Our research group has over 15 years of experience dedicated to the development of a sleep-cardiovascular program. The team was the first to identify a large-scale epidemiologic association of sleep apnea and nocturnal cardiac arrhythmia. The overarching goals are to use findings from epidemiologic studies demonstrating high magnitude associations between the incidence of sleep apnea and cardiac arrhythmia to better understand mechanistic underpinnings, to apply these findings to the clinical research realm, to advance and optimize care of the patient with sleep disorders, and to mitigate arrhythmic and cardiovascular risk.
Our research team has led sleep-cardiovascular clinical trials, clinical and translational science, and epidemiologic studies. We have administered several projects with the following research foci: 1) sleep disordered breathing and cardiac arrhythmia epidemiology (with a focus on atrial fibrillation) characterized by leading de novo analyses of cardiac electrophysiologic signals in large-scale epidemiologic cohorts involving thousands of participants (i.e., the Sleep Heart Health Study and Outcomes of Sleep Disorders in Older Men study); 2) identification of polysomnographic predictors of atrial fibrillation; 3) examination of cardiometabolic biomarkers in sleep disordered breathing; and 4) investigation of the impact of sleep apnea treatment in cardiovascular disease and risk on patient reported outcomes. Through these studies, we have performed hundreds of research polysomnograms mainly in the Cleveland Clinic Clinical Research Unit and actigraphy studies with quality measures in place. Our group efforts are characterized by team science that includes the establishment of collaborative ties with epidemiologists, neurologists, cardiologists, electrophysiologists, biomedical engineers, and biostatisticians.
2018-2023 NIH/NHLBI The Impact of Low Flow Oxygen Therapy on Hospital Admissions and Mortality In Patients with Heart Failure and Central Sleep Apnea (LOFT-HF), PI: S Redline, Site PI: R Mehra
2018-2022 American Heart Association SDRFN Upstream Targeting for the Prevention of Atrial Fibrillation: Targeting Risk Interventions and Metformin for Atrial Fibrillation (TRIM-AF), PI: M Chung
2018-2019 NIH Clinical Translational Science Collaborative Large Pilot Grant Obstructive Sleep Apnea and Cardiac Electrophysiologic Biomarkers of Sudden Cardiac Death, PI: R Mehra
2017-2018 Cleveland Clinic Research Programs Committees Grant Validation of Novel Circulating Protein Biomarkers in Sleep Apnea and Atrial Fibrillation Identified by Aptamer-Based Serum Proteomics, PI: R Mehra
2011-2017 NHLBI R01 HL 109493 – 01 Elucidation of the Risk of Sleep Apnea in Atrial Fibrillation, PI: R Mehra
2011-2014 NHLBI 1 R21 HL108226-01A1 Sleep-Related Respiratory and Electrophysiological Atrial Fibrillation Predictors
2006-2011 NIH/NHLBI HL079114, K23 Mentored Patient-Oriented Clinical Research Career Development Award Title: Oxidative Stress in Sleep Apnea and Cardiac Disease
- Progress toward the prevention and treatment of atrial fibrillation: A summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9–10, 2013.Van Wagoner DR, Piccini JP, Albert CM, Anderson ME, Benjamin EJ, Brundel B, Califf RM, Calkins H, Chen P-S, Chiamvimonvat N, Darbar D, Eckhardt LL, Ellinor PT, Exner DV, Fogel RI, Gillis AM, Healey J, Hohnloser SH, Kamel H, Lathrop DA, Lip GYH, Mehra R, Narayan SM, Olgin J, Packer D, Peters NS, Roden DM, Ross HM, Sheldon R and Wehrens XHT. Heart Rhythm. 2015; 12:e5-e29. PMC4425127.
- Association of Sleep Characteristics with Atrial Fibrillation: the Multi-Ethnic Study of Atherosclerosis. Kwon Y, Gharib SA, Biggs ML, Jacobs DR Jr, Alonso A, Duprez D, Lima J, Lin GM, Soliman EZ, Mehra R, Redline S, Heckbert SR. Thorax. 2015 May 18. PMC5495463.
