Upper Airway Motor Control during Sleep in Children

儿童睡眠期间的上呼吸道运动控制

• 批准号: 7256214
• 负责人: ELIOT S KATZ
• 金额: $ 12.58万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7256214
• 关键词: Accounting; Address; Adolescence; Age-Years; Apnea; Arousal; Attenuated; Behavior; Benign; Boston; Caliber; Carbon Dioxide; Cardiovascular system; Chemoreceptors; Child; Childhood; Clinical; Condition; Continuous Positive Airway Pressure; Data; Dilator; Electrodes; Environment; Epiglottis structure; Equilibrium; Financial compensation; Functional disorder; Gases; Goals; Hospitals; Human; Hypercapnia; Hypertrophy; Hypoxemia; Impairment; Induction of neuromuscular blockade; Laboratories; Lung diseases; Maintenance; Masks; Measures; Mechanics; Mechanoreceptors; Mentored Patient-Oriented Research Career Development Award; Morbidity - disease rate; Muscle; Nose; Obstruction; Obstructive Sleep Apnea; Oral; Peat; Pediatric Hospitals; Phenotype; Physiology; Polysomnography; Population; Public Health Schools; Pulse Pressure; REM Sleep; Range; Recurrence; Reflex control; Relative (related person); Reporting; Research Personnel; Resistance; Role; Scientist; Sleep; Sleep Apnea Syndromes; Sleep Fragmentations; Snoring; Surface; Techniques; Training; Wakefulness; Woman; airway obstruction; awake; base; carbon dioxide tension; infancy; insight; motor control; neurobehavioral; neuromuscular activity; pharyngeal critical pressure; pressure; programs; respiratory; response; roentgen equivalent man; sedative; size; viscoelasticity

DESCRIPTION (provided by applicant): Obstructive sleep apnea syndrome (OSAS) is a common and serious cause of morbidity during childhood OSAS is characterized by recurrent episodes of partial or complete airway obstruction resulting in hypoxemia hypercapnea, and/or respiratory arousal. The sleep fragmentation and gas exchange abnormalities observed with OSAS may produce serious cardiovascular and neurobehavioral impairment. Habitual snoring is reported in 3-12% of the general pediatric population, although only 1-3% will have OSAS. The anatomical and/ol neuromuscular basis of the primary snoring (PS) and OSAS phenotype has not been elucidated. Upper airway patency is maintained by an intricate balance between the static pharyngeal mechanics, neuromuscular activity, and luminal pressure. A prominent role for upper airway neuromuscular control mechanisms in the pathophysiology of OSAS is hypothesized to explain the observation that obstruction does not occur while awake and is infrequently seen during NREM sleep. Using a validated intra-oral surface electrode to record genioglossus activity (EMGgg) and a nasal mask technique for measuring airway collapsibility (Pcrit), we will assess children with OSAS, PS and normal controls, awake and asleep, for the following; 1) Basal tonic and phasic EMGgg activity as a percentage of maximal; 2) Muscle and airway mechanical responses to hypercapnea (chemoresponsiveness); 3) Muscle and airway mechanical responses to continuous positive airway pressure (CPAP) and pulses of negative airway luminal pressure (mechanoresponsiveness); 4) Muscle and airway mechanical responses to inspiratory resistance loading. These studies address the role of neuromuscular compensatory mechanisms in the maintenance of airway patency during wakefulness and sleep in children. This proposal for a Mentored Patient-Oriented Research Career Development Award will permit the applicant to pursue his goal to become a clinical scientist. This training is set in the rich intellectual environment provided by the airway physiology laboratory of Dr. David P. White at Brigham and Women's Hospital, the Division of Respiratory Diseases at Children's Hospital Boston and the Harvard School of Public Health.

描述(由申请人提供)： 阻塞性睡眠呼吸暂停综合征(OSAS)是儿童时期常见而严重的致病原因，其特征是反复发作部分或完全呼吸道阻塞，导致低氧血症、高碳酸血症和/或呼吸觉醒。OSAS患者的睡眠碎片和气体交换异常可能会导致严重的心血管和神经行为障碍。尽管只有1-3%的儿童会患上阻塞性睡眠呼吸暂停综合征，但据报道，有习惯性打鼾症的儿童占总人口的3-12%。原发性鼾症(PS)和阻塞性睡眠呼吸暂停综合征(OSAS)表型的解剖学和/或神经肌肉学基础尚未阐明。上呼吸道通畅是通过静态咽力学、神经肌肉活动和管腔压力之间的复杂平衡来维持的。上呼吸道神经肌肉控制机制在OSAS的病理生理学中的重要作用被假设为解释了观察到的观察结果，即在清醒时不会发生阻塞，并且在NREM睡眠中很少见。使用经验证的口腔内表面电极记录颧舌肌活动(EMGgg)和鼻罩技术测量气道塌陷性(Pcrit)，我们将评估OSAS、PS和正常对照组(清醒和睡眠)以下指标：1)基本紧张性和相性EMGgg活动占最大值的百分比；2)肌肉和呼吸道对高二氧化碳的机械反应(化学反应性)；3)肌肉和呼吸道对持续气道正压(CPAP)和气道腔内负压脉冲(机械反应性)的机械反应(机械反应性)；4)肌肉和呼吸道机械对吸入阻力负荷的反应。这些研究探讨了神经肌肉代偿机制在儿童清醒和睡眠期间维持呼吸道通畅中的作用。这项关于以患者为导向的导师研究职业发展奖的提议将允许申请者追求成为临床科学家的目标。这项培训是在布里格姆妇女医院的大卫·P·怀特博士的呼吸道生理学实验室、波士顿儿童医院的呼吸科和哈佛大学公共卫生学院提供的丰富的智力环境中进行的。