Relating sleep disordered breathing to daytime function

将睡眠呼吸障碍与日间功能联系起来

• 批准号: 7643352
• 负责人: INDU A AYAPPA
• 金额: $ 42.22万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-16 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7643352
• 关键词: Acute; Adult; Affect; Airway Resistance; Algorithms; Arousal; Behavior; Cannulas; Characteristics; Chronic; Complex; Continuous Positive Airway Pressure; Data; Development; Diagnosis; Disease; Dose; Electroencephalography; Event; Excessive Daytime Sleepiness; Exhibits; Grant; Hour; Hypoxia; Individual; Measures; Monitor; Nature; Nose; Obstruction; Obstructive Sleep Apnea; Outcome; Patient Self-Report; Patients; Physiological; Physiology; Population; Relative (related person); Research; Research Personnel; Residual state; Resistance; Risk Factors; Severities; Sleep; Sleep Apnea Syndromes; Sleep Fragmentations; Societies; Stress; Symptoms; Syndrome; System; Techniques; Technology; Testing; Therapeutic; Traumatic Stress Disorders; Withdrawal; Work; base; falls; improved; indexing; nCPAP Ventilation; novel; prevent; programs; public health relevance; respiratory; response; sensor; vigilance; volunteer

DESCRIPTION (provided by applicant): Excessive daytime sleepiness (EDS), is the most common complaint of subjects suffering from obstructive sleep apnea hypopnea syndrome (OSAHS). The broad long term objective of this research is to examine the complex relationship between the physiological stress, sleep disordered breathing (SDB), its associated sleep fragmentation, and its outcome (daytime sleepiness). Because correlations between conventional measures of fragmentation and measures of sleepiness have been poor, SDB will be assessed over multiple nights using the best available technology for identifying obstructive respiratory events and a novel measure, the obstructive index (Ol) will be obtained from the events detected. These will be related to EDS, quantified using multiple measures including the psychomotor vigilance task, the Multiple Sleep Latency Test and subjective scales of sleepiness. These relationships will be evaluated in subjects with suspected OSAHS following monitored treatment with nasal Continuous Positive airway Pressure (CPAP) and in normal volunteers. The specific aims of the study are Specific Aim 1: Evaluate the correlation of our integrated Obstruction Index (Ol) to sleepiness in untreated subjects with a range of severity of obstructive sleep disordered breathing. In a subanalysis, the relative contributions to EDS of events with different characteristics (eg O2 desaturation, EEG and autonomic arousal, changes in upper airway resistance) will be evaluated to further refine the Ol if it can be shown they contribute additional predictive power of the index for EDS. Specific Aim 2: Test the utility of the Obstruction Index to predict changes in sleepiness associated with changes in SDB following treatment with CPAP. Specific Aim 3: Experimentally introduce SDB through suboptimal CPAP therapy to demonstrate a "dose-response" relationship of SDB (using the Ol) to EDS. Specific Aim 4: Use the Obstruction Index to predict sleepiness following an acute period of SDB induced by a brief withdrawal of CPAP. Defining these relationships not only has implications for our understanding of this disease, its diagnosis and treatment, but also contributes to a more general understanding of the relationship between sleep and sleepiness. Public Health Relevance: Obstructive sleep apnea/hypopnea syndrome affects 2-4% of the adult U.S. population. Excessive daytime sleepiness is the primary problem in these patients. The present study contributes to understanding these symptoms of sleepiness in patients with sleep apnea. Validating a measure of sleep disordered breathing that relates to sleepiness will help improve the diagnosis and treatment of obstructive sleep apnea.

描述（由申请人提供）：白天过度嗜睡（EDS）是患有阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的受试者最常见的主诉。这项研究的广泛长期目标是检查生理压力、睡眠呼吸障碍 (SDB)、其相关的睡眠碎片及其结果（白天嗜睡）之间的复杂关系。由于传统的碎片测量和嗜睡测量之间的相关性很差，因此将使用识别阻塞性呼吸事件的最佳可用技术和一种新颖的测量方法，在多个晚上评估 SDB，从检测到的事件中获得阻塞指数 (Ol)。这些将与 EDS 相关，使用多种措施进行量化，包括精神运动警戒任务、多重睡眠潜伏期测试和主观嗜睡量表。这些关系将在经鼻持续气道正压通气 (CPAP) 监测治疗后的疑似 OSAHS 受试者和正常志愿者中进行评估。该研究的具体目标是具体目标 1：评估我们的综合阻塞指数 (Ol) 与未经治疗的具有一系列严重阻塞性睡眠呼吸障碍的受试者的困倦的相关性。在子分析中，将评估具有不同特征的事件（例如 O2 去饱和、EEG 和自主唤醒、上气道阻力变化）对 EDS 的相对贡献，以进一步完善 Ol（如果可以证明它们对 EDS 指数有额外的预测能力）。具体目标 2：测试阻塞指数在预测 CPAP 治疗后与 SDB 变化相关的睡意变化方面的效用。具体目标 3：通过次优 CPAP 治疗实验引入 SDB，以证明 SDB（使用 Ol）与 EDS 的“剂量反应”关系。具体目标 4：使用阻塞指数来预测短暂撤除 CPAP 引起的 SDB 急性期后的困倦情况。定义这些关系不仅对我们对这种疾病、其诊断和治疗的理解具有影响，而且有助于更全面地理解睡眠和困倦之间的关系。公共卫生相关性：阻塞性睡眠呼吸暂停/呼吸不足综合征影响 2-4% 的美国成年人口。白天过度嗜睡是这些患者的主要问题。本研究有助于了解睡眠呼吸暂停患者的这些嗜睡症状。验证与困倦相关的睡眠呼吸障碍的测量将有助于改善阻塞性睡眠呼吸暂停的诊断和治疗。