- Automated detection of atrial fibrillation from the electrocardiogram channel of polysomnograms, Sleep Breath. Monahan K, Song Y, Loparo K, Mehra R, Harrell FE Jr, Redline S. 2015 Jun 20. PMC5027603.
- Effect of Continuous Positive Airway Pressure on Blood Pressure in Resistant Hypertension and Hypertension in a Large Clinic-Based Cohort, Walia HK, Griffith SD, Thomas G, Bravo EL, Moul DE, Foldvary-Schaefer, Mehra R. CHEST. 2015 Jul 30. PMC4944790.
- Central Sleep Disordered Breathing Predicts Incident Atrial Fibrillation in Older Males.May AM, Blackwell T, Stone PH, Stone KL, Cawthon PM, Loparo KA, Varosy PD, Redline S, Sauer W, Mehra R for the Osteoporotic Fractures in Men (MrOS) Study Group. Am J Respir Crit Care Med. 2015 Nov 23. PMC4824932.
- Sleep Disordered Breathing and Risk of Stroke in Older Community-dwelling Men.Stone KL, Blackwell T, Redline S, Ancoli-Israel S, Barrett-Connor E, Bauer DC, Cauley J, Ensrud K, Hoffman AR, Mehra R, Stefanick M, Varosy P, Yaffe K. Sleep. 2016 Jan 15. PMC4763364.
- Relationship of Bisphosphonate Therapy and Atrial Fibrillation/Flutter: Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study.Thadani S, Ristow B, Blackwell T, Mehra R, Stone KL, Marcus GM, Varosy PD, Cummings SR, Cawthon PM. Chest. 2015 Dec 12. PMC4944772.
- Sleep Disordered Breathing and Daytime Cardiac Conduction Abnormalities on 12-lead Electrocardiogram in Community-Dwelling Older Men. Kwon Y, Picel P, Adabag S, Vo T, Taylor B, Stone KL, Mehra R, Ancoli-Israel S, Ensrud KE. Sleep and Breathing. 2016 Mar 12. PMC5018906.
- Effect of Continuous Positive Airway Pressure on Cardiovascular Biomarkers: the Sleep Apnea Stress Study Randomized Controlled Trial. Paz Y Mar H, Hazen SL Tracy RP, Strohl KP, Auckley D, Bena J, Wang L, Walia HK, Patel SR, Mehra R. CHEST. 2016 Jul;150(1):80-90. PMC4980547.
- Oxidative Stress and Inflammation Differentially Elevated in Objective versus Habitual Subjective Reduced Sleep Duration in Obstructive Sleep Apnea. DeMartino T, El ghoul R, Hazen SL, Li H, Rehman T, Johnson NL, Thomas C, Aylor JE, Auckley D, Mehra R. SLEEP. 2016 Jul 1;39(7):1361-9. PMC4909618.
- Positive Airway Pressure-Induced Conversion of Atrial Fibrillation to Normal Sinus Rhythm in Severe Obstructive Sleep ApneaWalia HK, Chung, MK, Ibrahim S, Mehra R., J Clin Sleep Med. 2016 May 3. PMC4990954.
- Echocardiographic Characteristics of Right Ventricular Structure and Function are Associated with Incident Heart Failure and Mortality in Patients with Sleep Disordered Breathing and Preserved Ejection Fraction, Kusunose K, Phelan D, Seicean S, Seicean A, Collier C, Boden KA, Mehra R, Griffin BP. Am J Cardiol. 2016 Jul 28. PMID:27553095.
- Longitudinal Effect of CPAP on BP in Resistant and Nonresistant Hypertension in a Large Clinic-Based Cohort. Walia HK, Griffith SD, Thompson NR, Moul DE, Foldvary-Schaefer N, Mehra R. Chest. 2016 Mar;149(3):747-55. PMC5033737.
