Breathing Instability and Upper Airway Obstruction During Sleep: Effect of Aging

睡眠期间呼吸不稳定和上呼吸道阻塞：衰老的影响

• 批准号: 7797917
• 负责人: M. Safwan Badr
• 金额: --
• 依托单位: JOHN D DINGELL VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-10-01 至 2013-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7797917
• 关键词: Address; Age; Area; Blood Vessels; Breathing; Carbon Dioxide; Clinical; Connective Tissue; Data; Development; Disease; Elderly; Environmental air flow; Gonadal Steroid Hormones; Health; High Prevalence; Hyperventilation; Individual; Laboratories; Literature; Measures; Mechanics; Motor output; Nasopharyngoscopy; Nose; Pathogenesis; Predisposition; Prevalence; Prevention approach; Property; Relative (related person); Research; Sleep; Sleep Apnea Syndromes; Structure; Syndrome; Testing; Veterans; Work; abstracting; age difference; age effect; airway obstruction; base; healthy aging; indexing; middle age; neuromuscular; neuromuscular activity; novel strategies; pharyngeal critical pressure; pressure; young adult

DESCRIPTION (provided by applicant): Project Abstract Sleep apnea-hypopnea syndrome (SAS) is common and has a higher prevalence in the elderly relative to middle-aged individuals. This proposal is concerned with investigating the age-specific differences in susceptibility to breathing instability and upper airway susceptibility to collapse during sleep. The following specific aims will be investigated. Specific Aim 1 is to determine the age-specific effect on periodic breathing susceptibility during sleep. To this end, we will use non-invasive positive pressure ventilation (NIPPV) in the pressure-support mode to induce periodic breathing (as an index of breathing instability). Specific Aim 2 is to determine the age-specific effect on upper airway mechanics during sleep. We will test the hypothesis that pharyngeal retro- palatal compliance and the passive critical closing pressure are higher in older adults as compared to young adults. Therefore, we will measure the critical closing pressure, under baseline conditions and under hypotonic (passive) conditions to establish differences in collapsibility with, and without, active neuromuscular control. Using naso- pharyngoscopy, we will also measure pharyngeal compliance during sleep. Specific Aim 3 is to determine the age-specific effects of reduced ventilatory motor output and upper airway patency during NREM sleep. We hypothesize that expiratory pharyngeal narrowing is more pronounced in older adults as compared to young adults. We will investigate whether the pharyngeal cross-sectional area under conditions of induced hypocapnic hypopnea, in the aftermath of nasal mechanical hyperventilation, is smaller in older adults. The proposed studies address a significant clinical problem and will further our understanding of the pathogenesis of sleep apnea PUBLIC HEALTH RELEVANCE: Project Narrative Sleep-disordered breathing (SDB) is common among middle-aged and older veterans. Many have co-morbid conditions that may amplify breathing instability during sleep. This proposal will further our understanding of the mechanisms that contribute to the development of sleep apnea in older adults. We anticipate that our finding will provide the basis for new approaches to the prevention and management of sleep apnea syndrome.

描述（由申请人提供）： 睡眠呼吸暂停低通气综合征（SAS）是一种常见的疾病，在老年人中的患病率高于中年人。本研究旨在探讨不同年龄段睡眠时呼吸不稳定和上呼吸道塌陷的易感性差异。将研究以下具体目标。具体目标1是确定睡眠期间对周期性呼吸敏感性的年龄特异性影响。为此，我们将在压力支持模式下使用无创正压通气（NIPPV）来诱导周期性呼吸（作为呼吸不稳定的指标）。具体目标2是确定睡眠期间对上气道力学的年龄特异性影响。我们将检验老年人的咽后腭顺应性和被动临界闭合压高于年轻人的假设。因此，我们将在基线条件下和低渗（被动）条件下测量临界闭合压力，以确定有和无主动神经肌肉控制的可耐受性差异。使用鼻咽镜检查，我们也将测量睡眠时的咽顺应性。具体目标3是确定在NREM睡眠期间减少的呼吸运动输出和上气道通畅的年龄特异性影响。我们假设老年人呼气性咽部狭窄比年轻人更明显。我们将调查是否咽横截面积的条件下，诱导低碳酸血症低通气，在鼻机械过度通气后，是较小的老年人。这些研究解决了一个重要的临床问题，并将进一步加深我们对睡眠呼吸暂停发病机制的理解 公共卫生关系： 睡眠呼吸障碍（SDB）在中老年退伍军人中很常见。许多人患有合并症，可能会在睡眠期间放大呼吸不稳定性。这一建议将进一步加深我们对老年人睡眠呼吸暂停发展机制的理解。我们预计，我们的发现将为预防和管理睡眠呼吸暂停综合征的新方法提供基础。