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.
Novel Neuromechanical Measurements Of The Human Upper Airway In Health And Disease
Funder
National Health and Medical Research Council
Funding Amount
$543,728.00
Summary
Obstructive sleep apnea (OSA) is a common condition, in which the upper airway repeatedly collapses during sleep, causing the oxygen concentration in the blood to drop, carbon dioxide to rise, and the person to arouse in order to re-establish adequate oxygen supply. Consequences of OSA include increased daytime sleepiness, increased risk of accidents, and increased risk of cardiovascular diseases. It most commonly affects middle-aged males, but is also seen in the broader population. OSA is asso ....Obstructive sleep apnea (OSA) is a common condition, in which the upper airway repeatedly collapses during sleep, causing the oxygen concentration in the blood to drop, carbon dioxide to rise, and the person to arouse in order to re-establish adequate oxygen supply. Consequences of OSA include increased daytime sleepiness, increased risk of accidents, and increased risk of cardiovascular diseases. It most commonly affects middle-aged males, but is also seen in the broader population. OSA is associated with obesity and specific shapes of the upper airway and facial structure. These anatomical factors can be compensated for while awake but inadequate activity of the muscles surrounding the upper airway during sleep contributes to an increased predisposition of the airway to collapse. Airway collapse occurs when the muscles are unable to withstand the low pressures in the airway and collapse, obstructing the airway. This project will measure the stiffness and motion of the muscles surrounding the airway, in healthy people and those with OSA, to determine how these influence airway collapsibility. We will use two novel non-invasive Magnetic Resonance Imaging (MRI) techniques, MR Elastography, and MR tagging which will allow us to quantify the airway stiffness, or elasticity, and its motion (deformation). These will be the first direct measurements of the upper airway elasticity and deformation in humans. We will also measure how various treatments, such as CPAP therapy and mandibular advancement affect airway elasticity and deformation, so that their mechanisms can be better understood. This may also explain why some patients do not benefit from these therapies. These studies may lead to new diagnostic and treatment modalities, as well as gaining important insights into the basic mechanisms of airway collapse in humans.Read moreRead less
Identification Of Brain Regions Involved In The Regulation Of Coughing
Funder
National Health and Medical Research Council
Funding Amount
$431,146.00
Summary
Cough is a symptom of more than 100 clinical conditions of the respiratory system, and is the most common reason that people seek medical advice. However, currently available cough suppresant drugs are at best only modestly effective at treating cough disorders. In this study we aim to better understand how the brain regulates coughing in the hope to identify new therapeutic targets for relieving cough.
Neurobiological Effects Of Sleep Apnea And Sleepiness
Funder
National Health and Medical Research Council
Funding Amount
$320,437.00
Summary
Sleep apnea affects over one million Australians. It not only affects the quality of a persons sleep and the oxygen supply to their brain, but can cause sleepiness during the day which can in turn affect the ability of the person to conduct their normal activities. Over 30,000 sleep studies are conducted annually in Australia and current therapies result in significant improvements in the quality of life of the patient. However, the data analysis during these studies does not give a clear indica ....Sleep apnea affects over one million Australians. It not only affects the quality of a persons sleep and the oxygen supply to their brain, but can cause sleepiness during the day which can in turn affect the ability of the person to conduct their normal activities. Over 30,000 sleep studies are conducted annually in Australia and current therapies result in significant improvements in the quality of life of the patient. However, the data analysis during these studies does not give a clear indication of the degree to which individual patients may have problems with performing their normal tasks during the day. Tasks like driving vehicles are of particular interest due to the potential for accidents through fatigue or a lack of concentration. This research is designed to investigate the impact of sleep apnea on brain function and daytime performance using certain new techniques - more sophisticated analysis of the brain's activity, detection of brain chemicals and metabolism using a specific form of brain scan called MR spectroscopy, a special monotonous computer based driving simulator, an other tests of performance. We will assess a large group of patients with sleep apnea to determine how the impact of sleep apnea on performance may be differ throughout the population and how this may be affected by the current standard treatment for sleep apnea. We will examine the impact on brain function and performance of removing the current standard therapy in a group of patients previously diagnosed with sleep apnea (as this is a common occurrence in the community). We will also repeat some specific measurements on a control group without any symptoms of sleep apnea for the purpose of comparison. We plan to show a relationship between the effects of sleep apnea and the ability of a person to carry out activities such as driving and thinking. We will then be able to better assess the risk a patient may face and the most appropriate way to treat them.Read moreRead less
Ventilation Heterogeneity And Airway Remodelling In Asthma
Funder
National Health and Medical Research Council
Funding Amount
$522,586.00
Summary
Asthma is a common and important as a cause of significant symptoms and even death. Associated with asthma is narrowing and stiffening of the arways which causes uneven ventilation of the lungs and reduced lung function. We have developed a new technique of imaging the lungs, as well as new lung function tests which measure uneven ventilation and stiffening of airways. This will help us design better medications, and help predict those who are at risk or severe asthma and death.
