Through a long-standing collaboration with Virginia Tech’s Center for Biostatistics and Health Data Science (CBHDS), researchers are working to better understand how treating common sleep disorders may help protect brain health in older adults. By combining clinical expertise in sleep medicine with rigorous statistical methods, the partnership is helping generate evidence that could inform how clinicians assess and treat sleep problems in aging populations.

A key collaborator in this work is Dr. Nalaka Gooneratne, a sleep medicine physician and researcher at the University of Pennsylvania whose research focuses on the intersection of sleep, aging, and neurological health, in partnership with CBHDS investigators, Dr. Gooneratne has led and contributed to NIH-funded studies examining whether effective treatment of sleep disorders, such as sleep apnea and insomnia, can slow or delay cognitive decline in later life.

Gooneratne’s interest in sleep research is both professional and personal. 

“I developed insomnia in medical school,” he said. “I could relate to the stress that it caused, and that made me interested in the area.” 

As his training progressed, he became increasingly aware that older adults are particularly vulnerable to sleep disorders, with high rates of both insomnia and sleep apnea. For him, this represented an opportunity to address a widespread but often underrecognized public health issue.

Cognitive decline is one of the most feared consequences of aging, and it rarely has a single cause. 

“There are many things that contribute to cognitive impairment,” Dr. Gooneratne explained. “Cardiovascular disease, mood disorders, prior brain injury, and other medical conditions all play a role. Increasingly, we understand that sleep is also a factor.” 

Sleep apnea and insomnia are among the most common sleep disorders in older adults, each affecting an estimated 15 to 30 percent of the U.S. population. Importantly, both conditions are treatable yet sleep apnea often goes undiagnosed. 

“The benefit of studying sleep disorders is that we already have effective treatments,” Dr. Gooneratne said. “What’s often missing is awareness, and rigorous evidence showing how much treating sleep can help protect brain health.”

Generating that evidence is the focus of Memories2, a large parent study involving approximately 300 older adults. The study examines whether treatment of sleep apnea using continuous positive airway pressure (CPAP) is associated with improved neurological outcomes, particularly among individuals with mild cognitive impairment. Supported by funding from the National Institutes of Health (NIH), the project relies on close collaboration between clinical investigators and quantitative scientists.

Through a sub-award on the NIH-funded project, CBHDS serves as a key statistical partner, with Dr. Alexandra Hanlon, Director of CBHDS acting as Principal Investigator and Wenyan Ji, Muyao (Jenny) Lin, and Alicia Lozano serving as Co-Investigators. In this role, the CBHDS team provides statistical leadership and collaboration across study design, grant development, data collection planning, and analytic strategy throughout the study lifecycle. 

“Without their help, we would not have gotten the grant in the first place,” Dr. Gooneratne said.

He credited CBHDS with developing a thoughtful and nuanced statistical analysis plan, a critical component of successful NIH proposals. As the study progressed, CBHDS team continued to provide guidance on data collection and analytic strategy and are now leading the final analyses and preparation of publication-ready results.

“What’s been especially impressive is their use of state-of-the-art statistical approaches,” Gooneratne added, noting the team’s expertise in methods such as propensity score analysis. “That level of rigor allows us to use the dataset to its full potential and strengthens the impact of the findings.”

While final results are still forthcoming, the goal of the collaboration is clear: to help clinicians and patients better prioritize sleep as part of cognitive health care. By building a strong statistical evidence base, this partnership aims to support greater recognition of sleep assessment and treatment as an important component of healthy aging and cognitive care.