Faculty Profile

Robert J. Thomas, MD


Assistant Professor of Medicine, Harvard Medical School
Physician, Assistant Professor, Pulmonary, Critical Care & Sleep, Department of Medicine, Beth Israel Deaconess Medical Center
Visiting Scientist, Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital

Administrative Title(s)

Sleep Medicine Fellowship Director, Beth Israel Deaconess Medical Center

See publications


Address

Beth Israel Deaconess Medical Center
330 Brookline Avenue, KB 023 (Pulmonary Office)
Boston, MA 02215
USA

Inter-office Mail Address

KB 023 (Pulmonary Office), Beth Israel Deaconess Medical Center

Phone 617-667-5864
Fax 617-667-4849

Email rthomas1@bidmc.harvard.edu

Society Memberships

American Academy of Sleep Medicine
World Association of Sleep Medicine
American Academy of Neurology

Research Unit(s)

Division of Pulmonary, Critical Care and Sleep, Beth Israel Deaconess Medical Center
(J. Woodrow Weiss)
Cardiology Research Core Laboratory (Peter Kang)
Margret & H. A. Rey Institute for Nonlinear Dynamics in Medicine (Ary Goldberger)
Martinos Center for Biomedical Imaging (Kenneth Kwong)

Research Interests

The central theme of my research is integration of data obtained from diverse physiological measurement tools to better understand sleep and sleepiness. Functional neuroimaging has demonstrated the neurocircuitry vulnerable in sleep apnea, narcolepsy, and following sleep deprivation and fragmentation. Assessment of hypoxia effects relatively free from sleep fragmentation is ongoing. There are strong suggestions that residual symptoms in highly treatment compliant patients with sleep apnea are due to ongoing sleep fragmentation from "complex disease" - chemoreflex mediated or modulated upper airway obstruction. We are developing methods to modulate CO2 to improve management of chemoreflex-driven sleep apnea syndromes.
The development of a ECG-based sleep spectrographic technique has provided profound insights into the nature of sleep that challenges the conventional characterization of sleep (staging, utility of delta power as an assay of sleep homeostatic drive, arousal scoring, respiratory event scoring). Sleep spectrograms are now being applied to rodent models of heart failure to between understand the temporal relationships between sleep fragmentation and heart failure. The hereditability of spectrographic phenotyping characteristics is being evaluated.

Trainees

Weohong Pan (2009-2010)
Trustin Ennacheril, M.D. (2009-2010)
Anil Agarwal, M.D (2009-2010)
Thadeus Shattuck, M.Dl (2009-2010)
Matt Bianchi, M.D. Ph.D. (2008-2009)
Andrew Lim, M.D. (2008-2009)
Jonathan Lipton, M.D., Ph.D. (2008-2009)
Umakanth Khatwa, M.D. (2008-2009)
Matthew Weiss, MD (2006-2008)
Karin Johnson, M.D. (2007-2008)
Ramesh Donepudi, M.D. (2007-2008)
Asha Singh, M.D. (2007-2008)
Viktor Hanak,. M.D. (2007-2008)
Mushtaque Chachar, M.D. (2007-2008)
Leon Ting, MD (2004-2005)
Matthew Curley, MD (2004-2005)
Anne Laraia, MD (2004-2005)
James Mojica, MD (2004-2005)
Amjad Husain, MD (2004-2005)
Lourdes Flaminiano, MD (2003-2004)
Daniel Normal, MD (2003-2004)
Amit Anand, MD (2003-2004)
Geoffrey Gilmartin, MD, MMSc (2003-2005)
Martha Praught, MD (2002-2004)
Diwarkar Balachandran, MD (2001-2002)
Arunabh Sharma, MD (1999-2000)

Mentor(s)

J. Woodrow Weiss, MD
Kenneth K. Kwong, PhD
Ary L. Goldberger, MD

Research Funding

NIH / NHLBI / 1RC1HL099749-01 PI: Thomas 9/2009-8/2011
ECG-derived cardiopulmonary coupling biomarkers of sleep, sleep-breathing and cardiovascular disease.
This Challenge Grant will evaluate the ECG-spectrogram as a biomarker of cardiovascular and respiratory control function using healthy subjects and those with congestive heart failure.
Role: PI

American Fibromyalgia Syndrome Association PI: Thomas 8/2009-7/2010
The ECG - derived sleep spectrogram: a dynamic marker of state in fibromyalgia
This study will assess the ECG-derived sleep spectrogram as a biomarker of sleep state in fibromyalgia.
Role: PI

NIH SBIR – Primary: CleveMed R44HL092686 PI: Thomas 10/1/2008-9/31/2011
Principal investigator (site): Robert Thomas, M.D.
Positive Airway Pressure Gas Modulator: a new method to treat central sleep apnea.
The major goal of this project is to develop a device to safely deliver precise concentrations of CO2 into the positive airway pressure circuit, for the management of central and mixed / complex forms of sleep apnea.
Role: Site PI

