DOES TREATMENT REVERSE THE NEUROCOGNITIVE AND CARDIOVASCULAR SEQUELAE OF SLEEP DISORDERED BREATHING IN CHILDREN?
Funder
National Health and Medical Research Council
Funding Amount
$519,826.00
Summary
Studies in children have shown that disruption to normal sleep patterns resulting from sleep disordered breathing (SDB) has severe consequences for both the cardiovascular system and neurocognition. To date there have been no studies in children to investigate whether treatment of SDB with adenotonsillectomy, which has been shown to reduce sleep fragmentation and neurocognition, also reduces blood pressure.
Long Term Follow-up Of Two Randomised Controlled Trials Of Treatment For Depression And Alcohol-other Drug Comorbidity
Funder
National Health and Medical Research Council
Funding Amount
$252,925.00
Summary
This study proposes the long term follow-up of participants in two of the first and largest studies of psychological treatment for people with co-occurring depression and alcohol-other drug use problems ever conducted. This is a crucial next step in research on the effectiveness of psychological treatment among this highly prevalent yet often neglected section of the community.
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
Impact Of Sleep Disordered Breathing On Cardiovascular, Behavioural And Neurocognitive Function In Preschool Children
Funder
National Health and Medical Research Council
Funding Amount
$425,703.00
Summary
Studies in school age children have shown that disruption to normal sleep patterns resulting from sleep disordered breathing (SDB) has severe consequences for both the cardiovascular system and neurocognition. To date there have been limited investigations of the effects of SDB in pre-school children despite the knowledge that disruptions to breathing during sleep are maximal at this age and the central nervous system which is immature and developing at this time, is most vulnerable to injury.
Cardiovascular, Neurophysiological And Neurocognitive Assessments To Define Sleep Disordered Breathing In Children
Funder
National Health and Medical Research Council
Funding Amount
$324,008.00
Summary
Disruptions to breathing during sleep (snoring), known as sleep disordered breathing occurs in up to 27% of children and forms a continuum of symptoms ranging from mild to severe. It has previously been thought that only severe disruptions to breathing, as occurs in obstructive sleep apnoea (OSA), were of clinical significance requiring intervention, however recent studies have shown that even snoring with no currently used signs of altered blood oxygenation levels or sleep disruption can have a ....Disruptions to breathing during sleep (snoring), known as sleep disordered breathing occurs in up to 27% of children and forms a continuum of symptoms ranging from mild to severe. It has previously been thought that only severe disruptions to breathing, as occurs in obstructive sleep apnoea (OSA), were of clinical significance requiring intervention, however recent studies have shown that even snoring with no currently used signs of altered blood oxygenation levels or sleep disruption can have a significant impact on daytime functioning and school performance. It is also known that cardiovascular disease is a long-term consequence of untreated sleep disordered breathing in adults, however the long-term effects on the cardiovascular system in children are unknown. This study will examine both the neurocognitive and cardiovascular effects of a range of severities of sleep disordered breathing in children and will identify new more sensitive markers of sleep disruption in order to predict neurocognitive dysfunction. In order to address this most important issue, this project will combine the expertise of scientists and clinicians in the fields of paediatric sleep, cardiovascular control and neuropsychological assessment from Monash and Melbourne Universities, and the Monash Medical Centre and Royal Children's Hospital.Read moreRead less
The Role Of Cannabis In An Nrg1 Animal Model Of Genetic Vulnerability To Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$455,323.00
Summary
The link between psychosis and cannabis use has been discussed for decades. As the majority of users do not develop schizophrenia, it seems that other risk factors are necessary to trigger psychosis. Adolescence may be a time of particular vulnerability to the effects of cannabis use. We aim to use an animal model for schizophrenia to clarify cannabis' impact on the development of schizophrenia when interacting with the risk factors genetic vulnerability and age of onset of cannabis use.
