Obstructive sleep apnea (OSA) is a common disorder with important consequences for afflicted individuals. This disorder is characterized by recurrent pharyngeal collapse during sleep with subsequent repetitive arousals, along with substantial hypoxia and hypercapnia. Associated consequences include daytime somnolence, decreased performance on cognitive and vigilance testing and decreased quality of life. In addition, there is also increasing evidence that OSA may lead to adverse cardiovascular outcomes such as hypertension, arrhythmias, myocardial infarction and stroke. The pathophysiology of sleep apnea is dependent upon a complex interaction between upper airway anatomy, pharyngeal dilator muscle function and ventilatory control mechanisms, and the effects of state related changes in these variables. Substantial literature indicates that this disorder is much more common in men than in women, and that androgens in both men and women can exacerbate the disorder. However, neither the true extent of the effect of androgens on sleep apnea incidence and severity, nor the mechanisms by which androgens predispose to apnea have been well delineated to this point. With the proposed Mentored Patient-Oriented Research Career Development Award, the applicant will build upon his prior experiences investigating the role of androgens in the pathophysiology of sleep apnea. Based upon very positive experiences in the laboratory to date, the applicant is firmly committed to a career in academic pulmonary and critical care medicine, focused primarily on clinical research. The laboratory of Dr. David P. White at the Brigham and Women's Hospital will provide a rich intellectual environment.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HL004400-03
Application #
6526581
Study Section
Special Emphasis Panel (ZHL1-CSR-F (M1))
Program Officer
Rothgeb, Ann E
Project Start
2000-08-01
Project End
2005-07-31
Budget Start
2002-08-01
Budget End
2003-07-31
Support Year
3
Fiscal Year
2002
Total Cost
$133,920
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02115
Fogel, Robert B; Trinder, John; White, David P et al. (2005) The effect of sleep onset on upper airway muscle activity in patients with sleep apnoea versus controls. J Physiol 564:549-62
Fogel, Robert B; Malhotra, Atul; Dalagiorgou, Georgia et al. (2003) Anatomic and physiologic predictors of apnea severity in morbidly obese subjects. Sleep 26:150-5
Fogel, Robert B; White, David P; Pierce, Robert J et al. (2003) Control of upper airway muscle activity in younger versus older men during sleep onset. J Physiol 553:533-44
Stanchina, Michael L; Malhotra, Atul; Fogel, Robert B et al. (2003) The influence of lung volume on pharyngeal mechanics, collapsibility, and genioglossus muscle activation during sleep. Sleep 26:851-6
Fogel, Robert B; Trinder, John; Malhotra, Atul et al. (2003) Within-breath control of genioglossal muscle activation in humans: effect of sleep-wake state. J Physiol 550:899-910
Stanchina, Michael L; Malhotra, Atul; Fogel, Robert B et al. (2002) Genioglossus muscle responsiveness to chemical and mechanical stimuli during non-rapid eye movement sleep. Am J Respir Crit Care Med 165:945-9
Fogel, R B; Malhotra, A; Pillar, G et al. (2001) Genioglossal activation in patients with obstructive sleep apnea versus control subjects. Mechanisms of muscle control. Am J Respir Crit Care Med 164:2025-30