Experimental Investigation Of Driving Impairment In Obstructive Sleep Apnea
Funder
National Health and Medical Research Council
Funding Amount
$466,764.00
Summary
Obstructive Sleep Apnea (OSA) affects 2-4% of the adult population. Repetitive throat obstructions at night lead to sleep disturbance and oxygen deprivation which in turn lead to excessive daytime sleepiness and poor concentration. Studies in severely affected OSA patients have demonstrated driving simulator performance impairment and a 2-7 fold increased rate of motor vehicle accidents. Current data suggest that up to 50,000 MVAs may be caused each year in Australia by OSA. While driving impair ....Obstructive Sleep Apnea (OSA) affects 2-4% of the adult population. Repetitive throat obstructions at night lead to sleep disturbance and oxygen deprivation which in turn lead to excessive daytime sleepiness and poor concentration. Studies in severely affected OSA patients have demonstrated driving simulator performance impairment and a 2-7 fold increased rate of motor vehicle accidents. Current data suggest that up to 50,000 MVAs may be caused each year in Australia by OSA. While driving impairment and increased crash risk in severe OSA seems clear it is not known whether patients with mild-moderate disease are also affected. This is an important question since patients with mild-moderate disease make up the great majority of OSA sufferers and therefore potentially pose the greatest concern for overall public safety. This study will determine whether mild-moderate, as well as severe, OSA is associated with driving impairment. The study will also determine how partial sleep deprivation and low dose alcohol impact on driving performance in OSA. These two behaviours are considered part of the norm for modern societies, yet we recently showed that they act synergistically to markedly impair driving in healthy subjects. We suspect that years of prior sleep disturbance and oxygen deprivation will render OSA sufferers more vulnerable to the effects of these additional central nervous system insults. Finally, we will determine how well driving impairment in severe OSA responds to nose mask CPAP treatment. We will find out what minimum level of treatment adherence is needed to produce significant improvement and whether driving impairment is ever truly reversed. The information obtained in this study will inform and significantly improve patient care,fitness to drive guidelines and driver safety campaigns.Read moreRead less
Collapsibility Of The Human Upper Airway: Relationships Between Sleep, Sedation, Anaesthesia And Head Posture.
Funder
National Health and Medical Research Council
Funding Amount
$469,359.00
Summary
The proposed studies will examine the sites and mechanisms of narrowing and collapse of the upper airway (throat) in individuals with obstructive sleep apnoea (OSA) during different levels of general anaesthesia, stages of sleep and head postures. The studies will help us understand the reasons for upper airway collapse in individuals with OSA and may result in the development of methods of identifying the most appropriate patients for specific surgical treatments of OSA.
DEEP LEARNING AND PHYSIOLOGY BASED APPROACH TO DERIVE AND LINK OBSTRUCTIVE SLEEP APNOEA PHENOTYPES AND SYMPTOMATOLOGY
Funder
National Health and Medical Research Council
Funding Amount
$402,978.00
Summary
Obstructive sleep apnoea (OSA) is a highly prevalent nocturnal breathing disorder strongly related to daytime sleepiness, accident risk and reduced quality of life. However, the current severity index, the apnoea-hypopnoea index, poorly predicts daytime sleepiness and vigilance. In this project we elegantly combine physiological insight and artificial intelligence to develop and evaluate novel clinically applicable computational tools for detailed quantification of OSA severity and its symptoms.
Mechanisms And Treatment Of Upper Airway Collapse In Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$328,668.00
Summary
Obstructive sleep apnoea (OSA) is characterized by intermittent closure of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and disturbed sleep. Repetitive overnight arousals from sleep cause excessive daytime tiredness and lethargy, which have major consequences for social well-being and productivity in our community. OSA is a common condition, affecting as many as 2 to 4% of middle aged adults, and is associated with an increased cardio ....Obstructive sleep apnoea (OSA) is characterized by intermittent closure of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and disturbed sleep. Repetitive overnight arousals from sleep cause excessive daytime tiredness and lethargy, which have major consequences for social well-being and productivity in our community. OSA is a common condition, affecting as many as 2 to 4% of middle aged adults, and is associated with an increased cardiovascular risk, however the mechanisms underlying the increased upper airway collapsibility in individuals with OSA are not well understood. The proposed studies represent a series of investigations into fundamental mechanisms of neural and mechanical control of upper airway patency, how these mechanisms act to stabilize the upper airway, and whether these reflex control mechanisms can be manipulated to provide a novel treatment for OSA.Read moreRead less
There are many challenges to the management of sleep disorders. There is mounting evidence that sleep problems promote impaired memory and thinking and ultimately dementia. My research will focus on improving detection and management of sleep disorders using cutting edge technologies in different patient groups with the aim of maximising brain health. This will be achieved by a range of new treatments including clinical trials, digital health approaches and new ways of improving deep sleep.
