An objective snoring index and its association with carotid atherosclerosis

描述（由申请人提供）：候选人的总体长期目标是成为一名独立研究者，研究打鼾及其与心血管疾病和动脉粥样硬化的关系。在与睡眠有关的呼吸障碍的严重程度中，打鼾是最轻微的，而阻塞性睡眠呼吸暂停（OSA）则是最严重的。虽然阻塞性睡眠呼吸暂停与心/脑血管疾病有关，但仅打鼾对健康结果的影响在很大程度上是未知的。此外，大多数关于打鼾的研究都采用问卷调查的方式来测量打鼾，强调需要对打鼾进行客观有效的测量。本研究的目的是(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打鼾指数，独立于潜在的心血管混杂因素；(b)在大队列中验证独立关联，并检查与颈动脉粥样硬化密切相关的打鼾、OSA和肥胖之间的相互作用（R00期）。我们有机会利用韩国基因组流行病学研究（KoGES），这是一项正在进行的韩国中老年人群队列研究，以实现研究目标。迄今为止，5020名随机选择的参与者接受了两年一次的全面体检，包括颈动脉内膜-中膜厚度和其他与心血管风险相关的变量。在K99阶段，我们将对来自KoGES的100名非窒息性打鼾者和100名年龄、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，使用便携式睡眠设备测量客观打鼾。客观的打鼾测量将包括(a)打鼾发作的频率，(b)打鼾时间占整个睡眠时间的百分比，以及(c)打鼾声音强度。在R00阶段，我们将在800名不同程度打鼾的KoGES参与者中进行睡眠研究和评估打鼾。利用现有的、正在进行的、具有参与者健康结果综合数据的大型队列，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。有一个坚实的基础设施，候选人可以免费获得多个其他元素，如颈动脉IMT，生物标志物，以及用于未来遗传分析的DNA。在家庭环境中客观地测量打鼾是方法学上的创新，将促进未来打鼾和护理研究。鉴于亚洲人口在美国的快速增长，本研究将对美国人口中亚洲人的健康具有重要意义。为了成功地进行拟议的研究并实现总体的长期职业目标，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。包括打鼾~ (b)颈动脉粥样硬化测量~ (c)客观测量打鼾的门诊技术~ (d)科学写作，同行评审和传播~ (e)职业发展到护理学校的教师职位。

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.