PHARYNGEAL COLLAPSIBILITY IN HEALTH AND DISEASE

这项建议的目的是研究控制咽 成人和儿童阻塞性睡眠呼吸暂停综合征患者的可耐受性。 这项工作的主要重点是确定特定的机械 或神经系统的改变会导致成人咽部的可吸收性增加 和患有阻塞性睡眠呼吸暂停的儿童。 在我们最近的工作中， 能够量化咽部可吸收性的差异， 考虑到睡眠期间沿着沿着 从健康到疾病的连续体。 在目前的建议中，我们将继续 采用上气道的Starling阻力模型来表征 上气道的临界压力（Pcrit）是主要的 可扩展性的决定因素。在具体目标1中，我们将确定如何 年龄影响上呼吸道的结构和神经肌肉决定因素 呼吸暂停患者与有呼吸暂停风险的患者相比的耐受性 发生呼吸暂停（正常打鼾者）。 在具体目标2中，我们将确定 颏舌肌的神经激活如何影响可重复性 在存在和不存在全身性神经肌肉活动的情况下。 在 具体目标3，我们将研究神经活动的机制， 特异性上呼吸道肌肉调节对 特定的结构改变。人类和动物实验都有 以互补的方式设计。标准化记录 技术将用于测量睡眠、压力和流量。 将采用新技术刺激特定肌肉， 确定上气道的被动特性。 的结果 这些研究对疾病的检测和治疗具有潜在的意义。 疾病。

The purpose of this proposal is to examine the control of pharyngeal collapsibility in both adults and children with obstructive sleep apnea. The major focus of this work is to determine whether specific mechanical or neural alterations cause increased pharyngeal collapsibility in adults and children with obstructive sleep apnea. In our recent work, we have been able to quantitate differences in pharyngeal collapsibility which account for varying degrees of airflow obstruction during sleep along a continuum of health to disease. In the current proposal, we will continue to employ a Starling resistor model of the upper airway to characterize the critical pressure (Pcrit) of the upper airway which is the major determinant of collapsibility. In Specific Aim 1, we will determine how age affects the structural and neuromuscular determinants of upper airway collapsibility in patients with apnea compared to those at risk for developing apnea (normal snorers). In Specific Aim 2, we will determine how neural activation of the genioglossus muscle influences collapsibility in the presence and absence of generalized neuromuscular activity. In Specific Aim 3, we will examine the mechanism by which neural activity in specific upper airway muscles modulate responses in collapsibility to specific structural alterations.Both human and animal experiments have been designed in a complementary fashion. Standardized recording techniques will be used for measurements of sleep, pressure, and flow. Novel techniques will be employed to stimulate specific muscles to determine the passive properties of the upper airway. The results of these studies have potential implications on the detection and treatment of disease.