A RANDOMIZED, CONTROLLED TRIAL OF TREATMENT FOR UPPER AIRWAY RESISTANCE SYNDROME

上呼吸道阻力综合征的随机、对照治疗试验

• 批准号: 7607924
• 负责人: Avram Gold
• 金额: $ 0.45万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-23 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7607924
• 关键词: Airway Resistance; Arousal; Clinical Treatment; Computer Retrieval of Information on Scientific Projects Database; Diagnosis; Drowsiness; Functional disorder; Funding; Grant; Headache Syndrome; Hemoglobin; High Prevalence; Individual; Institution; Irritable Bowel Syndrome; Medical; Migraine; Patients; Placebos; Randomized Controlled Trials; Recurrence; Research; Research Personnel; Resources; Severities; Signs and Symptoms; Sleep; Sleep Apnea Syndromes; Source; Symptoms; Syndrome; Testing; Uncertainty; United States National Institutes of Health; base; nCPAP Ventilation; sleep onset insomnia

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The upper airway resistance syndrome (UARS) was first described in 19931 as a form of sleep disordered breathing distinct from sleep apnea/hypopnea syndrome. Based upon the early descriptions of UARS, it differed from sleep apnea chiefly in the severity of inspiratory flow limitation during sleep observed in the two syndromes. UARS patients were observed to have higher inspiratory airflows during sleep with lesser oxy-hemoglobin desaturation than sleep apnea patients, but had recurrent arousals and daytime hyper-somnolence (similar to sleep apnea patients). Subsequent research demonstrated that UARS patients differ from sleep apnea patients not only in their inspiratory airflow dynamics during sleep, but also in other symptoms and signs. Specifically, UARS patients have a high prevalence of sleep onset insomnia, irritable bowel syndrome, headaches (migraine and tension-type) and alpha wave intrusion into NREM sleep2. Despite the evidence supporting the existence of a sleep disordered breathing syndrome discrete from sleep apnea, some researchers question whether UARS should be considered a medical syndrome.3 Rather, they view UARS as mild hypopnea and not as a discrete pathophysiology. Their doubt is based upon a lack of evidence that inspiratory flow limitation during sleep is associated with the symptoms of UARS patients. They argue that inspiratory flow limitation during sleep can be observed in individuals who lack the symptoms of UARS patients. Further, they argue that the improvement in the hyper-somnolence of UARS patients after nasal continuous positive airway pressure (CPAP) treatment has never been tested against a placebo nasal CPAP treatment. Thus, the existence of UARS as a distinctive diagnosis necessitating treatment remains controversial.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 上气道阻力综合征（UARS）于1993年首次被描述为一种不同于睡眠呼吸暂停/低通气综合征的睡眠呼吸障碍。 根据UARS的早期描述，它与睡眠呼吸暂停的区别主要在于两种综合征在睡眠期间观察到的吸气流量限制的严重程度。 观察到UARS患者在睡眠期间具有较高的吸气气流，与睡眠呼吸暂停患者相比，氧合血红蛋白去饱和度较低，但具有复发性觉醒和白天过度嗜睡（与睡眠呼吸暂停患者相似）。 随后的研究表明，UARS患者与睡眠呼吸暂停患者不仅在睡眠期间的吸气气流动力学方面不同，而且在其他症状和体征方面也不同。 具体而言，UARS患者睡眠发作失眠、肠易激综合征、头痛（偏头痛和紧张型）和α波侵入NREM睡眠的患病率较高2。 尽管有证据支持存在与睡眠呼吸暂停分离的睡眠呼吸障碍综合征，但一些研究人员质疑UARS是否应被视为医学综合征。3相反，他们将UARS视为轻度呼吸不足，而不是一种分离的病理生理学。 他们的怀疑是基于缺乏证据表明睡眠期间吸气流量限制与UARS患者的症状有关。他们认为，睡眠期间的吸气流量限制可以在缺乏UARS患者症状的个体中观察到。 此外，他们认为，经鼻持续气道正压通气（CPAP）治疗后UARS患者过度嗜睡的改善从未与安慰剂鼻CPAP治疗进行过比较。 因此，UARS作为一种需要治疗的独特诊断的存在仍然存在争议。