Pediatric Sleep Research Program

描述（由申请人提供）： 近期目标：研究阻塞性睡眠呼吸暂停（OSA）儿童的心血管疾病发病率。 职业发展目标：提供足够的时间来制定儿科睡眠医学的研究培训计划，并建立在当前以患者为导向的研究基础上。 研究项目：该项目将测试以下假设：患有OSA的儿童具有压力感受器功能障碍，其与BP异常相关，BP异常反过来预测左心室质量增加形式的终末器官损伤。 目的是在儿童中检查（1）OSA和压力反射功能障碍之间的相互作用， (2)OSA严重程度和压力反射功能障碍与清醒和睡眠期间血压控制异常的关系，（3）压力反射增益减少和血压控制受损与终末器官损伤指数、左心室质量指数的关系，和（4）OSA的有效治疗是否导致压力感受器功能的显著改善，血压控制和左心室质量指数降低。 我们将通过横断面设计研究7-13岁的OSA儿童和配对的正常儿童来实现这些目标。 将研究压力感受器功能、24小时动态血压和左心室质量指数。 压力感受器功能将通过非侵入性技术测量，该技术基于对portapres测量的心率和血压的组合计算机分析。 24-将通过空间实验室监测仪测量小时动态血压，并通过直接M型超声心动图测量左心室质量指数。 在一项纵向研究中，将检查OSA的适当治疗对压力感受器功能、日间和夜间血压以及左心室质量指数的影响。 治疗后将对OSA儿童和匹配对照组进行为期12个月的随访。 (End摘要）

DESCRIPTION (provided by applicant): Immediate Goals: To examine the cardiovascular morbidity in children with obstructive sleep apnea (OSA). Career Development Goals: To provide sufficient time to develop a research training program in pediatric sleep medicine and build on the current patient-oriented research. Research Project: The project will test the hypothesis that children with OSA have baroreceptor dysfunction, which correlates with BP abnormalities, which in turn predict end organ injury in the form of an increase in left ventricular mass. The goal is to examine in children (1) the interaction between OSA and baroreflex dysfunction, (2) the relation of OSA severity and baroreflex dysfunction to abnormalities in blood pressure control during wakefulness and sleep, (3) the association of the diminished baroreflex gain and impaired blood pressure control with an index of end organ damage, the left ventricular mass index, and (4) whether effective treatment of OSA results in significant improvement in baroreceptor function, blood pressure control and a decrease in left ventricular mass index. We will accomplish these aims by studying 7-13 year-old children with OSA and a matched group of normal children in a cross-sectional design. Baroreceptor function, 24-hour ambulatory blood pressure and left ventricular mass index will be studied. Baroreceptor function will be measured by non-invasive techniques based on combined computer analysis of heart rate and blood pressure measured by portapres. 24-hour ambulatory blood pressure will be measured by a spacelab monitor, and left ventricular mass index will be measured by direct M-mode echocardiogram. In a longitudinal study, the effect of adequate treatment of OSA on baroreceptor function, daytime and nocturnal blood pressure and left ventricular mass index will be examined. A cohort of children with OSA and matched controls will be followed for a period of 12 months after treatment. (End of Abstract)