Sleep Disorders Clinical Research Program
Explore This Research Lab
The Sleep Disorders Clinical Research Program, led by John Winkelman, MD, PhD, is part of the Outpatient Psychiatry Division of Massachusetts General Hospital. The program is dedicated to clinical and investigative efforts in sleep disorders and the overlap of sleep medicine and psychiatric disorders. It focuses in particular on the following disorders:
- Restless legs syndrome (RLS)
- Sleep-related eating disorder (SRED)
While the Sleep Disorders Clinical Research Program is focused on sleep research, Dr. Winkelman is also available for clinical appointments through the Division of Sleep Medicine in the Department of Neurology at Mass General.
Our goal is to improve the understanding of sleep disorders, particularly restless legs syndrome (RLS), insomnia, abnormal behaviors during sleep (including sleep-related eating disorder) and the relationship of psychiatric disorders and sleep. We work to translate these insights into improved treatments for these disorders.
Our research focuses mainly on the treatment of restless legs syndrome using a number of different interventions:
- IV iron infusions
- Understanding the cardiovascular aspects of RLS
We also conduct studies investigating the relationships between insomnia and both depression and diabetes, as well as medication studies for sleep-related eating disorder.
National RLS Opioid Registry
The National RLS Opioid Registry based at Massachusetts General Hospital brings together patients all around the country to assess the long-term safety and effectiveness of opioid medications for RLS.
Well-Controlled RLS and Insomnia Study
We are studying whether an FDA-approved sleeping medication (suvorexant) will improve sleep in individuals with well-controlled RLS and persistent insomnia. Qualified participants can receive study medication, compensation and medical evaluations at no cost.
Treatment of RLS in Protracted Opioid Withdrawal
We are studying whether pramipexole is an effective treatment for RLS symptoms in OUD patients during post-detox clinical stabilization. Further, we are investigating whether the treatment of RLS in this context will also improve overall symptoms of opioid withdrawal.
Please contact us to learn more about our research or enroll in a study.
Current Lab Members
- John Winkelman, MD, PhD – Chief
- Jordana Zackon – Research Coordinator
- Ben Wipper – Medical student
- Christopher Romero-Gutierrez – Research assistant
- Seung-Gul Kang, MD, PhD – Gachon University
- Tien-yu Chen, MD – National Defense Medical Center
- Atilla Gonenc, PhD – McLean Hospital
Past lab members
- Sayaka Aritake-Okada, PhD, Postdoctoral fellow
- Ryan Bottary, Boston College
- Song Chi, MD, Research fellow
- Cathy McCall, MD, Resident
- Leslie Mei, Research Coordinator, Weill Cornell Medical College
- Julia Purks, Larner College of Medicine at the University of Vermont
- Laura Schoerning, Marian University
The research done by the Sleep Disorders Clinical Research Program focuses primarily on understanding the following sleep-related disorders.
Restless legs syndrome
Restless legs syndrome (RLS) is a common, chronic sleep-related movement disorder that affects 3-5% of the general population. It is characterized by an irresistible urge to move the legs, often in response to uncomfortable sensations in the legs. People who have RLS describe the sensations as creeping, crawling, tingling, aching or burning. The symptoms are provoked by inactivity and relieved with movement. RLS symptoms are most severe in the evening or at night, so RLS can cause significant sleep disturbance. RLS has been associated with low iron levels, endstage renal disease with dialysis and peripheral neuropathy.
Treatment options: RLS can be treated with different kinds of medication, including dopamine medications, alpha-2 delta medications and opioids. Oral iron supplements or intravenous infusions may also help improve RLS symptoms.
Learn more about restless legs syndrome
- Symptoms and diagnosis of RLS - RLS Foundation
- Practice guidelines: Treatment of RLS - American Academy of Neurology
- Long-term treatment of RLS - CNS Drugs
- The Long-Term Psychiatric and Cardiovascular Morbidity and Mortality of RLS – Sleep Medicine Clinics
- Baseline and 1-year longitudinal data from the National RLS Opioid Registry – Sleep
- Topiramate reduces nocturnal eating in sleep-related eating disorder – Sleep
Roughly one-third of adults have difficulty falling or staying asleep or find themselves waking up too early on a regular basis. A diagnosis of insomnia disorder is appropriate for people with prolonged sleeplessness that causes substantial distress, problems with daytime functioning, or both. Chronic insomnia can cause reductions in perceived health and quality of life, increases in workplace injuries or absenteeism and even fatal injuries. Additionally, prolonged insomnia is associated with an increased risk for depression and may be a risk factor for other health problems like heart disease, hypertension and diabetes, especially when combined with regular sleep of less than six hours per night.
Treatment options: The first-line therapy for insomnia is cognitive behavioral therapy (CBT), which includes setting realistic sleep goals, limiting time spent in bed, addressing skewed beliefs about sleeplessness and practicing relaxation techniques. For those who have short-term insomnia due to a known cause, doctors can prescribe sleep medications. For people with severe insomnia that is unresponsive to behavioral treatments, medications can be considered.
Learn more about insomnia
Sleep-related eating disorder
Sleep-related eating disorder (SRED) is a sleep disorder characterized by partial or full waking from sleep coupled with compulsive eating. People with SRED cannot control their nighttime eating and may be only partially conscious while doing so. The most common concern about SRED is weight gain, though disturbed sleep and daytime fatigue may also be issues. This disorder is more common in women, and symptoms typically appear in early adulthood. SRED is closely related with Night Eating Syndrome (NES).
Treatment options: Current treatments for SRED have been directed towards treating any underlying sleep disorder, eating disorder or psychiatric disorder that is present. Medications can sometimes be used—selective serotonin reuptake inhibitors (SSRIs), dopaminergic agonists, benzodiazepines, anorectics, hypnotics and opioids have been used, but success in treatment has varied.
The work of Dr. Winkelman has been featured in both academic and popular publications.
- See all of Dr. Winkelman’s academic publications
- Practice guideline summary: Treatment of restless legs syndrome in adults, American Association of Neurology Podcast
- 11 tips to help restless legs patients manage their symptoms, Sleep Review, July 2019
- Should sleep specialists prescribe opioids for restless legs syndrome?, Sleep Review, March 2019
- 9 Facts to know about restless legs syndrome, Self, March 2019
- Diving into the dangers of sleepwalking, ABC Boston, August 2018
- Restless legs syndrome an independent suicide risk factor?, Medscape, June 2018 (requires login)
- Roseann Barr isn’t the first person to blame Ambien, Boston Globe, May 2018
- The ‘Ambien defense’ has a long, dubious history, Time, May 2018
- Are leg and foot cramps waking you up at night? You’re not alone, Washington Post, August 2017
- Restless legs syndrome: Clinical implications for psychiatrists, Psychiatric Times, July 2017
- AAN releases first treatment guideline on restless legs syndrome, Medscape, December 2016
- New guidelines help patients suffering from restless leg syndrome, CBS Boston, March 2016
- A new study proves it: You should totally sleep in this weekend, Glamour, January 2016
- Ask well: Do sleeping pills induce restorative sleep?, New York Times Well Blog, December 2015
- 8 things your sleep habits say about you, Prevention, October 2014
- Sleeping in your 70s, Boston Globe, November 2014
- Healthful habits can help induce sleep without the pills, NPR, December 2013
- Opioids in the Treatment of RLS, Restless Legs Syndrome Foundation
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