- Fine-mapping, Novel Loci Identification, and SNP Association Transferability in a Genome-Wide Association Study of QRS Duration in African Americans. Evans DS, Avery CL, Nalls MA, Li G, Barnard J, Smith EN, Tanaka T, Butler AM, Buxbaum SG, Alonso A, Arking DE, Berenson GS, Bis JC, Buyske S, Carty CL, Chen W, Chung MK, Cummings SR, Deo R, Eaton CB, Fox ER, Heckbert SR, Heiss G, Hindorff LA, Hsueh WC, Isaacs A, Jamshidi Y, Kerr KF, Liu F, Liu Y, Lohman KK, Magnani JW, Maher JF, Mehra R, Meng YA, Musani SK, Newton-Cheh C, North KE, Psaty BM, Redline S, Rotter JI, Schnabel RB, Schork NJ, Shohet RV, Singleton AB, Smith JD, Soliman EZ, Srinivasan SR, Taylor HA Jr, Van Wagoner DR, Wilson JG, Young T, Zhang ZM, Zonderman AB, Evans MK, Ferrucci L, Murray SS, Tranah GJ, Whitsel EA, Reiner AP; CHARGE QRS Consortium, Sotoodehnia N. Hum Mol Genet. 2016 Aug 29. PMC5291202.
- Longitudinal Relationships of Periodic Limb Movements During Sleep and Incident Atrial Fibrillation. May A, Blackwell T, Stone KL, Cawthon-Mannen P, Sauer WH, Varosy P, Redline S, Koo BB, Mehra R. Sleep Med. 2016 Sep;25:78-86. PMC5126983.
- Obesity as an Effect Modifier of Sleep Disordered Breathing and Post-Operative Cardiac Surgery Atrial Fibrillation. Kaw R, El Zarif S, Bena J, Wang L, Mehra R. CHEST. 2017 Mar 11. pii: S0012-3692(17)30367-7. PMID: 28300569.
- Polysomnographic Heart Rate Variability Indices and Atrial Ectopy Associated with Incident Atrial Fibrillation Risk. Raman D, Kaffashi F, Lui L, Redline S, Stone P, Cawthon Mannen P, Stone KL, Ensrud K, Ancoli-Israel S, Loparo K, Mehra R. JACC Clin Electrophysiol. 2017 May;3(5):451-460. PMC5437978.
- Impact of Continuous Positive Airway Pressure and Oxygen on Health Status in Patients with Obstructive Sleep Apnea: A HeartBEAT Analysis. Lewis EF, Wang R, Quan S, Gottlieb D, Bhatt D, Blumenthal R, Mehra R, Punjabi NM, Patel SR, Weng J, Redline S. Am Heart J. 2017 Jul;189:59-67. PMID: 28625382.
- Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation. Tung P, Levitsky YS, Wang R, Weng J, Quan SF, Gottlieb DJ, Rueschman M, Punjabi NM, Mehra R, Bertisch S, Benjamin EJ, Redline S et al. J Am Heart Assoc. 2017 Jul 1;6(7). PMCID: PMC5586257.
- Impact of Sleep Disordered Breathing Treatment on Quality of Life Measures in a Large Clinic-Based Cohort. Walia HK, Thompson NR, Katzan I, Foldvary-Schaefer N, Moul DE, Mehra R. J Clin Sleep Med. 2017 Nov 15;13(11):1255-1263. PMCID: PMC5656474.
- Dissociation of Objective and Subjective Daytime Sleepiness and Biomarkers of Systemic Inflammation in Sleep Disordered Breathing and Systolic Heart Failure. Mehra R, Wang L, Andrews N, Tang WH, Young JB, Javaheri S, Foldvary-Schaefer N. J Clin Sleep Med. 2017 Dec 15;13(12):1411-1422. PMCID:PMC5695987.