High Field Magnetic Resonance Evaluation Of Cerebral And Brainstem Dysfunction In Obstructive Sleep Apnea.
Funder
National Health and Medical Research Council
Funding Amount
$335,175.00
Summary
BACKGROUND: Obstructive Sleep Apnea (OSA) is a condition where repetitive obstruction of the upper airway occurs during sleep. This occurs in susceptible patients when the muscles which normally hold the upper airway open relax with sleep onset. During these interruptions to breathing (apneas) oxygen levels can fall significantly and repetitive awakenings from sleep result. Patients with sleep apnea are often sleepy during the day and experience difficulties with concentration on complex or bori ....BACKGROUND: Obstructive Sleep Apnea (OSA) is a condition where repetitive obstruction of the upper airway occurs during sleep. This occurs in susceptible patients when the muscles which normally hold the upper airway open relax with sleep onset. During these interruptions to breathing (apneas) oxygen levels can fall significantly and repetitive awakenings from sleep result. Patients with sleep apnea are often sleepy during the day and experience difficulties with concentration on complex or boring tasks. Recent improvements in magnetic resonance imaging (MRI) technology allow targeting very small areas of the brain, such as the brainstem, the region of the brain which contols the upper airway muscles. MRI can detect subtle signs of damage to brain cells, and can assess brain activation induced by a task, such as moving the tongue . AIM 1. To identify the presence and patterns of damage to brain cells in patients with OSA by MRI scanning. 2. To examine whether patients with the most severe patterns of injury are also those with the greatest difficulties with sleepiness and concentration. 3. To determine whether these brain abnormalities improve after 6 months of treatment of OSA. 4. To assess activity of the brainstem in wakefulness in OSA patients and compare this to the activity in subjects without OSA. SIGNIFICANCE: This project will advance our understanding of the causes of obstructive sleep apnea. We anticipate it will provide a new method for investigating injury to brain cells in this disease. It will also provide a new means for investigating the causes of OSA and for evaluating novel therapies aimed at enhancing the activity of upper airway muscles and preventing obstruction during sleep.Read moreRead less
Biomechanical, Neural And Sensory Phenotyping Of The Upper Airway In Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$746,138.00
Summary
Obstructive sleep apnoea (OSA) is a common disorder where the upper airway closes repeatedly during sleep. It results in daytime sleepiness, increased risk of accidents and cardiovascular disease. But not all patients are the same, and individually tailored treatments are needed. This project will develop new ways to identify the causes of OSA in individual patients, using new MRI imaging methods, sensory testing, and measurements of the neural activity in the muscles that keep the airway open.
Predicting The Long Term Lung Health Outcomes In Young Adults Born Very Preterm
Funder
National Health and Medical Research Council
Funding Amount
$854,201.00
Summary
Preterm birth and its resulting lung problems can lead to breathing problems during childhood and into adult life. There are very few lung health studies that have tracked preterm individuals from childhood and into early adult life. This study will conduct a detailed lung health assessment in a follow-up of a group of preterm individuals at 19 years of age. We aim to identify if information we obtained in the group at 6 and 11 years can predict how the lungs look and behave at 19 years of age.
Regional Mechanisms Of Ventilator Induced Lung Injury: Insights From Dynamic Lung Imaging
Funder
National Health and Medical Research Council
Funding Amount
$623,323.00
Summary
Mortality rates due to acute respiratory distress syndrome (ARDS) are high (>30%). While ARDS requires mechanical ventilation as a lifesaving intervention, it is clear that mechanical ventilation itself can contribute to the high mortality rates. We will use a new lung imaging technology (CTXV) to visualize the damage that occurs to the lung as a result of mechanical ventilation in order to design better ventilation strategies and reduce mortality rates in these critically ill patients.