Dr. Carter collaborates with interdisciplinary colleagues across the nation to explore the use of Behavioral Sleep Medicine approaches that can be useful to improving sleep quality in vulnerable populations. Her work has focused on designing, testing, and evaluating non-pharmacologic approaches to decreasing insomnia and depression symptoms while improving quality of life in active and bereaved family caregivers of persons with chronic and disabling conditions, in persons with cancer, in new mothers, and in college students.
In the past 17 years of research Dr. Carter has found that family caregivers of persons with chronic conditions (specifically cancer or dementia) suffer with severe insomnia, but they are unable to take advantage of pharmacologic treatments, because the excessive sedation does not allow for ongoing monitoring of the patient’s needs throughout the night. Therefore behavioral therapies are the most effective in decreasing the chronic sleep deprivation experienced in this population.
In the more recent 2-4 years, her work has expanded to include the exploration of how the cancer experience for both the patient and family caregiver is influenced by their sleep quality. In this time she has successfully begun to describe dyadic relationships between caregiver sleep quality and cancer patient symptom management. Additionally, she has piloted a brief behavioral intervention for sleep in the cancer patient-caregiver dyad that was delivered in a community oncology center during infusion therapy. These projects have resulted in submission of an RO1 application to NCI that was favorably reviewed, although not funded. This application is undergoing revision for resubmission.
An additional ongoing area of focus has been to develop junior sleep research scientists. This has been accomplished through the coaching and mentorship she has provided to undergraduate, masters, and doctoral students in a number of disciplines. Examples of undergraduate student projects include: exploring how college student’s sleep quality impacts their physical, mental, and social health as well as their academic success; how college student use of social media hinders sleep quality and how social media could be leveraged as mechanism for delivering positive sleep habits promotion messages to this population. While graduate student projects include: Exploration of sleep apnea assessment in pain clinics: Influence on opioid related deaths; Sleep assessment and quality of life in cancer patients: match between provider and patient ratings; Assessment of the role sleep quality plays daily function and quality of life for older adults across living environments (independent, assisted, memory care). The breadth of these projects supports her belief that sleep is a basic building block of health and wellbeing. By helping junior scientists to explore their passion through the lens of sleep broadens the impact of their work while contributing to the body of science that could not be generated by traditional sleep scientist alone.
Recently, Dr. Carter has been afforded the opportunity to broaden her own focus of research to include health promotion techniques (motivational interviewing) to promote CPAP adherence in older adults with mild cognitive impairment (MCI). Beginning this year (2017), she will be a co-investigator on Kathy Richards multiple PI NIH funded project to investigate the impact CPAP adherence has on MCI progression in older adults. This project allows her to broaden her own focus to include both obstructive sleep apnea and mild cognitive impairment, while maintaining her focus on non-pharmacological behavioral interventions and health promotion. She will be exploring opportunities to add to the current project aspects to describe the role and experience of the care partner in CPAP adherence and MCI progression.