An objective snoring index and its association with carotid atherosclerosis

描述(由申请者提供)：应聘者的总体长期目标是成为一名独立的研究人员，从事关于鼾症及其与心血管疾病和动脉粥样硬化的关系的研究。在与睡眠相关的呼吸障碍的严重程度的连续体中，鼾声是频谱中最轻微的一端，而阻塞性睡眠呼吸暂停(OSA)是比较严重的一端。尽管阻塞性睡眠呼吸暂停综合征与心脑血管疾病有关，但仅打鼾症对健康结果的影响在很大程度上尚不清楚。此外，大多数关于鼾症的研究都使用问卷来衡量鼾声，强调需要一个客观有效的鼾声测量方法。这项拟议研究的目标是(A)在病例对照研究(K99期)中确定与颈动脉粥样硬化最佳相关的客观鼾症指数，与潜在的心血管混杂因素无关；(B)在一大群队列中验证独立的相关性，并检查鼾症、阻塞性睡眠呼吸暂停综合征和肥胖与颈动脉粥样硬化(R00期)之间的相互作用。我们有机会使用韩国基因组流行病学研究(KoGES)，这是一项正在进行的针对韩国中老年人的队列研究，以实现研究目标。到目前为止，随机挑选的5020名参与者接受了两年一次的全面体检，其中包括颈动脉内中膜厚度和其他与心血管风险相关的变量。在K99阶段，我们将对100名非窒息鼾症患者和100名来自KoGES的年龄、体重指数和性别匹配的正常对照组进行基于家庭的睡眠研究，以使用便携式睡眠设备来测量客观的鼾声。目的鼾症测量将包括(A)鼾症发作的频率，(B)整个睡眠时间内鼾声时间的百分比，和(C)鼾声强度。在R00阶段，我们将在800名不同程度鼾症的KoGES参与者中进行睡眠研究和评估鼾症。利用现有的正在进行的大规模队列，并提供参与者健康结果的全面数据，是实现拟议研究最终目标的一种低成本和非常创新的方法。有大量的基础设施，候选人将可以免费获得多种其他元素，如颈动脉IMT、生物标记物和DNA，用于未来的基因分析。在家庭环境中客观测量鼾声是一种方法创新，将有助于未来的鼾症和护理研究。鉴于美国的亚裔人口正在迅速增长，这项研究将对美国亚裔人口的健康成功进行拟议的研究和实现总体长期职业目标具有重要意义，候选人将在K99阶段积极参加关于(A)睡眠相关呼吸障碍的培训计划，包括鼾症~(B)颈动脉硬化测量~(C)非卧床技术客观测量鼾症~(D)科学写作、同行评测，并传播~和(E)职业发展以晋升为护理学校教员职位。 公共卫生相关性：这项研究将(A)提供关于客观测量的鼾症及其对颈动脉粥样硬化和未来心脑血管健康结果的影响的新知识，(B)为进一步的纵向评估奠定基础，以及(C)允许制定早期发现和干预策略，以防止高危鼾症患者发生心脑血管疾病。

DESCRIPTION (provided by applicant): The candidate's overall long-term goal is to become an independent investigator with a program of research on snoring and its association with cardiovascular disease and atherosclerosis. On the continuum of severity of sleep-related breathing disorders, snoring is at the mildest end of the spectrum of which obstructive sleep apnea (OSA) is at the more severe end. Although OSA has been associated with cardio/cerebrovascular disease, effects of snoring alone on health outcomes are largely unknown. In addition, most studies on snoring have used questionnaires to measure snoring, emphasizing that an objective validated measurement of snoring is needed. The goals of the proposed research are (a) to determine the objective snoring index that is optimally associated with carotid atherosclerosis, independent of potential cardiovascular confounders, in a case-control study (K99 phase) and (b) to validate the independent association in a large cohort and examine interactions among snoring, OSA, and obesity that are strongly related to carotid atherosclerosis (R00 phase). We have the opportunity to use the Korean Genome Epidemiology Study (KoGES), an ongoing cohort study of Korean middle-aged and older adults, to achieve the research goals. To date, 5,020 randomly selected participants have undergone biennial comprehensive physical examinations that include carotid intima-media thickness and other variables related to cardiovascular risk. During the K99 phase, we will conduct home-based sleep studies for 100 non-apneic snorers and 100 age-, body-mass index-, and gender-matched normal-controls from the KoGES, to measure objective snoring using a portable sleep device. Objective snoring measurement will include (a) the frequency of snoring episodes, (b) the percentage of snoring time during whole sleeping hours, and (c) snoring sound intensity. During the R00 phase, we will do sleep studies and assess snoring in a large cohort that will consist of 800 KoGES participants with different degrees of snoring. Using an existing ongoing large cohort with comprehensive data on participants' health outcomes is a low-cost and very innovative approach to achieving the ultimate goal of the proposed study. There is a substantial infrastructure and the candidate will have access to multiple other elements at no cost, such as carotid IMT, biomarkers, and DNA for future genetic analyses. Measuring snoring objectively in the home environment is methodologically innovative and will facilitate future snoring and nursing research. Given that the Asian population is growing rapidly in the United States, this study will be significant for the health of Asians in the US population To successfully conduct the proposed research and achieve overall long-term career goals, the candidate will actively participate in a training program during the K99 phase on (a) sleep- related breathing disorders, including snoring~ (b) carotid atherosclerosis measure~ (c) ambulatory technologies to objectively measure snoring~ (d) scientific writing, peer revie, and disseminating~ and (e) professional development for career advancement into a faculty position in a nursing school. PUBLIC HEALTH RELEVANCE: This study will (a) provide novel knowledge about objectively measured snoring and its effects on carotid atherosclerosis and future cardio/cerebrovascular health outcomes, (b) lay a foundation for further longitudinal evaluations, and (c) permit the development of strategies for early detection and intervention to prevent the development of cardio/cerebrovascular disease in at-risk snorers.