Faculty Q&A: Ruth Benca

Focused on sleep for more than 25 years, Ruth Benca, MD, PhD, describes the new clinical and research programs she directs and explains why sleep research and sleep medicine are so interesting and important.

Benca is a professor of psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison.

What are these beautiful facilities at Research Park?

This is the home of Wisconsin Sleep, our clinical arm, and the Center for Sleep Medicine and Sleep Research, our research arm. It's one of the nicest sleep laboratories anywhere in terms of amenities, and potentially one of the most sophisticated in terms of its technical capabilities.

What was your role in creating this?

I've been deeply involved in every step of designing everything from the building to the clinical and research programs. Fortunately, I had great support from the UW Medical Foundation, the School of Medicine and Public Health and my fellow faculty here in the center. Meriter Hospital is also a partner in Wisconsin Sleep.

The project was very attractive to me because it involved putting together a new academic program in a brand new field of medicine. Since there was no template, we had the opportunity to create something novel and forward looking.

What's unique here?

We are probably one of the first truly multidisciplinary academic sleep centers in the country. This has the advantage of allowing us to develop a multispecialty team in which no single department has "ownership" of the center.

Everything we do here has two general goals. First, to provide the best clinical care possible for our patients and, second, to embed good research methodologies and data-gathering practices into everything we do.

Sounds like a great description of "translational."

Yes, we built this program to foster translational research, with the clinic and research missions fully integrated. Research is not an add-on to our clinical program. The idea is that our research and clinical missions are seamless. For example, any bed can be used for clinical or research purposes, and our technicians are cross-trained to perform clinical and research duties.

What kind of research do you and your colleagues conduct here?

We do a broad range of clinical research. For example, Dr. Giulio Tononi's group has been performing studies ranging from the effects of sleep loss to biological markers in sleep for psychiatric disorders. In terms of basic research, Dr. Chiara Cirelli is conducting exciting research on the molecular biology of sleep.

My current research is on the effect of seasonal changes on bird sleep and behavior. Wisconsin has a great tradition of sleep research, especially the groundbreaking epidemiologic studies being done by Dr. Terry Young with her Wisconsin Cohort for more than two decades.

What can you tell us about the clinic?

We're very busy! We see patients with the full range of sleep disorders, from sleep apnea to insomnia to abnormal behaviors during sleep. The staff consists of 11 physicians representing pulmonology, geriatrics, neurology, psychiatry and pediatrics, as well as two nurse practitioners.

What special technology do you use?

We are the world's first high-density EEG sleep laboratory, which means that we can record up to 256 channels of EEG to map brain activity in sleep across the entire night. We are also the world's largest high-density EEG facility of any type.

Do you get a lot of referrals?

We are a tertiary care center, so we get referrals from the entire region. Most of our patients are referred to us by other health care providers, and we also get referrals for second opinions from other sleep centers in the region. Patients can self-refer to the clinic if they think they might have sleep apnea.

Why are people so interested in sleep?

It's a huge part of our lives - one third - and it's still somewhat mysterious. People generally assume - rightly so - that not sleeping enough or not sleeping well isn't good for you. The links between sleep disorders and other health problems are becoming more evident.

When did you first become interested in sleep?

I suppose I became interested in sleep as an undergraduate at Harvard. I was a German literature major and my undergraduate thesis was on the function of dreams in the turn-of-the-century Viennese novella. These were written around the time of Freud, so I also studied his psychoanalytic theories, albeit from a literary standpoint.

What were your interests during medical school?

I was in the MD/PhD program at the University of Chicago. My original plan was to be a pathologist. I earned my PhD in pathology, but decided it wasn't the right field for me because there wasn't enough patient contact. During my last two years of medical school, I found myself most interested in psychiatry, which is probably the opposite of pathology in terms of patient interaction.

How about your first research?

I first learned about sleep research during my psychiatry residency at Chicago, which was probably the birthplace of the discipline, with REM sleep first described there in the early 1950s. I worked with Dr. Allan Rechtschaffen to look at the role of sleep loss on immune function and then ended up doing a fellowship in sleep medicine. I spent eight years on the faculty at Chicago before moving to Madison.

Have you stayed connected to Chicago?

Yes, since my husband is an associate dean at the university. He directs the Medical Scientist Training Program and the Biological Sciences Collegiate Division. We've been commuting between Chicago and Madison for 17 years now. We have three children; the youngest just graduated from college.

What's your research here at Wisconsin been about?

I've worked on various animal models related to sleep and mood disorders, from how changes in light conditions and seasons affect behavior to the effects of sleep deprivation in birds and mammals.

For example, our work suggests that migratory birds show seasonal changes in sleep and behavior that are similar to what occurs in people with bipolar disorders. With the creation of the sleep center, I've turned my focus to studying sleep in patients with mood disorders and insomnia.

Do you do a lot of teaching?

I enjoy teaching and mentoring students and trainees at all levels in the medical school and the university. We're also developing continuing medical education programs through the sleep center. This fall, we're teaching a course for primary care providers on the diagnosis and treatment of common sleep disorders.

Not nearly enough time is devoted to sleep and sleep disorders in medical schools or residency programs. For that reason, I just wrote a handbook on sleep medicine that contains basic information that I think every healthcare provider should know.

How much do you sleep?

I get about 6.5 to 7.5 hours most nights, probably about average for my age. Certainly I don't sleep as much now as I used to, but given how much there is to do, that may not be a bad thing!

This story appears in the summer 2010 issue of Quarterly.