- Continuous Positive Airway Pressure Adherence Predictors in a Randomized Controlled Trial Enriched with Women and Minorities. May A, Gharibeh T, Wang L, Hurley A, Strohl KP, Mehra R. CHEST. 2018 Apr 20. PMCID: PMC6130325
- Obstructive Sleep Apnea and REM Sleep: Double Trouble for Atrioventricular Conduction Delay in the Conditioned Heart. Kaur S. Mehra R. Chest. 2018 Nov;154(5):e139-e142. PMID:30409368.
- Reducing coronary heart disease risk through treatment of insomnia using web-based cognitive behavioral therapy for insomnia: a methodological approach. Javaheri S, Reid M, Drerup M, Mehra R, Redline S. , Behav Sleep Med. 2019 Mar 4:1-11. PMID:30829067.
- Mean nocturnal respiratory rate predicts cardiovascular mortality in community dwelling older men and women. Baumert M, Linz D, Stone K, Cummings S, Redline S, Mehra R, Immanuel S. Eur Respir J. 2019 Jul 25;54(1). PMID:31151958.
- Upper Airway Stimulation versus Positive Airway Pressure Impact on Blood Pressure and Sleepiness Symptoms in Obstructive Sleep Apnea. Walia H, Thompson NR, Strohl MD KP, Faulx MD , Waters T, Kominsky A, Foldvary-Schaefer N, Mehra R. Chest. 2019 Jul 9. PMID:31299245.
- Association of Individual Periodic Limb Movements and Non-sustained Tachycardia During Sleep: A Case-Crossover Analysis. May A, May RD, Bena J, Wang L, Monahan K, Stone KL, Cawthon PM, Barrett-Connor E, Koo BB, Winkelman JW, Redline S, Mittleman MA, Mehra R. for the Osteoporotic Fractures in Men (MrOS) Study Group. Sleep. 2019 Jul 17.
- Impact of Positive Airway Pressure Therapy on Drowsy Driving in a Large Clinic-Based Obstructive Sleep Apnea Cohort. Walia H, Thompson NR, Pascoe M, Faiisal M, Moul, DE, Katzan I, Mehra R, Foldvary-Schaefer N. J Clin Sleep Med. 2019 Oct 7.
- Sleep Apnea and Cardiovascular Disease. Mehra R. Advance for Managers of Respiratory Care Jan/Feb 2007: 16: 47-50. (invited review).*
- Sleep-Disordered Breathing and Cardiovascular Disease: Exploring Pathophysiology and Existing Data. Mehra R. Current Respiratory Medicine Reviews 2007 Vol.3, No. 4: 258-269. (invited review).*
- Sleep apnea: a proinflammatory disorder that coaggregates with obesity. Mehra R, Redline S. J Allergy Clin Immunol. 2008 May;121(5):1096-102. PMID: 18466782 (invited review).*
- Arrhythmia Risk Associated with Sleep Disordered Breathing in Heart Failure. Mehra R, Redline S. Current Heart Failure Reports. Volume 10, Issue 1. 2013 (invited review).*
- Targeting Sleep Disordered Breathing to Prevent Heart Failure: What is the Evidence? Kusonose, K, Mehra R. Current Cardiovascular Risk Reports. Curr Cardiovasc Risk Rep. 2014 Oct 1;8(10):403.PMID:25215169.
- Obstructive Sleep Apnea: Role of Intermittent Hypoxia and Inflammation. May A, Mehra R. Seminars in Respiratory and Critical Care Medicine. 2014 Oct; 35(5):531-44. PMID: 25333334.
- Obstructive Sleep Apnea and Cardiovascular Disease, Sleep Medicine, Mehra R. Editor Nancy Collop., UpToDate, 2014, 2015, 2016, 2017, 2018.
- Mechanistic Insights of Sleep Disordered Breathing and Cardiac Arrhythmogenesis. May A, Mehra R. CHEST 2016 Sep 29.
- Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Javaheri S, Malhotra A, Martinez-Garcia MA, Mehra R, Pack AI, Polotsky VY, Redline S, Somers VK. J Am Coll Cardiol. 2017 Feb 21;69(7):841-858.
