The Effect Of CPAP On Erectile And Endothelial Dysfunction In Impotent Men With Obstructive Sleep Apnea
Funder
National Health and Medical Research Council
Funding Amount
$609,559.00
Summary
Erectile dysfunction is common in men with obstructive sleep apnea, due to vascular damage, which leads to heart attack. CPAP is the preferred treatment for patients with OSA because of its well-proven ability to decrease sleepiness and improve blood pressure control. This study will establish if CPAP can also improve erectile and vascular endothelial dysfunction. These results will shed light on the mechanisms that underpin the relationship between OSA and Erectile Dysfunction.
Metabolic And Neurobiological Changes After Continuous Positive Airway Pressure Treatment For Obstructive Sleep Apnea
Funder
National Health and Medical Research Council
Funding Amount
$503,497.00
Summary
CPAP is the preferred treatment for patients with OSA because of its well-proven ability to decrease sleepiness and improve blood pressure control. This study will definitively establish if CPAP can also improve markers of cardio-metabolic health, such as visceral fat, insulin sensitivity, central blood pressure and arterial stiffness. The results of the study will shed light on the broader health consequences of OSA and contribute to the development of more targeted treatment strategies.
The Impact Of CPAP Treatment On Carotid Artery Atherosclerosis In Heavy Snoring And Mild Sleep Disordered Breathing
Funder
National Health and Medical Research Council
Funding Amount
$697,512.00
Summary
Mild sleep disordered breathing, including habitual snoring, is a very common problem in the adult population, with a prevalence of between 20-40%. Increasingly it is now recognised that habitual snoring may be an independent risk factor for the development of stroke. In this proposal we will explore the hypothesis that treatment for snoring will slow or stop the development of carotid artery atherosclerosis.
A Randomised Controlled Trial Of A Simplified Management Strategy Versus Standard Care In Moderate To Severe OSA
Funder
National Health and Medical Research Council
Funding Amount
$561,400.00
Summary
Currently breathing difficulties during sleep known as obstructive sleep apnea (OSA) are undertreated in our community. This reflects an inability of the current diagnostic and treatment strategies to deal with the high clinical burden of OSA. As a result, in particular in rural and remote areas, many have long waits for treatment, or no access to therapy at all. The purpose of this project is to evaluate a simplified protocol for the management of OSA. This will be done using diagnostic devices ....Currently breathing difficulties during sleep known as obstructive sleep apnea (OSA) are undertreated in our community. This reflects an inability of the current diagnostic and treatment strategies to deal with the high clinical burden of OSA. As a result, in particular in rural and remote areas, many have long waits for treatment, or no access to therapy at all. The purpose of this project is to evaluate a simplified protocol for the management of OSA. This will be done using diagnostic devices and treatment strategies that are more widely available than the current approaches to the diagnosis and management of obstructive sleep apnea. This will involve measurement of the numbers of falls in oxygen levels in a patient via a device to measure oxygen levels called an oximeter. These falls in oxygen levels correlate well with breath holding episodes during sleep characteristic of OSA. Treatment can be commenced in the patient's home depending on these results. We intend to compare these new approaches with the current best practice in OSA. If the outcomes are good these stategies could be applied to reduce the waiting times for to diagnose and manage OSA and make therapy more widely available throughout the community.Read moreRead less
Recognition And Management Of Sleep Apnea In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$650,866.00
Summary
Obstructive sleep apnoea (OSA, ie frequent choking episodes during sleep, associated oxygen deprivation and sleep disturbance) affects at least 4% of the adult population and leads to serious health problems if untreated. These health problems include excessive tiredness, fall-asleep accidents, and premature stroke and heart attacks. Currently patients suspected of OSA are referred for management to specialist sleep centres, where sleep specialists order overnight laboratory tests to confirm the ....Obstructive sleep apnoea (OSA, ie frequent choking episodes during sleep, associated oxygen deprivation and sleep disturbance) affects at least 4% of the adult population and leads to serious health problems if untreated. These health problems include excessive tiredness, fall-asleep accidents, and premature stroke and heart attacks. Currently patients suspected of OSA are referred for management to specialist sleep centres, where sleep specialists order overnight laboratory tests to confirm the diagnosis and test the effects of treatment (CPAP via a nasal mask) and thereafter direct management. These centres are not coping