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.

Public Health Relevance

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.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
3R01HL085188-07S1
Application #
9283062
Study Section
Program Officer
Laposky, Aaron D
Project Start
2006-07-01
Project End
2019-03-31
Budget Start
2016-09-01
Budget End
2017-03-31
Support Year
7
Fiscal Year
2016
Total Cost
Indirect Cost
Name
University of California San Diego
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
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Hepokoski, Mark L; Odish, Mazen; Malhotra, Atul (2018) Prone positioning in acute respiratory distress syndrome: why aren't we using it more? J Thorac Dis 10:S1020-S1024
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