This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.In this study, the aim is to define the relative contribution of the following variables to both apnea presence and severity in a group of individuals with a wide range of respiratory disturbance index (RDI): a) pharyngeal anatomy (MRI and Pcrit), b) pharyngeal dilator muscle responsiveness to increasing mechanical load during NREM sleep, c) ventilatory control stability (loop gain), d) arousal threshold. These variables will be modeled as predictors of apnea severity in each individual to define the different apnea phenotypes. It is hypothesized that there will be five or six groupings of the phenotypic traits (cluster analysis) that will either cause obstructive sleep apnea or prevent its development. This proposal also aims to determine if apnea phenotype predicts responsiveness to certain forms of therapy: 1) Does oxygen administration or acetazolamide, both of which stabilize the control of breathing, improve sleep apnea in patients with unstable ventilatory control (high loop gain)? 2) Does sedative administration, such as Trazodone, improve sleep apnea in patients identified as having a low arousal threshold (i.e. awaken easily from sleep, which would make breathing more variable and promote sleep apnea)?
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