A Randomised Controlled Trial Of CPAP Versus Oral Appliance In Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$416,155.00
Summary
Obstructive sleep apnoea (OSA) is a very common disorder, affecting approximately 25% of women and 9% of men in the middle-aged workforce . It is characterised by repetitive, complete or partial closure of the throat passage during sleep, resulting in sleep disturbance and low oxygen levels. When associated with symptoms, termed Obstructive Sleep Apnoea Syndrome, it occurs in 4% of men and 2% of women in middle age. OSA is recognised as a serious public health problem. Continuous Positive Airway ....Obstructive sleep apnoea (OSA) is a very common disorder, affecting approximately 25% of women and 9% of men in the middle-aged workforce . It is characterised by repetitive, complete or partial closure of the throat passage during sleep, resulting in sleep disturbance and low oxygen levels. When associated with symptoms, termed Obstructive Sleep Apnoea Syndrome, it occurs in 4% of men and 2% of women in middle age. OSA is recognised as a serious public health problem. Continuous Positive Airway Pressure is the gold standard treatment, and has been demonstrated to produce major health benefits. However, there is growing evidence supporting the use of oral appliances to treat OSA, which are potentially simpler to use. It is thought that these work by enlarging the throat passage. Recent practice guidelines recommend their use as a first line treatment for mild to moderate OSA. The aim of this project is to directly compare the health benefits achievable with these therapies, taking into account patient compliance and preference, and will assist in the development of protocols for the use of these treatments in clinical practice.Read moreRead less
Assessment Of Physical Therapies To Improve Secretion Clearance In Patients With Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$302,310.00
Summary
People with cystic fibrosis (CF) produce thick mucus that is not cleared normally from the lungs. This retained mucus often becomes infected, which progressively damages the lungs. Various physical therapies which may help clear secretions are being used in CF. These include several types of devices which provide positive pressure to the airways. However, it is not known to what extent these devices, or other interventions such as manual chest physiotherapy and exercise, enhance mucus clearance. ....People with cystic fibrosis (CF) produce thick mucus that is not cleared normally from the lungs. This retained mucus often becomes infected, which progressively damages the lungs. Various physical therapies which may help clear secretions are being used in CF. These include several types of devices which provide positive pressure to the airways. However, it is not known to what extent these devices, or other interventions such as manual chest physiotherapy and exercise, enhance mucus clearance. As a result, it is not currently possible to scientifically prescribe intervention(s) to enhance mucus clearance in CF. This is partly because much of the research that has been performed in this area has been poorly-designed or has used inaccurate measures. Also, recent research has shown that these therapies may have significant effects beside their effect on mucus clearance. For instance, bacterial infection and the exchange of oxygen and carbon dioxide between the blood supply and air in the lung may all be affected by these interventions. Notably, the extent of benefit or detriment seen in these parameters does not always correlate with the effect on mucus clearance. We therefore believe a series of experiments is necessary to provide evidence upon which the scientific selection of mucus clearance therapies may be based. We have developed a new technique which allows clearance of mucus from the airways to be objectively measured in three-dimensions (3D). We intend to use the 3D technique to examine the effects of three different positive pressure devices, exercise, and manual chest physiotherapy on mucus clearance. Based on the outcomes of this research, we intend to compare the most appropriate therapy to performing no mucus clearance therapy in a short term trial. This trial will assess changes in the following: bacterial infection, mucus plugging in the airways, how well the lungs move air and exchange oxygen and carbon dioxide, and the patient's quality of life.Read moreRead less
Chronotherapy Of Hypertension In Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$232,738.00
Summary
Obstructive Sleep Apnoea (OSA) is linked with excess cardiovascular disease, and this is partly attributed to increased high blood pressure (hypertension). Understanding how both conditions exacerbate hypertension and whether blood pressure control can be improved by altering the time that medication is taken will lead to improvements in health.
Chronotherapy For Hypertension In Obstructive Sleep Apnea
Funder
National Health and Medical Research Council
Funding Amount
$253,229.00
Summary
Obstructive Sleep Apnea (OSA) is a common cause of hypertension, however treatment of OSA only results in a modest improvement in blood pressure (BP) and patients who are unable to tolerate treatment must rely on pharmacotherapy to control their BP. This study will definitively establish if altering the time of taking medication can improve BP control over 24 hours. The results will conribute to the development of more targeted treatment strategies for hypertension in people with OSA.