Mechanisms Of Pharyngeal Collapse In Obstructive Sleep Apnoea Defined By Optical Coherence Tomography
Funder
National Health and Medical Research Council
Funding Amount
$476,764.00
Summary
Obstructive sleep apnoea is characterised by intermittent collapse of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and sleep disruption. Obstructive sleep apnoea is common, affecting 5% of middle-aged adults, and is associated with worsening health, increased motor vehicle accidents and increased risk of heart disease. However the mechanisms responsible for obstructive sleep apnoea are not well understood. One reason for this lack of ....Obstructive sleep apnoea is characterised by intermittent collapse of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and sleep disruption. Obstructive sleep apnoea is common, affecting 5% of middle-aged adults, and is associated with worsening health, increased motor vehicle accidents and increased risk of heart disease. However the mechanisms responsible for obstructive sleep apnoea are not well understood. One reason for this lack of understanding is that current diagnostic techniques can not accurately measure changes in the size and shape of the upper airway during sleep. Such information is vital for the accurate diagnosis and treatment of obstructive sleep apnoea. This project proposes to use a technique called endoscopic optical coherence tomography (eOCT), recently developed by ourselves, to measure the changes in upper airway size and shape in patients with obstructive sleep apnoea during wakefulness and, importantly, during sleep. A prototype of the system has been developed. Preliminary in vivo studies have been performed in the human upper airway and the results from these preliminary trials have been published. To our knowledge, world-wide, this is the only such system capable of making these measurements. The studies proposed in this application will provide a better understanding of the mechanisms underlying obstructive sleep apnoea and may lead to the development of greatly improved and more specific treatments that are tailored to the exact needs of the individual patient.Read moreRead less
Local Sleep In The Awake Brain: An Underlying Cause Of Neurobehavioural Deficits In Sleep Apnea?
Funder
National Health and Medical Research Council
Funding Amount
$582,330.00
Summary
Obstructive sleep apnea (OSA) is a common sleep disorder which significantly impacts daytime functioning leading to excessive sleepiness, and problems with attention and thinking. Currently, the causes for cognitive impairment in OSA (including attentional lapses and performance deficits) are poorly understood. In the awake state, groups of neurons can briefly go “offline” as they do in sleep. These periods of “local sleep” may explain impaired task performance in OSA.
We have found that leptin, a new hormone produced by fat cells which regulates appetite and metabolism, is a powerful inhibitor of osteoclast formation. Osteoclasts are large cells present in bone which are responsible for bone resorption and therefore these cells contribute to common bone conditions such as osteoporosis, Paget's disease and bone cancer. Osteoporosis causes a great deal of pain and disability and it alone costs the Australian taxpayers more than $400 million per year. Persons wh ....We have found that leptin, a new hormone produced by fat cells which regulates appetite and metabolism, is a powerful inhibitor of osteoclast formation. Osteoclasts are large cells present in bone which are responsible for bone resorption and therefore these cells contribute to common bone conditions such as osteoporosis, Paget's disease and bone cancer. Osteoporosis causes a great deal of pain and disability and it alone costs the Australian taxpayers more than $400 million per year. Persons who are overweight tend to have higher circulating blood levels of leptin and also tend to have denser bones, which suggests that there might be a relationship between blood leptin and bone density or strength. Furthermore, leptin is produced in the bone marrow which is where osteoclasts are produced. Osteoclasts are formed from white blood cells which are present in the bone marrow and the blood. Very recent discoveries have identified a family of new factors which play a key role in the formation of osteoclasts. One of these factors has been called osteoprotegerin and is an inhibitor of osteoclast formation. Mutant mice lacking osteoprotegerin have greatly increased numbers of osteoclasts and severe osteoporosis whereas mutants with too much osteoprotegerin have bones which are much denser than normal. The availability of these factors now allows the generation of human osteoclasts in the laboratory which enables the further study of how the process is regulated. We have found that leptin increases the amount of osteoprotegerin produced by white blood cells and we believe that this is the major way that leptin inhibits osteoclast generation. In this project, we intend to further investigate how and why leptin is able to influence the generation and function of osteoclasts as leptin may be a suitable treatment for osteoporosis and other bone diseases.Read moreRead less
Addressing Therapeutic Challenges In Sleep Disorders
Funder
National Health and Medical Research Council
Funding Amount
$851,980.00
Summary
The aim of this fellowship is to improve the health and well-being of Australians by reducing the burden of sleep and disorders that disrupt the body clock such as shift work. My program will involve different fields of research combining their efforts together to understand more about sleep apnea and insomnia, the two most common sleep disorders. By this strategy, better treatment for sleep disorders will be found with particular impact on our aging population