Obstructive sleep apnea (OSA) is a common disease with major cardiovascular and neurocognitive consequences and yet current therapies are unacceptable for some patients. While CPAP (continuous positive airway pressure) can be transformative for some patients, adherence to this treatment is highly variable and alternative therapies suffer from incomplete efficacy. We have recently observed evidence of neuromyopathy in OSA using some newly developed sophisticated electrophysiological techniques. These data have corroborated the findings of other groups showing either sensory or motor impairment of upper airway neuromuscular reflexes in OSA. However, we remain unclear whether the observed findings are indeed clinically important. We plan to define the variability in reinnervation (a marker of nerve injury) in OSA compared to matched controls, also trying to identify predictors of this pattern for clinicians to use. We will further assess the importance of these findings by assessing tongue protrusion force and fatigability as well as the potential impact of neuromyopathy on upper airway mechanics during sleep. We will also conduct a pilot clinical trial to assess the impact of muscle training exercises on OSA patients with and without evidence of reinnervation. Ultimately, we hope that our research will help to define new therapeutic targets at least for a subset of OSA patients.

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Statement Sleep apnea patients sometimes have serious complications. Recent evidence suggests that the nerves and muscles controlling the upper airway may be damaged in sleep apnea patients. We will determine how common this problem is, how it affects the function of the airway muscles during wakefulness and sleep and whether it can be treated effectively with muscle training exercises.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Respiratory Integrative Biology and Translational Research Study Section (RIBT)
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Laposky, Aaron D
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University of California San Diego
Internal Medicine/Medicine
Schools of Medicine
La Jolla
United States
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Hepokoski, Mark; Owens, Robert L; Malhotra, Atul et al. (2016) Mechanical ventilation in acute respiratory distress syndrome at ATS 2016: the search for a patient-specific strategy. J Thorac Dis 8:S550-2
Mbanze, Irina; Moschovis, Peter P; Malhotra, Atul (2016) The American Thoracic Society Global Scholars Program. J Thorac Dis 8:S586-7
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Malhotra, Atul; Jordan, Amy (2016) The importance of arousal in obstructive sleep apnea-updates from the American Thoracic Society 2016. J Thorac Dis 8:S542-4

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