomnias (NevSom).

- Patients with sleep disorders are an overlooked and undertreated patient group in Norway. The prevalence of chronic sleep problems has increased in recent years. At the same time, it is estimated that about 85 percent of those suffering from sleep problems do not receive treatment, according to The Norwegian Directorate of Health.

Fortunately, it's a discipline that clinicians are starting to pay attention to, according to Olberg.

- The Sleep Congress organized by the European Sleep Research Society, held every other year, has never had as many attendees as this year's congress in Seville. The sleep community, in collaboration with the Brain Council, is working to highlight sleep medicine and incorporate sleep disorders into the new brain health strategy, which will be presented in the spring. Work is currently underway to include neurological sleep disorders in the prioritization guide for neurology. More and more people are seeing the importance of mapping and treating sleep disorders and problems. There are also great opportunities for new treatments in sleep medicine in the coming years, and we want to be part of the development by running clinical trials on this in Norway. So far, we only have one ongoing pharmaceutical study, on narcolepsy, which is being conducted both at Haukeland and at Oslo University Hospital, says Olberg.

Sleep disorders are divided into 6 main groups

1. Insomnia
2. Sleep-related breathing disorders
• Sleep apnea in adults
• Sleep-related breathing disorders in children
3. Circadian rhythm disorders
• Shift work disorder
• Delayed sleep phase disorder
• Jet lag
4. Hypersomnias
• Narcolepsy type 1
• Narcolepsy type 2
• Idiopathic hypersomnia
• Kleine-Levin syndrome
5. Parasomnias
• Sleepwalking (somnambulism)
• Night terrors (pavor nocturnus)
6. Sleep-related movement disorders
• Restless legs syndrome
• Periodic limb movements during sleep (PLMS)

(Source: SOVno)

Sleep and brain diseases are closely connected

- Why are sleep disorders under brain health and neurology?

- There are many reasons for this, but among others, because the control and mechanisms of the sleep process come from the brain. Secondly, most neurological diseases can involve or damage the parts of the brain that regulate sleep and wakefulness. Thirdly, sleep disorders are seen more frequently in several neurological diseases, such as Parkinson's disease, multiple sclerosis (MS) and restless legs syndrome (RLS). Fourthly, sleep disorders can increase the risk of, or worsen, many neurological diseases such as stroke or neurodegenerative conditions. Sleep is simply a prerequisite for good brain health, says Olberg.

He reports that the cost of insufficient quality sleep is estimated to be between 1-3% of GDP in OECD countries.

- With the demographic changes we see ahead, including an increasing number of elderly people, the proportion of sleep disorders will also increase in the population, says Olberg.

He sees the importance of attracting industry trials in sleep disorders, even though it involves work on top of an already 100% position in the clinic.

- The national action plan for clinical trials aims to integrate clinical trials as part of the patient treatment. Research is one of four statutory tasks in Norwegian specialist healthcare service, and it is therefore important that managers at all levels in all hospitals comply with this, says NorTrials Brain Health centre lead Kjell-Morten Myhr.

Here is an overview of all NorTrials networks within brain health, with contact persons:

• MS – Øivind Torkildsen
• ALS – Ole-Bjørn Tysnes
• Parkinson's disease – Charalampos Tzoulis (Haris)
• Dementia – Kristoffer Haugarvoll, Ragnhild Eide Skogseth
• Brain tumor – Anette Storstein, Terje Sundstrøm, Tor-Christian Aase Johannessen
• Stroke – Annette Fromm, Nicola Lagallo
• Headache – Marte Bjørk
• Epilepsy – Marte Bjørk
• Neuropediatrics – Omar Hikmat
• Psychoses – Erik Johnsen
• Mood disorders – Ketil Ødegaard
• Sleep disorders - Henning Kristian Olberg

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