REGULATION OF PHARYNGEAL MUSCLE CONTRACTION

频繁的睡眠相关呼吸障碍（SRRD）已被 被认为发生在多达70%的老年人和15%的中年人中 科目 尽管人们普遍认为， 与严重阻塞性心脏病相关的日间嗜睡 睡眠呼吸暂停（呼吸紊乱指数（RDI）>30） 治疗他们的睡眠障碍;没有共识（和缺乏 关于受试者治疗获益的数据）， disorder. 合理利用医疗诊断资源 睡眠呼吸暂停的治疗需要评估 轻度或中度SRRD会对健康产生影响， 以及这些健康影响是否可以通过治疗逆转。 在这项研究中，我们建议确定神经- 心理表现和一般健康状况和功能可能是 轻度和中度SRRD受试者中受损，与 呼吸暂停的受试者 的程度 还将评估在特定治疗后可能出现的改善。 我们建议评估神经心理学表现，嗜睡和 330例受试者的一般功能状态，包括 呼吸暂停活动（RDI<5）、轻度活动（RDI 5-14）和中度活动 (RDI 15-25）。 在这些受试者中，75%将从基于诊所的 25%将从正在进行的基于人群的研究中招募。 150例轻度和中度活动的受试者将随机分配至 接受“保守”药物治疗（CMT）或CMT+鼻CPAP 疗法 我们将利用简单的统计，以及多元 技术，以确定SRRD（和相关联的 低氧血症、睡眠片段化和生理性嗜睡）至：a） 智力、注意力和警惕性、精神运动表现， 学习和记忆，以及执行功能，和B）一般健康 地位和作用。 睡眠特异性治疗的潜在益处 还将确定轻度和中度SRRD受试者的呼吸暂停 经过两个月的CPAP治疗。 这些数据将提供新的 轻度和中度睡眠呼吸暂停对健康的影响 进行适当的临床决策和利用所需的信息 医疗保健资源。

Frequent sleep-related respiratory disturbances (SRRD) have been recognized to occur in as many as 70% of elderly and 15% of middle-aged subjects. Although it is widely agreed that subjects with obvious daytime sleepiness that occurs in association with severe obstructive sleep apnea (Respiratory disturbance indices (RDI) >30) benefit from treatment of their sleep disorders; there is no consensus (and a paucity of data) regarding treatment benefits in subjects with a less profound disorder. Rational utilization of health care resources for diagnosis and treatment of sleep apnea requires assessment of whether adverse health effects occur as a consequence of mild or moderate levels of SRRD, and whether any such health effects may be reversible with treatment. In this study, we propose to determine the degree to which neuro- psychological performance and general health status and function may be impaired in subjects with mild and moderate degrees of SRRD, as compared to subjects with minimal apneic activity. The degree to which improvement may occur following specific treatment will also be assessed. We propose to assess neuropsychological performance, sleepiness and general functional status in 330 subjects, including subjects with little apneic activity (RDI<5), mild activity (RDI 5-14), and moderate activity (RDI 15-25). Of these subjects, 75% will be selected from a clinic-based sample, and 25% will be recruited from an ongoing population-based study. 150 subjects with mild and moderate activity will be randomized to receive "conservative" medical therapy (CMT) or CMT plus nasal CPAP therapy. We will utilize simple statistics, as well as multivariate techniques, to determine the relationship between SRRD (and associated hypoxemia, sleep fragmentation, and physiological sleepiness) to: a) intellectual abilities, attention and vigilance, psychomotor performance, learning and memory, and executive functions, and b) to general health status and function. Potential benefits of treatment specific for sleep apnea in subjects with mild and moderate SRRD will also be determined after two months of CPAP therapy. These data will provide new information about the health effects of mild and moderate sleep apnea that are needed for appropriate clinical decision making and utilization of health care resources.