TRANS NASAL INSUFFLATION FOR SLEEP APNEA IN CHILDREN

这个子项目是众多研究子项目之一

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. Obstructive sleep apnea syndrome (OSA) is common in children, yet the pathophysiology remains poorly understood. The observed prevalence in adults is 2-4%(1), and in children is 1-3%(2-4). Complications of mild to moderate OSA in children include failure to thrive, cor pulmonale, neurocognitive abnormalities (8), and hypertension. While CPAP therapy, in theory, remains the simplest and most effective treatment for obstructive SDB, patient compliance to CPAP is low (less than 50% reported in the literature). Therefore, this protocol will examine the effect of nasal insufflation of fresh air (TNI) on upper airway collapse during sleep and its therapeutic effect on sleep disordered breathing (SDB) in children. Preliminary results in adults (JHMI-IRB protocol#: 04-05-18-02) demonstrates that the administration of TNI at high flow rates of 20 L/m during sleep abolishes mild degrees of upper airway obstruction (hypopneas) and stabilizes the breathing pattern in all subjects studied. In this study we will determine the effect of TNI on ventilation and respiratory pattern in children during sleep both during upper airway collapse. Quantitative measurements of airflow will allow us to evaluate respiratory patterns in children during sleep specifically to assess maximum inspiratory airflow, and tidal volume. While these measurements are performed routinely in adult research protocols, little data exists in children. Quantitative airflow measurements will be made with a lightweight pneumotachograph attached to a small nasal mask. This allows for the assessment of ventilation during periods of upper airway obstruction and TNI compared to nonobstructed breathing during sleep. Thus, our study will provide insight into the etiology of sleep-disordered breathing and the mechanisms responsible for alleviation of upper airway collapse with TNI in children.