Revolution Of Sleep Diagnostics And Personalized Health Care Based On Digital Diagnostics And Therapeutics With Health Data Integration
Funder
National Health and Medical Research Council
Funding Amount
$500,000.00
Summary
Almost 1 billion people suffer from sleep apnoea. Unfortunately, the current diagnostic metric relates poorly to the symptoms and comorbidities of sleep apnoea merely measuring the frequency of breathing cessations. We aim to develop machine learning techniques to better estimate sleep apnoea severity. These techniques are implemented to high-end wearables developed in this project. Finally, we aim to design a digital diagnostic platform and create new standardised guidelines for sleep medicine.
A Functional Autoantibody In Human Narcolepsy: Direct Evidence For The Autoimmune Hypothesis
Funder
National Health and Medical Research Council
Funding Amount
$444,928.00
Summary
Narcolepsy is a chronic disabling sleep disorder causing irresistible sleepiness and, in most cases, brief attacks of weakness on emotional arousal (cataplexy). Other symptoms include a transient paralysis at the beginning or end of sleep and vivid hallucinations at the start of sleep. Symptoms usually appear during adolescence or early adulthood. It affects between one in 1,000 and one in 2,000 people, yet the diagnosis is often delayed for several years because of the lack of a simple diagnost ....Narcolepsy is a chronic disabling sleep disorder causing irresistible sleepiness and, in most cases, brief attacks of weakness on emotional arousal (cataplexy). Other symptoms include a transient paralysis at the beginning or end of sleep and vivid hallucinations at the start of sleep. Symptoms usually appear during adolescence or early adulthood. It affects between one in 1,000 and one in 2,000 people, yet the diagnosis is often delayed for several years because of the lack of a simple diagnostic marker. It has been suspected for some time that narcolepsy is caused by a malfunctioning immune system, but direct evidence for the so-called autoimmune hypothesis has been lacking. We have recently discovered the smoking gun in the form of an autoantibody that circulates in the bloodstream and produces some of the features of narcolepsy on transfer to experimental animals. The identification of the autoantibody, which we term a functional autoantibody because it directly alters the function of nerves thought to be involved in narcolepsy and cataplexy, opens a new chapter in narcolepsy research that has important diagnostic and therapeutic implications. Testing for the autoantibody in subjects recruited from national and international centres for sleep research will determine its value in the diagnosis of narcolepsy and may help distinguish narcolepsy from other sleep disorders. Preliminary findings are encouraging and suggest that the autoantibody is a sensitive and specific marker for human narcolepsy and might lead to a clinically useful diagnostic test. In another part of the project, experimental approaches willl be used to identify an antibody called an antiidiotype that can neutralise the narcolepsy autoantibody and therefore be developed as a therapeutic agent. Finally, experiments have been designed to examine the effect of the autoantibody on neurotransmitters in the brain that are believed to result in cataplexy.Read moreRead less
Factors Determining Collapsibility Of The Human Upper Airway During Sleep And General Anaesthesia
Funder
National Health and Medical Research Council
Funding Amount
$259,625.00
Summary
Obstructive sleep apnoea (OSA) is common, affecting between 2-4% of middle-aged adults. It is characterised by repetitive partial or complete collapse of the upper airway during sleep. Each episode is accompanied by transient hypoxemia, hypertension and arousal. The repetitive arousals disrupt sleep resulting in excessive daytime tiredness and lethargy, which have major consequences for social well-being and productivity in our community. OSA is an independent risk factor for vascular disease. C ....Obstructive sleep apnoea (OSA) is common, affecting between 2-4% of middle-aged adults. It is characterised by repetitive partial or complete collapse of the upper airway during sleep. Each episode is accompanied by transient hypoxemia, hypertension and arousal. The repetitive arousals disrupt sleep resulting in excessive daytime tiredness and lethargy, which have major consequences for social well-being and productivity in our community. OSA is an independent risk factor for vascular disease. Central to understanding OSA is knowledge of the mechanisms responsible for vulnerability to upper airway collapse. It remains unclear to what extent this vulnerability relates to abnormalities in the underlying structure and passive physical characteristics of the upper airway, versus abnormalities in activity of upper airway muscles. Making this distinction has been problematic because current methods of testing upper airway collapsibility in sleeping humans tend to result in changes in muscle activity and-or sleep state, affecting the measurements. It is, however, possible to suppress upper airway muscle activity and eliminate measurement-related changes in muscle activity and state with general anaesthesia, while maintaining normal spontaneous breathing. We have developed and refined this method and propose to use it in novel investigations to (a) relate the behaviour of the flaccid airway (no muscle activity) under anaesthesia to its behaviour during sleep (when muscle activity is variable but quantifiable), and (b) determine the effect of changes in body habitus (posture and lung volume) on airway collapsibility. These studies will allow examination of the exciting possibility that measurements made under brief general anaesthesia could be used to define propensity to obstruction during sleep. They will also allow examination of the contribution of common changes in body habitus toward vulnerability to upper airway collapse.Read moreRead less
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
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