EAGER: The Sleep Environment as a Risk Factor for Eye Pressure Elevation

EAGER：睡眠环境是眼压升高的危险因素

• 批准号: 1337502
• 负责人: Alison Flatau
• 金额: $ 18万
• 依托单位: University of Maryland, College Park
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1337502&HistoricalAwards=false
• 关键词: EAGER; Sleep; Environment; Risk; Factor

PI: Flatau, AlisonProposal Number: 1337502The proposed EAGER research project will lead to obtaining the preliminary data needed to establish that a correlation exists between the physical environment in contact with eyes during non-supine sleep and sustained periods of elevated intraocular pressure (IOP) during non-supine sleep. The hypothesis to be tested by this research is that a traditional sleep environment, i.e. resting on a conventional mattress and pillow, places the eyes of non-supine sleepers in a physical environment that leads to an elevation in IOP. To test this hypothesis, study subjects, half with healthy eyes and half with asymmetric glaucoma damage, will be fitted with two Sensimed Triggerfish® wireless, contact-lens-based strain sensors (one in each eye). These sensors will be used to record changes in IOP throughout the night. The studies will be conducted at the Johns Hopkins Sleep Center to simultaneously record video of sleep positions. IOP and position data will be used to correlate eye contact with the physical environment to changes in IOP as well as to establish potential differences in the sensitivity of subjects with and without glaucoma to variations in physical environment properties. The technical merit of establishing the hypothesized correlation lies in advancing the understanding of a here-to-fore overlooked factor that contributes to the elevation of IOP. The significance of is that IOP elevation is primary risk factor associated with eye damage and vision loss in individuals with glaucoma. (Glaucoma is the second leading cause of blindness worldwide and affects an estimated 60 million people globally at this time; a number is expected to increase to 80 million by 2020) The impact of validating this hypothesis is that understanding that the sleep environment contributes to the primary risk factor for disease progression will lead to developing strategies to fix or alter the environment. The exploratory nature of the proposed research, i.e. that funding is needed to obtain preliminary results that substantiate the proposed hypothesis, is the reason the proposed research does not fit well within the existing programmatic opportunities. The justification for seeking support for this research through the EAGER mechanism is that the proposed research is high risk, exploratory, and potentially transformative. The research is high risk in that conventional wisdom suggests that the result will be negative. After almost 400 years of study related to different aspects of this disease, how is it that this macro-scale concern has been neglected? Vision experts readily provide the following as the justification for the current practice of ignoring loads from the sleep environment as a risk factor for glaucoma patients: the pre-operative application of compressive loads to the eye is routinely used to increase aqueous outflow and thereby lower IOP. This argument, however, neglects the potential importance of differences in the eye environment during load application; the importance of these differences is precisely what we aim to discover with the proposed research. Next, the proposed research is exploratory in that this will be the first quantitative study of the interaction of environment to which the eye is exposed during non-supine sleep with IOP. The ability to obtain preliminary result to address this research is greatly facilitated by of the advent in 2011 of Sensimed's Triggerfish® wireless contact-lens-based strain sensors. Finally, if/when the research hypothesis is demonstrated to be correct, the broader impact of the research on those with glaucoma-related visual impairment will be transformational. The impact on altering conventional wisdom, which completely neglects sleep environment as a risk factor for those with glaucoma, will be immediate. Further research will be necessary to address how to most effectively alter sleep environments to mitigate IOP elevation. Results from the proposed EAGER research will provide the preliminary results needed to raise awareness of that sleep environment can pose a significant risk for glaucoma patients who are non-supine sleepers, and that modifications to a sleep environment can be used to slow the progressive loss to field of vision experienced by these individuals.

PI：Flatau，Alison Propoposal编号：1337502拟议的急切研究项目将导致获得所需的初步数据，以确定在非苏普丁睡眠期间，在非苏品睡眠期间与眼睛接触的物理环境之间存在相关性，并持续的眼睛内压（IOP）。这项研究要检验的假设是，传统的睡眠环境，即放置在传统的床垫和枕头上，将非苏门风卧铺的眼睛置于物理环境中，导致IOP升高。为了检验这一假设，研究对象，一半，具有健康的眼睛，一半伴有不对称的青光眼损伤，将配备两个感应的Triggerfish®无线，基于隐形眼镜的应变传感器（每只眼睛一个）。这些传感器将用于整个晚上记录IOP的变化。这些研究将在约翰霍普金斯睡眠中心进行，以简单地录制睡眠位置的视频。 IOP和位置数据将用于将目光接触与物理环境与IOP的变化以及具有和没有青光眼的受试者的敏感性建立潜在差异与物理环境特性的变化相关。建立假设相关性的技术优点在于促进对这一忽视的因素的理解，这有助于提高IOP的升高。意义在于，IOP升高是与青光眼患者的眼睛损伤和视力丧失相关的主要危险因素。 （青光眼是全球失明的第二主要原因，目前在全球范围内影响约6000万人；预计到2020年，预计数量将增加到8000万人）验证这一假设的影响是，理解睡眠环境对拟议的研究的探索性有助于探索性的性质，即需要证明拟议中的拟议成果，而拟议的结果是，在拟议中，拟议中的资金是不适合拟议的。机会。通过急切的机制寻求支持支持这项研究的理由是，拟议的研究是高风险，探索性和潜在的变革性。这项研究是高风险，因为传统观念表明结果将是负面的。经过将近400年的研究，与该疾病的不同方面有关，这种宏观尺度的关注如何被忽略了？视力专家很容易提供以下内容，作为当前忽略睡眠环境中的负载作为青光眼患者的危险因素的理由：术前将压缩负荷施加到眼睛中的术前施用，以增加水性输出，从而降低IOP。但是，该论点忽略了施用期间眼睛环境中差异的潜在重要性。这些差异的重要性正是我们旨在通过拟议的研究发现的目的。接下来，探讨了拟议的研究，因为这将是对在非苏宾与IOP期间暴露于眼睛的环境相互作用的第一个定量研究。 2011年Semmimed的Triggerfish®无线接触透镜的应变传感器，获得了获得初步结果以解决这项研究的能力得到了极大的支持。最后，如果/如果证明研究假设是正确的，那么研究对与青光眼相关的视觉障碍的人的广泛影响将是变化的。对改变传统智慧的影响将立即立即忽视睡眠环境作为青光眼患者的危险因素。需要进一步的研究，以解决如何最有效地改变睡眠环境以减轻IOP升高。拟议中的急切研究的结果将为提高对睡眠环境的认识所需的初步结果，这可能会对非西班牙卧铺的青光眼患者构成重大风险，并且可以使用对睡眠环境的修改来减缓这些人对视野经历的逐步损失。