It was a souvenir from the other side of the world in the early 1990s that set a trainee in pulmonary medicine at Case Western Reserve University hospital system on the path to becoming Susan Redline, MD, MPH, the 2025 recipient of one of the ATS’s most prestigious prize, the Edward Livingston Trudeau Medal.

The “Unique” Device

That souvenir—or more precisely, the idea of it—was brought back from Australia by Dr. Redline’s then-mentor, Kingman Strohl, MD, an internationally recognized pioneer in sleep medicine and respiratory control, who had been exposed to the work of Colin Edward Sullivan, MBBS, PhD, at the Royal Prince Alfred Hospital in Camperdown, Australia. Dr. Sullivan had hand-manufactured and patented a unique “device for treating snoring sickness” that would become known as the CPAP.

Returning to Cleveland, Dr. Strohl began manufacturing similar devices in the basement of his hospital and showing them to others, including Dr. Redline.

This was still a time when, Dr. Redline noted, the condition of sleep apnea was “not understood at all” and noninvasive therapies such as the new CPAP machines were a novel approach in settings where patients suffering from sleep apnea were commonly given tracheostomies.

These noninvasive CPAP machines would represent an approach that would transform Dr. Redline’s field, provide an impetus for her career, and shape new understandings of how better understanding sleep disorders could transform patients’ lives.

“I had this experience of having patients who had been treated with tracheostomies being transitioned to CPAP machines,” Dr. Redline recalled. “And what a life difference it is not to have to have a tracheostomy and to be treated and wake up feeling awake and alert, to be part of your family and have your blood pressure under control.  Those were very formative experiences for me.”

Big Questions

Dr. Redline earned her medical degree from Boston University and pursued further training at Brigham and Women’s Hospital in respiratory epidemiology, then earned a master’s in public health from the Harvard T.H. Chan School of Public Health.

She said that during this education, she was “exposed to a group of researchers who were very skilled in asking really big questions about why people get a disease and who gets treatment.”

This experience, she added, pushed her beyond thinking of disease treatment on an individual basis and to try to think more in terms of prevention, including identifying environmental, social and genetic risk factors and their interplay, as well as to think of how the information she collected could help ensure that specialists are screening the people who are most in need of screening and treating the people most likely to benefit from treatment.

Dr. Redline began applying these approaches in her research and clinical practice after being recruited to Case Western Reserve University School of Medicine, which provided an opportunity to form a Division of Epidemiology within the Department of Pediatrics at University Hospitals Rainbow Babies and Children’s Hospital. Her focus on breathing and sleep disorders in individuals across their entire lifespan and her collaborations with colleagues across medical fields led to renowned research such as the Cleveland Family Study, which would continue for 16 years and become the world’s largest family-based study on sleep apnea.

The study also set a precedent that continued through Dr. Redline’s numerous subsequent award-winning research projects: paying close attention to a disease or condition, and to how it might play out differently for different types of patients. This meant collecting and appreciating data on gender, ethnicity, racial heritage, social conditions, environmental conditions, and other factors affecting patient health.

Among other findings, Dr. Redline’s research and collaboration have revealed phenomena such as racial differences in sleep apnea between Black and white children in sample populations in the United States, the significant impact of environmental tobacco on children with sickle cell anemia, and the effect of fine particulate matter on sleep apnea in children.

Listening to Patients

Dr. Redline would continue pioneering rigorous, data-focused, and population-based research as she became Harvard Medical School’s Peter C. Farrell Professor of Sleep Medicine, as well as the senior physician at both Beth Israel Deaconess Medical Center and Brigham and Women’s Hospital. As she researched and was credited as a co-author on more than 800 peer-reviewed articles, Dr. Redline continued to actively listen to patients and other stakeholders, then integrate their experiences into the questions she explored in ways that went beyond the distinction of drawing on qualitative as well as quantitative data.

“I became very aware that many women reported sleep apnea symptoms, such as brain fog, that I had not been as familiar with through literature or even through my own patient interactions. They reported having very long periods where their sleep problems and sleep-related daytime impairment were brushed off. Their own physicians told them they were just out of shape or overweight, but actually, they had a very treatable sleep condition. So, it was a delayed diagnosis from not being taken seriously,” Dr. Redline said.

“A New Taxonomy”

With these and similar experiences in mind, Dr. Redline went on to become instrumental in founding and empowering patient-advocate organizations such as the online community of MyApnea.org, which led to the establishment of an independent, patient-driven organization, the Alliance of Sleep Apnea Partners. By providing a welcoming environment and carefully considering patient experiences, Dr. Redline was able to collaborate with other colleagues in several studies reexamining the measures used to diagnose sleep apnea and how the condition manifests differently in women.

In a 2021 study, Dr. Redline joined her former mentee Ali Azarbarzin, PhD, in developing metrics that included the sleep apnea-hypoxic burden and sleep-apnea pulse-rate response (or delta heart rate), which proved to better predict health outcomes in women than the traditional clinic metric, the Apnea Hypopnea Index. The research also observed that women are more likely to have a very brisk heart rate response even without a drop in their oxygen saturation (the indication based on studies of male patients that had been used to identify sleep apnea), supporting the use of a gender-informed lens for diagnosing sleep apnea.

This research led to Dr. Redline’s current focus on investigating and documenting what she hopes will be a new taxonomy of sleep apnea that would be informed by the different manifestations of sleep apnea across gender, age, and other individual background factors.

“I do believe that sleep apnea is multiple diseases,” Dr. Redline said. “And when we measure by our standard metric, the number of breathing pauses—apnea or hypopnea—in an hour, that actually obscures the differences in the diseases.”

Collaboration and Continuity

While Dr. Redline continues to pursue research, she has also advocated for and enabled the sharing of data with the global research community, so that others can better understand and publish findings on various aspects of respiratory health.

Through initiatives such as co-founding the National Sleep Research Resource (NSRR), Dr. Redline has helped to create enormous, shared databases on sleep science. Supported by the National Heart, Lung and Blood Institute, the repository provides findable, accessible, interoperable, and reusable resources for researchers across the globe.

She has frequently talked about the rewards of witnessing and enabling new generations of researchers to pose novel questions and pursue unforeseen possibilities by drawing on this data.

“It has been really fun to see how people are coming to the data from diverse backgrounds—from engineering, artificial intelligence, neuroscience, respiratory physiology, and clinical medicine—and extracting the raw data that we share from these sleep studies in conjunction with the other clinical data,” Dr. Redline said.

By receiving the Edward Livingston Trudeau Award, Dr. Redline is now linked in name to a succession of esteemed scholars, doctors, and medical professionals, as well as to the award’s namesake, who pioneered treatment and understanding of tuberculosis in the late 19^th and early 20^th centuries. And though an entire century of scientific advances in the field of respiratory health separates the two medical luminaries, her career echoes the approach and concerns that Dr. Trudeau outlined in his autobiography: an understanding of environmental factors and the importance of public health, rigorous scientific evaluations, a collaborative approach to research, and a profound respect and gratitude toward the patients to whom they listened and for whom they have advocated as they provided counsel, treatment, and hope, study by study, day by day, and breath by breath.