Early Detection Of Pulmonary Exacerbation In Cystic Fibrosis Using Nocturnal Measurements Of Cough And Sleep
Funder
National Health and Medical Research Council
Funding Amount
$140,949.00
Summary
Cystic Fibrosis (CF), the most common lethal inherited disorder effecting Australians, is a medical success story, with survival increasing from 5 years in 1970 to 40 years now. However, lower respiratory tract infections remain the major problem in CF. This project will develop and test a simple, non-invasive device to detect early chest infections, allowing early treatment, improving quality of life and preventing lung scarring. Less hospitalisations will benefit both patients and hospitals.
A Randomised Controlled Trial Of The Effect Of Substantial Weight Loss On Obstructive Sleep Apnoea.
Funder
National Health and Medical Research Council
Funding Amount
$404,061.00
Summary
Obstructive sleep apnea is now commonly recognized as a major health problem and frequently ocurrs in overweight or obese individuals. Several studies have now demonstrated that weight loss can be an effective treatment for sleep apnea in those with a weight problem. But, it is extremely difficult to achieve and sustain the major weight loss required to adequately treat this condition. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in very obese ....Obstructive sleep apnea is now commonly recognized as a major health problem and frequently ocurrs in overweight or obese individuals. Several studies have now demonstrated that weight loss can be an effective treatment for sleep apnea in those with a weight problem. But, it is extremely difficult to achieve and sustain the major weight loss required to adequately treat this condition. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in very obese individuals, and several studies have found that along with weight loss there are major improvements in sleep symptoms, and sleep apnea following weight loss surgery. Despite these findings surgery is rarely advised and has never been formally tested as a therapy for sleep apnea. We propose to formally test, for the first time, the effectiveness of weight loss surgery, as an addition to best conventional therapy, in those individuals with the combination of problems; obesity and significant sleep apnea. We propose that significant weight loss, following surgery, may indeed be the best therapy for those with these combined problems, and that weight loss may have additional benefits for other common problems related to obesity, including high blood pressure, poor body image and impaired quality of life. Forty appropriate patients who suffer these combined problems will be randomly allocated to either conventional therapy for their sleep apnea and weight problems or to a similar program that includes placement of a Lap-Band, a minimially invasive form of obesity surgery. We will follow the patients for 2-years and serially measure a broad range of health and quality of life outcomes and compare the effects of each program. This study will help us assess the role of obesity surgery in this group of patients with major health problems.Read moreRead less
The Role Of Sleep And Cardiorespiratory Control In The Pathogenesis Of Pre-eclampsia
Funder
National Health and Medical Research Council
Funding Amount
$235,095.00
Summary
Pre-eclampsia occurs in 7-10 % of the pregnant population. This makes it one of the most common diseases associated with pregnancy in the Western world. The cause of pre-eclampsia remains elusive, however, recent research suggests that the initiating factor is abnormal implantation of the placenta into the uterus. This in turn leads to poor flow of blood through the placenta (known as placental ischaemia) resulting in release of mediators (including substances known as cytokines) into the matern ....Pre-eclampsia occurs in 7-10 % of the pregnant population. This makes it one of the most common diseases associated with pregnancy in the Western world. The cause of pre-eclampsia remains elusive, however, recent research suggests that the initiating factor is abnormal implantation of the placenta into the uterus. This in turn leads to poor flow of blood through the placenta (known as placental ischaemia) resulting in release of mediators (including substances known as cytokines) into the maternal circulation which cause widespread damage to the endothelium (the protective layer of cells which line all of the blood vessels throughout the circulation). Furthermore, the greater the demand on the placenta, the more of these toxic substances will be released into the maternal circulation. During sleep, a large proportion of pregnant women snore and consequently have partial reduction in the volume of each breath. In women with healthy placental function, this is not a concern. However, we suggest that in women with pre-eclampsia, this results in further disruption to the blood flow through the placenta, which leads to a greater output of toxic substances from the placenta. We have shown that by controlling snoring during pregnancy in women with pre-eclampsia with the use of nasal continuous positive airway pressure (nasal CPAP), we are able to markedly reduce blood pressure over the night. In this project, we would like to investigate changes occurring during sleep in cytokines in the maternal circulation, and in maternal blood pressure both on and off nasal CPAP in order to establish whether a mechanism during sleep is contributing to the disease process of pre-eclampsia. Furthermore, we intend to investigate whether the long term use of nasal CPAP improves the outcome of pre-eclampsia.Read moreRead less
Microvascular And Macrovascular Disease In Snoring And Obstructive Sleep Apnoea: A Mechanism For Increased Stroke Risk.
Funder
National Health and Medical Research Council
Funding Amount
$679,744.00
Summary
This project will address the important question of the vascular risk of stroke associated with snoring and obstructive sleep apnoea, by using retinal photography of the eye to directly visualise the vascular changes in the cerebral circulation. Retinal photography may provide a useful clinical tool to help reduce the risk of stroke in patients with snoring and sleep apnoea.
Sleep Disordered Breathing In Pregnancy: Frequency And Impact.
Funder
National Health and Medical Research Council
Funding Amount
$607,034.00
Summary
Sleep disordered breathing (SDB)affects up to 15% of women during pregnancy. There is some evidence that it may have adverse effects on both mother and baby, particularly it may be associated with a 7-8 fold increase risk of developing hypertension during pregnancy. This study aims to measure breathing during sleep in pregnant women to determine its role in pregnancy-related hypertension and diabetes, then treat the SDB to assess its effect on maternal and foetal outcomes.
Respiratory Phenotyping For New Targeted Approaches To Treat Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$631,370.00
Summary
>9% of Australians have obstructive sleep apnoea (OSA). OSA has several causes. Untreated OSA is associated with major health consequences. <50% of OSA patients tolerate the main therapy, continuous positive airway pressure. New treatments are urgently required. This proposal aims to use & develop novel approaches to identify the causes of OSA on a per patient basis, improve current therapies & test if new targeted therapies can be used to treat OSA in appropriately selected patients.
Predicting Treatment Response To Mandibular Advancement Splints: A Novel Biomechanical Imaging Method
Funder
National Health and Medical Research Council
Funding Amount
$689,062.00
Summary
Mandibular advancement splints are an alternative to continuous positive airway pressure for patients with Obstructive Sleep Apnoea (OSA). However, they are effective for only about half of OSA patients, and it is not currently possible to predict who will benefit. This project will explore a new magnetic resonance imaging method to see if it can predict who will respond to mandibular advancement splint therapy.
The Influence Of Sleep On The Behaviour Of The Upper Airway Muscles, Genioglossus And Tensor Palatini
Funder
National Health and Medical Research Council
Funding Amount
$295,880.00
Summary
The human airway has limited bone or cartilage support and muscular activity is required to keep the airway open. Central activation of these muscles is reduced during sleep, resulting in the disorder Obstructive Sleep Apnoea. Potential treatments include pharmocological or electrical stimulation of upper airway muscles. However, this is hampered by a lack of understanding of the control of upper airway muscles. This project will study two critical muscles, genioglossus and tensor palatini.
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
A-Prof Wheatley is a respiratory and sleep disorders physician investigating the pathogenesis, health consequences and management of sleep breathing disorders, including sleep apnoea and snoring.