with current demand because of too few specialists and too few testing facilities. But worse than this up to 85% of cases in the community are not being identified. Many patients with OSA attend general practitioners for sometimes related conditions such as hypertension, diabetes and obesity, but are unrecognised for having a serious sleep disorder. This study will develop new and simplified methods of home diagnosis of OSA suitable for general practice. It will then use these methods to identify patients in general practice with moderate to severe OSA who will then enter a study that compares the effectiveness and the cost effectiveness of two models of care where the principle treatment will be CPAP: One is a new model which will be based in patients homes and general practice surgeries, the other, will be current standard care in our specialist sleep centre. We postulate that general practice based care will be as effective for patients as specialist sleep centre care but will be less costly. If this proves to be the case the study results will open the possibility for easier access to care for a larger number of patients with moderate to severe OSA, which will result in significant health benefits for the community.Read moreRead less
RCT Of Headbox Oxygen Vs CPAP For Neonatal Respiratory Distress In Non-tertiary Hospitals
Funder
National Health and Medical Research Council
Funding Amount
$225,500.00
Summary
Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safet ....Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safety. Currently, babies who need oxygen in a local hospital are placed in a crib with a clear plastic box around their head and oxygen is run into the box (headbox oxygen). There is an alternative method of providing oxygen called CPAP (Continuous Positive Airway Pressure). This involves giving the oxygen directly into the baby's nose via soft rubber prongs. CPAP has been used since the 1970's. It is the main form of respiratory support for infants in many NICUs in Australia and the world. There is some evidence that death and lung disease may be reduced. However, the babies in these studies are sicker and smaller than babies in local hospital nurseries. CPAP is used in some local nurseries in New Zealand, however no studies have been done to see if CPAP reduces the need for inter-hospital transfer. The study will involve hospitals that have been selected because of their level of on site medical and nursing staff. These hospitals will have support and advice from two NICUs that use CPAP as their main form of respiratory support. Babies who need oxygen will be randomly allocated to either have headbox oxygen or CPAP. If the baby becomes so unwell such that certain preset criteria are met, the baby will be transferred to a NICU in the usual way. If CPAP safely reduces the need for inter-hospital transfer, many parents will be saved the anxiety associated with transfer, and the separation it often causes.Read moreRead less
Previous research has shown that SIDS victims have a number of subtle abnormalities that set them apart from the normal population. These include the occurrence of upper airway obstruction in sleep, a reduced ability to awaken from sleep and abnormalities of the automatic control of heart rate and blood pressure in sleep. These body functions are controlled by a component of the brain called the autonomic nervous system which controls the heart and other internal functions by means of nerves cal ....Previous research has shown that SIDS victims have a number of subtle abnormalities that set them apart from the normal population. These include the occurrence of upper airway obstruction in sleep, a reduced ability to awaken from sleep and abnormalities of the automatic control of heart rate and blood pressure in sleep. These body functions are controlled by a component of the brain called the autonomic nervous system which controls the heart and other internal functions by means of nerves called the parasymmpathetic and sympathetic systems. The purpose of this project is to undertake studies of the autonomic system in normal infants and in those infants who are considered to be at risk for SIDS. As SIDS occurs almost exclusively in sleep it is important to study the infant?s heart rate and blood pressure responses to various challenges whilst asleep. All infants (both controls and subjects) enrolled in the protocol will therefore undergo overnight sleep studies during which their automatic responses to a variety of stimuli will be measured. Once we have established the normal response to these stimuli we can then compare them to the results of the at risk group. If, as we anticipate, there is a difference between our at risk group and the normal controls in automatic function then we will measure some of the stress hormones in the body which reflect the function of the autonomic nervous system. If there is a difference in the levels of these hormones between the normal and the at risk groups which correlates with the expected subtle abnormalities in function we may be able to devise an accessible and quantifiable measure for those infants at risk of SIDSRead moreRead less