Candidate Dr. Donald Fogelberg is currently Assistant Professor in the Department of Rehabilitation Medicine at the University of Washington (UW). He completed his PhD and his post-doctoral training in the Division of Occupational Science and Occupational Therapy at the University of Southern California (USC). While at USC, he worked on several federally funded research grants, including 3 ethnographic studies and two randomized controlled trials. In his current position, he works with two NIDRR-funded research teams, the Traumatic Brain Injury (TBI) Model System and the SCI Model System, both housed in the UW Department of Rehabilitation Medicine. Dr. Fogelberg's research experience includes multiple phases of the translational research process: collecting and analyzing qualitative, descriptive data;translating these data into structured clinical protocols suitable for testing;and preparing for and implementing an RCT. He has been actively involved in research concerning spinal cord injury (SCI) rehabilitation since 2005. Dr. Fogelberg's main research interest is in sleep disturbance in the context of chronic neurological conditions. His long term career objectives are to examine the impact of sleep disturbance on rehabilitation outcomes;to translate this knowledge into novel evidence- based rehabilitation strategies;and to utilize rigorous clinical trials research to evaluate interventions for sleep disturbance in those with chronic neurological conditions. Currently, his research is focused on sleep disturbance in SCI, with a view to developing a better understanding of both the frequency of sleep problems in SCI and the relationship of sleep disturbances to co-morbid conditions that are common in SCI, and developing more effective means of detecting sleep disturbance in this population. Environment The University of Washington School of Medicine consistently ranks among the top Medical Schools in the nation in the U.S. News and World Report for its excellence in research, clinical training programs, and patient care. The School of Medicine is an international leader in biomedical research, receiving over $500 million in research funding annually. The Department of Rehabilitation Medicine at the University of Washington has had a strong commitment to research since its inception. Research, both basic and clinical, is a major component of the departmental mission. The Department is consistently ranked in the top two in NIH funding and the top three in overall research funding for all rehabilitation departments. The department has six federally funded centers, including Model Systems grants for Spinal Cord Injuries, Traumatic Brain Injuries, and Burns;a Research and Training Center Grant for Multiple Sclerosis;a Program Project in Chronic Pain Management;and a Center for Outcomes Research in Rehabilitation. Research I will conduct two studies during the course of this award. From month 7 to month 30, I will complete a sleep study with two main components, each addressing one of my specific aims. The first component will be a structured cognitive interview with individuals living with SCI. Cognitive interviewing is a theory-based interview technique which focusses on the cognitive processes used by questionnaire respondents in generating their responses to survey or questionnaire items. The purpose of these interviews is to identify sources of response errors and improve questionnaire design. Working with the same subjects, I will then gather objective data on key sleep parameters using both actigraphy (ACT) and in-home polysomnography (PSG). After completing the sleep study, I will conduct the second study, a survey of adults with SCI. This survey will yield data on the psychometric properties of the screening instrument;the frequency of symptoms indicating insomnia, circadian rhythm sleep disorders (CRSD), and sleep related breathing disorders (SRBD) and the relationship of sleep disturbances to commonly co-occurring disorders.
Chronic sleep disturbance is a common but poorly understood problem for people who have a spinal cord injury (SCI), with many potential contributing factors including changes in neuroendocrine function and body temperature regulation;other medical conditions secondary to SCI;side effects of prescribed medications;and nighttime care routines. The goals of this research are to develop a screening instrument to identify individuals with SCI at high risk of sleep disturbance and to test the hypothesis that sleep is an important modifiable factor for a range of adverse outcomes such as depression, increased pain, weight gain, poor overall health, difficulty functioning on a daily basis, and decreased satisfaction with life.