Expanding The Role For Non-Invasive Ventilation In Cystic Fibrosis (CF)
Funder
National Health and Medical Research Council
Funding Amount
$315,375.00
Summary
Many patients with Cystic Fibrosis (CF) have disturbed breathing during sleep and poor sleep quality. Our preliminary data shows the problems may be worse during flare ups of the disease, with patients having less dreaming (REM) sleep causing reduced daytime attention and concentration. This could have adverse consequences for exam performance, work ability and driving skills. Also, even with maximum treatment, flare ups can result in permanent loss of lung capacity and quality of life. We propo ....Many patients with Cystic Fibrosis (CF) have disturbed breathing during sleep and poor sleep quality. Our preliminary data shows the problems may be worse during flare ups of the disease, with patients having less dreaming (REM) sleep causing reduced daytime attention and concentration. This could have adverse consequences for exam performance, work ability and driving skills. Also, even with maximum treatment, flare ups can result in permanent loss of lung capacity and quality of life. We propose a novel approach to treat the flare ups with short-term portable assisted ventilation (nBVS) as well as standard treatment as we strongly believe that the portable ventilator will improve gas exchange with better matching of ventilation and blood flow and will hasten recovery. We believe that long term nBVS will be superior to oxygen therapy alone in delaying the onset of respiratory failure and improving survival. We have convincing evidence to suggest that nBVS improves ventilation perfusion distributions rapidly and that this benefit increases over 6 months of regular use. The likely explanation is that it keeps the airways open and reduces mucus plugging. In short, nBVS is a treatment in its own right for abnormal gas exchange in CF. The ideal time for nBVS is during sleep when it can be used for a long time period when patients are most at risk of falls in oxygen saturation. In summary, we believe that nBVS is likely to have a major impact in delaying the progession of disease and improving patient outcomes. Almost all patients with CF have evidence of sinus disease and many have nasal polyps. We have convincing questionnaire data showing an association between sinusitis, nasal obstruction and poor sleep quality. Our preliminary sleep study data in patients with active sinusitis confirm multiple arousals and sleep fragmentation. We plan to examine the impact of sinus surgery in improving sleep disordered breathing and quality of life in patients with CF.Read moreRead less
The Interaction Between Obstructive Sleep Apnea And Cardiovascular Risk Factors On Cardiovascular Disease
Funder
National Health and Medical Research Council
Funding Amount
$1,263,050.00
Summary
Cardiovascular (CV) disease and obstructive sleep apnoea (OSA) are common causes of morbidity and mortality. OSA is an independent risk factor for CV disease but little is known about which patients with OSA are likely to develop CV disease, and the interaction between OSA and other CV risk factors. We seek to better understand this interaction by exploring which of 4,100 well characterised patients in the West Australian Sleep Health Study (WASHS) 2005-2010 have developed CV disease.
The Sleep Apnea Cardio Vascular Endpoints (SAVE) Study
Funder
National Health and Medical Research Council
Funding Amount
$1,177,047.00
Summary
Obstructive sleep apnea (OSA) affects 7% of the population and is increasing with the global epidemic of obesity. Research suggests that OSA may be a cause of premature cardiovascular (CV) disease, but definitive proof is lacking. This 5-year trial will answer this question by comparing the rate of CV events (eg stroke, heart attack) in OSA patients who are treated, versus those not treated, with CPAP. The results may lead to a new medical approach to the prevention of CV disease.
Pressures Exerted On Upper Airway Walls By Surrounding Tissue Structures
Funder
National Health and Medical Research Council
Funding Amount
$426,500.00
Summary
The obstructive sleep apnoea syndrome (OSA) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSA effects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect of the pressure in the tissues surrounding the throat on the ability of the throat to stay open a ....The obstructive sleep apnoea syndrome (OSA) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSA effects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect of the pressure in the tissues surrounding the throat on the ability of the throat to stay open and allow breathing. The major outcome of the animal studies is increased knowledge concerning mechanisms whereby collapsing forces are applied to the upper airway. This will give insights into potential factors influencing upper airway collapse during sleep in OSA patients. Of particular importance will be our studies on the effects of jaw position on the pressure exerted on the walls of the throat since the use of an intra-oral device to hold the jaw forward during sleep is one of the treatments used to prevent throat blockage during sleep. The studies in humans will examine, for the first time, the notion that the mass (weight) of the neck has a direct effect on the severity of sleep disordered breathing. If neck mass has a substantive influence on sleep disordered breathing then strategies aimed at reducing neck mass (fat) may provide a new therapeutic approach to the management of OSA patients.Read moreRead less
Obstructive sleep apnea (OSA) affects 7% of the population and is increasing with the global epidemic of obesity. Research suggests that OSA may be a cause of premature cardiovascular (CV) disease, but definitive proof is lacking. This 5-year trial will answer this question by comparing the rate of CV events (eg stroke, heart attack) in OSA patients who are treated, versus those not treated, with CPAP. The results may lead to a new medical approach to the prevention of CV disease.