If Childhood Primary Snoring Resolves, Do Neurocognition And Behaviour Also Improve?
Funder
National Health and Medical Research Council
Funding Amount
$568,067.00
Summary
Sleep breathing disorders (SBD) are common and affect around 10% of all children. Previous research however has shown that sleep disorders are often not recognised or considered important enough to report to general practitioners. Thus, the true incidence of sleep disorders in Australian children is not known. Nevertheless, even the mildest SBD, primary snoring, has been associated with significant deficits in daytime learning, memory, intelligence, attention and problematic behaviour. In severe ....Sleep breathing disorders (SBD) are common and affect around 10% of all children. Previous research however has shown that sleep disorders are often not recognised or considered important enough to report to general practitioners. Thus, the true incidence of sleep disorders in Australian children is not known. Nevertheless, even the mildest SBD, primary snoring, has been associated with significant deficits in daytime learning, memory, intelligence, attention and problematic behaviour. In severe cases of childhood SBD (i.e. sleep apnoea syndrome), removal of the tonsils and adenoids has been shown to improve the learning and behaviour problems. Thus there is increasing pressure on doctors to treat primary snoring in children with surgery to improve their intellectual functioning. However, recent evidence in children has shown that snoring may resolve naturally in up to 50% of cases over one to two years. In addition to the risks of surgery, the large number of children who may have a natural resolution of snoring suggestst that the pressure to treat primary snoring in may not be justified. This study will be the first to determine the prevalence of childhood snoring and associated problems in the Australian community. We also aim to discover whether snoring and the associated intellectual deficits persist over time during childhood. We will identify frequent snorers and healthy non-snorers in children aged 5-10 years old, using parental questionnaires. We will then study 75 snorers and 75 non-snorers in more detail, monitoring them with overnight sleep studies and questionnaires 2 years apart, to see if snoring, intellectual function and behavioural problems persist over time. This information will improve the health of Australian children by determining the prevalence of childhood SBD and persistence of associated deficits such as in learning, memory and behaviour.Read moreRead less
Diet Exercise And ARmodafinil For Obstructive Sleep Apnea (OSA) Patients Who Cannot Use Standard Treatments. (DEAR)
Funder
National Health and Medical Research Council
Funding Amount
$95,313.00
Summary
Obstructive sleep apnea (OSA) affects over 3.5 million Australians and is associated with marked daytime sleepiness and decreased concentration. It is also a common health complication of obesity. Many people are unable to use standard treatments for OSA in the form of a mouth splint or mask worn at night. This study will look at treating the daytime sleepiness with a stimulant medication, Armodafinil, whilst reducing OSA severity gradually with diet and lifestyle modification.
Functional Characterisation Of Novel Metabolites In Asthma And Identification Of New Biomarkers
Funder
National Health and Medical Research Council
Funding Amount
$829,922.00
Summary
Asthma is a chronic inflammatory disease of the airways that represents a major health burden. Severe asthma represents 10% of those suffering the disease and poses an urgent problem due to exacerbations and resistance to current therapies. We have conducted the first study of the metabolites that are altered in the airways of patients with severe asthma and identified functional metabolites and disease biomarkers. We now aim to assess the function of these molecules in asthma disease models.
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
We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other co ....We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other countries (in North and South America, Asia, and Europe). This study will provide the first nationally-representative information on the burden of chronic obstructive pulmonary disease (COPD) and the opportunities for health gain by improving the management of this illness. In Australia, COPD is a relatively silent and under-recognised disease but nevertheless is the third most important contributor to the burden of disease and the third leading cause of hospital admission as well as being the underlying cause of 4.2% of all deaths. The information we will collect is needed to form a basis for prevention and disease management interventions to reduce the burden of COPD, particularly among population sub-groups who are disproportionately affected, either due to greater exposure to risk factors (mainly tobacco smoking and occupation), greater susceptibility, under-recognition and under-diagnosis, or inadequate disease management. Importantly, the study will serve to raise awareness about the hazards of smoking for all Australians. By identifying target groups, prevalent exposures and management deficiencies, it will lead the way towards policy-relevant randomised controlled trials testing community-based interventions to prevent COPD and-or manage it more effectively. The information collected will help advance knowledge of the prevalence, burden and treatment of COPD that will be relevant to communities throughout the world.Read moreRead less
The Emerging Problem Of Non-tuberculous Mycobacteria Infection: Understanding Aetiology, Geospatial Epidemiology And Developing Interventions
Funder
National Health and Medical Research Council
Funding Amount
$988,791.00
Summary
This project will be largest study of non-tuberculous mycobacterial (NTM) infection in cystic fibrosis. By combining growing the bacteria with detailed information from the CF patient data registry, geographical location and environmental conditions, this study will provide novel insights into factors associated with NTM. Gene sequencing and airway infection profiling will extend understanding and has the potential to identify novel risk factors and biomarkers for NTM-related airways disease.