NIH SBIR 1R43NS066581-01 PI: Tarler (Site PI: Thomas) 9/2009-9/2010
Stimulation induced modulation of sleep
The aim of this project is to evaluate the clinical feasibility and effect of transcutaneous direct current stimulation of the carotid bodies, to modulate respiratory chemoreflexes in humans.
Role: Site PI

Center for Integration of Medicine and Innovative Technology (CIMIT) 6/1/08-6/31/10
P.I.: Thomas
Cervical Direct Current carotid body stimulation - preliminary evaluation of a novel method to modulate carotid chemoreflex function for treatment of central and complex sleep apnea.
The major goal of this exploratory project is to assess the feasibility of direct current stimulation in modulating carotid chemoreflexes in the rat.
Role: PI

Teaching

Heart Rate Variability 2006
SLEEP 2006 (Biology of Sleep Hypoxia - II)
Adaptive Medicine (Taiwan, 2009)
Indian Sleep Disorders Association (multiple talks, 2010)

Books: Atlas of Sleep Medicine (Chokroverty, Thomas, & Bhatt; Elsevier, 2005),
Principles and Practice of Sleep Laboratory Medicine (Thomas & Guilleminault; Elsevier, 2007)

Selected Publications

Original Articles   
 
Thomas RJ, Mietus JE, Peng CK, Goldberger AL, Crofford LJ, Chervin RD.
Impaired sleep quality in fibromyalgia: Detection and quantification with
ECG-based cardiopulmonary coupling spectrograms. Sleep Med. 2009 Dec 14. [PMID: 20015685]

Thomas RJ, Weiss MD, Mietus JE, Peng CK, Goldberger AL, Gottlieb DJ. Prevalent
hypertension and stroke in the Sleep Heart Health Study: association with an
ECG-derived spectrographic marker of cardiopulmonary coupling. Sleep. 2009 Jul
1;32(7):897-904. [PMID: 19639752]

Weiss MD, Tamisier R, Boucher J, Lynch M, Gilmartin G, Weiss JW, Thomas RJ. A
pilot study of sleep, cognition, and respiration under 4 weeks of intermittent
nocturnal hypoxia in adult humans. Sleep Med. 2009 Aug;10(7):739-45. Epub 2009
Mar 17. [PMID: 19282237]

Thomas RJ, Mietus JE, Peng CK, Gilmartin G, Daly RW, Goldberger AL, Gottlieb
DJ. Differentiating obstructive from central and complex sleep apnea using an
automated electrocardiogram-based method. Sleep. 2007 Dec 1;30(12):1756-69.
[PMID: 18246985]

Thomas RJ, Tamisier R, Boucher J, Kotlar Y, Vigneault K, Weiss JW, Gilmartin
G. Nocturnal hypoxia exposure with simulated altitude for 14 days does not
significantly alter working memory or vigilance in humans. Sleep. 2007 Sep
1;30(9):1195-203. [PMID: 17910391]

Yeh GY, Mietus JE, Peng CK, Phillips RS, Davis RB, Wayne PM, Goldberger AL,
Thomas RJ. Enhancement of sleep stability with Tai Chi exercise in chronic heart
failure: preliminary findings using an ECG-based spectrogram method. Sleep Med.
2008 Jul;9(5):527-36. Epub 2007 Aug 3. [PMID: 17689142]

Thomas RJ, Kwong K. Modafinil activates cortical and subcortical sites in the
sleep-deprived state. Sleep. 2006 Nov 1;29(11):1471-81. [PMID: 17162995]

Thomas RJ. Sleep fragmentation and arousals from sleep-time scales,
associations, and implications. Clin Neurophysiol. 2006 Apr;117(4):707-11. Epub 2006 Feb 23. [PMID: 16500146]

Thomas RJ, Mietus JE, Peng CK, Goldberger AL. An electrocardiogram-based
technique to assess cardiopulmonary coupling during sleep. Sleep. 2005 Sep
1;28(9):1151-61. [PMID: 16268385]

Thomas RJ. Fatigue in the executive cortical network demonstrated in
narcoleptics using functional magnetic resonance imaging--a preliminary study.
Sleep Med. 2005 Sep;6(5):399-406. [PMID: 15996898]

Thomas RJ, Daly RW, Weiss JW. Low-concentration carbon dioxide is an
effective adjunct to positive airway pressure in the treatment of refractory
mixed central and obstructive sleep-disordered breathing. Sleep. 2005 Jan
1;28(1):69-77. [PMID: 15700722]

Thomas RJ, Rosen BR, Stern CE, Weiss JW, Kwong KK. Functional imaging of
working memory in obstructive sleep-disordered breathing. J Appl Physiol. 2005
Jun;98(6):2226-34. Epub 2005 Jan 27. [PMID: 15677733]

Books, Reviews, etc.

Chokroverty, Thomas, & Bhatt. Atlas of Sleep Medicine. Elsevier (Butterworth-Heinemann); 2005.

Gilmartin GS, Daly RW, Thomas RJ. Recognition and management of complex
sleep-disordered breathing. Curr Opin Pulm Med. 2005 Nov;11(6):485-93. Review.
[PMID: 16217173]

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