- Biomarkers in Sleep Apnea and Heart Failure. Zhao YY, Mehra R. Current Heart Failure Reports. Curr Heart Fail Rep. 2017 Jun 30.
- Should I Evaluate My Patient with Atrial Fibrillation for Sleep Apnea? Ayache MB, Mayuga KM, Mehra R. Cleveland Clinic Journal of Medicine. Cleve Clin J Med. 2019 Nov;86(11):709-712.
- Sleep Apnea and the Heart. Cleveland Clinic Journal of Medicine. Mehra R. Cleve Clin J Med. 2019 Sep;86(9 Suppl 1):10-18.
- A Paradigm Shift in the Treatment of Central Sleep Apnea in Heart Failure. Mehra R, Gottlieb DG. CHEST, 2015 Oct 1;148(4):848-51.
- Association between OSA and glucose metabolism – more than meets the eye. Ip M, Mehra R, Lam K., American Journal of Respiratory and Critical Care Medicine. Am J Respir Crit Care Med. 2015 Sep 15;192(6):656-8.
- Obstructive Sleep Apnea as a Candidate Unifier in Atrial Fibrillation and Cryptogenic Stroke. Mehra R, Foldvary-Schaefer., Sleep. 2015 Oct 5.
- The Weighty Issue of Obesity Management in Sleep Apnea. Patel SR, Mehra R., CHEST. Chest. 2015 Nov 1;148(5):1127-9.
- Identification of optimal obstructive sleep apnea screening approaches in the diabetic population. Walia H, Mehra R., Sleep Med. 2016 Oct;26:77-78.
- Circulating Anti-Coatomer Protein Complex Subunit Epsilon (COPE) Autoantibodies as a Potential Biomarker for Cardio- and Cerebro-Vascular Events in Patients with Obstructive Sleep Apnea. Mehra R. Building Evidence Implicating Novel Cardiovascular Biomarkers in Obstructive Sleep Apnea: by Matsumura et al., J Clin Sleep Med 2017;13(3)
- Clarifying the Role of Nocturnal Hypoxia as a Potential Promulgator of Atrial Fibrillation in Ischemic Stroke. Walia H, Bena J, Mehra R., Journal of Clinical Sleep Medicine. J Clin Sleep Med. 2017 May 15;13(5):667-668.
- Positive Airway Pressure Physiologic Impact on the Hypertrophied Heart: Cause for Concern? Xu B, Mehra R., J Thorac Dis. 2017 Jun;9(6):1409-1411.
- Sleep Disordered Breathing and Post-Cardiac Surgery Atrial Fibrillation. Kaw R, Mehra R., J Thorac Dis. 2017 Jun;9(6):1409-1411.
- Sleep Apnea and Nocturnal Cardiac Arrhythmia: Understanding Differences Across Ethnicity. Mehra R., J Clin Sleep Med. 2017 Nov 15;13(11):1229-1231.
- Obstructive Sleep Apnea and Risk of Postcardiac Surgery Atrial Fibrillation. Kaw R, Mehra R., Anesth Analg. 2018 Sep 6. PMID:30176984.
- POINT: Should all patients with atrial fibrillation who are about to undergo pulmonary vein ablation be evaluated for obstructive sleep apnea? Yes. Point/Counterpoint. Mehra R, Wazni O., CHEST. Chest. 2018 Nov;154(5):1008-1010. PMID:30409356.
- Response: Should all patients with atrial fibrillation who are about to undergo pulmonary vein ablation be evaluated for obstructive sleep apnea? Yes. Point/Counterpoint. Mehra R, Wazni O., CHEST. Chest. 2018 Nov;154(5):1013-1014. PMID:30409358.
- Novel Insights into Sleep Disorder and Atrial Fibrillation Risk: More Than Sleep Apnea. Mehra R, Marcus G., Chest. 2019 Sep; 156(3):421-423.