Experimental Investigation Of Driving Impairment In Obstructive Sleep Apnea
Funder
National Health and Medical Research Council
Funding Amount
$466,764.00
Summary
Obstructive Sleep Apnea (OSA) affects 2-4% of the adult population. Repetitive throat obstructions at night lead to sleep disturbance and oxygen deprivation which in turn lead to excessive daytime sleepiness and poor concentration. Studies in severely affected OSA patients have demonstrated driving simulator performance impairment and a 2-7 fold increased rate of motor vehicle accidents. Current data suggest that up to 50,000 MVAs may be caused each year in Australia by OSA. While driving impair ....Obstructive Sleep Apnea (OSA) affects 2-4% of the adult population. Repetitive throat obstructions at night lead to sleep disturbance and oxygen deprivation which in turn lead to excessive daytime sleepiness and poor concentration. Studies in severely affected OSA patients have demonstrated driving simulator performance impairment and a 2-7 fold increased rate of motor vehicle accidents. Current data suggest that up to 50,000 MVAs may be caused each year in Australia by OSA. While driving impairment and increased crash risk in severe OSA seems clear it is not known whether patients with mild-moderate disease are also affected. This is an important question since patients with mild-moderate disease make up the great majority of OSA sufferers and therefore potentially pose the greatest concern for overall public safety. This study will determine whether mild-moderate, as well as severe, OSA is associated with driving impairment. The study will also determine how partial sleep deprivation and low dose alcohol impact on driving performance in OSA. These two behaviours are considered part of the norm for modern societies, yet we recently showed that they act synergistically to markedly impair driving in healthy subjects. We suspect that years of prior sleep disturbance and oxygen deprivation will render OSA sufferers more vulnerable to the effects of these additional central nervous system insults. Finally, we will determine how well driving impairment in severe OSA responds to nose mask CPAP treatment. We will find out what minimum level of treatment adherence is needed to produce significant improvement and whether driving impairment is ever truly reversed. The information obtained in this study will inform and significantly improve patient care,fitness to drive guidelines and driver safety campaigns.Read moreRead less
Randomised Double-blind Controlled Trial Of Oxygen Versus Air To Palliate Intractable End-of-life Dyspnoea When Pa02 >55
Funder
National Health and Medical Research Council
Funding Amount
$463,318.00
Summary
Shortness of breath at the end-of-life is one of the most feared symptoms. Unlike most other symptoms, it worsens as death approaches. Despite the fact that more than 50,000 Australian will die an expected death in the next year, of whom the majority will have breathlessness toward the end-of-life, we know little about how best to treat this symptom. Oxygen is frequently introduced but we have not identified whether it is more effective than medical air, and, if it is more effective, which patie ....Shortness of breath at the end-of-life is one of the most feared symptoms. Unlike most other symptoms, it worsens as death approaches. Despite the fact that more than 50,000 Australian will die an expected death in the next year, of whom the majority will have breathlessness toward the end-of-life, we know little about how best to treat this symptom. Oxygen is frequently introduced but we have not identified whether it is more effective than medical air, and, if it is more effective, which patients would most benefit from it. Because of this lack of evidence, oxygen is only funded in Australia in community settings for people who have severely low oxygen levels in their blood. Palliative oxygen is provided on a compassionate basis at times but this is on an ad hoc basis and does not ensure equitable access for people at the end of life who experience shortness of breath. This multi-centre study will compare oxygen and air, with neither the participant nor caring clinicians knowing which treatment they will receive. After careful explanation, volunteers who agree to participate will be asked to use the oxygen machine for at least 15 hours each day for 7 days and fill out a diary twice each day. Five centres across Australia are planning to enroll 240 participants in this study. Outcomes will include whether the sensation of breathlessness has improved, the overall quality of life while being treated, the ability to perform activities of daily living and any side effects experienced. This study is eagerly awaited by clinicians and health planners not only in Australia but in North America and Europe. This study will provide data in a long-standing international debate about the role of oxygen in people with relatively normal levels of oxygen in their blood who suffer from shortness of breath at the end-of-life.Read moreRead less
Developmental Aspects Of Respiratory Inflammation, Allergy And Asthma
Funder
National Health and Medical Research Council
Funding Amount
$7,169,609.00
Summary
Asthma develops as a complex series of interactions between genetic susceptibility and environmental exposures occurring in early life. While many children grow out of asthma others do not and develop the chronic form of the disease that persists into adult life. Our research involves understanding why some susceptible children develop asthma and why this becomes chronic in some. We will undertake studies in children to find out how and why this occurs. A major part of our studies involve longit ....Asthma develops as a complex series of interactions between genetic susceptibility and environmental exposures occurring in early life. While many children grow out of asthma others do not and develop the chronic form of the disease that persists into adult life. Our research involves understanding why some susceptible children develop asthma and why this becomes chronic in some. We will undertake studies in children to find out how and why this occurs. A major part of our studies involve longitudinal studies in cohorts of children recruited before birth. Having the ability to study children as they grow and develop conditions such as allergies and asthma allows us to understand why these conditions occur and allow us to predict which children are likely to develop them. Our research Program also has a solid focus on Translational Research, in which we will use the findings from our basic science studies to develop and test new methods of preventing and of treating asthma. These studies will include new methods for preventing the development of allergies, preventing the damage done to the lungs by severe viral respiratory infections in early life and better methods of treating established allergic asthma by improving immunotherapy techniques. By its very nature, primary prevention of disease in young children is controversial and raises some interesting questions. As part of this Program we intend to initiate consultation and debate in public, academic, regulatory and industry circles. An important role for our Program is shifting the current emphasis away from treatment of established disease towards preventing disease occurring. This is the best way to decrease the health, social and economic burden of chronic diseases such as asthma.Read moreRead less