Developmental Changes In Cerebral Oxygenation After Term And Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$445,306.00
Summary
Approximately 10% of all births are preterm and the numbers of infants surviving are increasing. We have previously found that infants born preterm have lower blood pressure over the first 6 months after term equivalent age than infants born at term. We will use new technology to examine how preterm birth affects brain oxygenation and how this is altered with gestational age, sleep states and sleeping position, to provide insights into their increased risk for SIDS.
Effects Of Lead And Socio-cultural Factors On Cognition And Behaviour Of Children In Port Pirie And Broken Hill
Funder
National Health and Medical Research Council
Funding Amount
$394,825.00
Summary
The effect of lead on children's 'intelligence' is controversial. Poorer IQ scores in children with higher exposure to lead, have been found reasonably consistently, - but there is disagreement on whether lead exposure is simply a common ASSOCIATE of poor IQ, or whether it actually CAUSES deficits. In 1994, the NHMRC prudently recommended a graded series of interventions to be implemented, depending on the proprtion of children in the community with blood lead concentrations in specific categori ....The effect of lead on children's 'intelligence' is controversial. Poorer IQ scores in children with higher exposure to lead, have been found reasonably consistently, - but there is disagreement on whether lead exposure is simply a common ASSOCIATE of poor IQ, or whether it actually CAUSES deficits. In 1994, the NHMRC prudently recommended a graded series of interventions to be implemented, depending on the proprtion of children in the community with blood lead concentrations in specific categories above 10 ug lead -100 ml of blood. The choice of this figure (10 ug-dl) was more pragmatic than scientific; there being very little data on the health effects of exposures below 10 ug-dl available at that time. A recent analysis of pooled data from past studies has now suggested there may be very large effects on child IQ at blood lead concentration BELOW 10 ug-dl. Health authorities will soon be lobbied intensely to spend vast sums on new lead abatement programs. Cities like Port Pirie and Broken Hill (where cooperative programs have achieved such significant reductions in lead exposure that a high percentage of their children now have blood lead levels below 10 ug-dl), will be forced to examine expensive options to avoid closure of the industries which provide their economic backbones, if this analysis proves to be correct. Our proposal argues that before committing to new and costly abatement programs, there is an urgent need to augment our evidence-base by conducting a new study ofchildren with lead exposures below 10 ug-dl, using more modern measures of intelligence. The study will pay closer attention to some of the socio-cultural and inherited determinants of child IQ which may have confounded the lead-IQ association in past studies, and will supplement IQ assessments (which are now considered to derive from a very old and narrow view of intelligence) with new tools for measuring 'intelligence' that may be less socio-culturally dependent.Read moreRead less
Randomised Controlled Trial Of A New Intervention For Alcohol Craving
Funder
National Health and Medical Research Council
Funding Amount
$780,673.00
Summary
Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and lo ....Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and long-term maintenance of change. Whilst current medications target craving, they provide only short-term symptom relief, and not all people find them effective. Cravings are both distracting and distressing during treatment, and increased craving often predicts treatment drop-out and relapse. This project evaluates a new treatment for alcohol misuse: CARM - Craving for Alcohol: Reduction and Management. This 8-session enhanced Cognitive-Behaviour Treatment (CBT) focuses on teaching people new skills to manage and reduce cravings, and is based on a new theory of craving that has strong research support. The study compares 4 groups: CARM; a more traditional CBT treatment for alcohol problems [motivational interviewing, problem solving for high-risk situations, and relapse prevention]; plus two brief interventions [Motivational Interviewing plus Self-Monitoring, and Self-Monitoring alone] both followed by CARM after an 8 week delay. All participants are able to set their own goals of abstinence or reduced use. Expected outcomes: all participants will learn effective skills to manage their alcohol use, resulting in significant reductions in alcohol consumption and fewer problems from alcohol use; however, those receiving CARM will find it easier to manage cravings during treatment, and will make faster progress and show less treatment drop-out. It is also anticipated that participants in CARM will show better long-term maintenance of treatment gains.Read moreRead less