Frequent sleep-related respiratory disturbances (SRRD) have been recognized to occur in as many as 70% of elderly and 15% of middle-aged subjects. Although it is widely agreed that subjects with obvious daytime sleepiness that occurs in association with severe obstructive sleep apnea (Respiratory disturbance indices (RDI) >30) benefit from treatment of their sleep disorders; there is no consensus (and a paucity of data) regarding treatment benefits in subjects with a less profound disorder. Rational utilization of health care resources for diagnosis and treatment of sleep apnea requires assessment of whether adverse health effects occur as a consequence of mild or moderate levels of SRRD, and whether any such health effects may be reversible with treatment. In this study, we propose to determine the degree to which neuro- psychological performance and general health status and function may be impaired in subjects with mild and moderate degrees of SRRD, as compared to subjects with minimal apneic activity. The degree to which improvement may occur following specific treatment will also be assessed. We propose to assess neuropsychological performance, sleepiness and general functional status in 330 subjects, including subjects with little apneic activity (RDI<5), mild activity (RDI 5-14), and moderate activity (RDI 15-25). Of these subjects, 75% will be selected from a clinic-based sample, and 25% will be recruited from an ongoing population-based study. 150 subjects with mild and moderate activity will be randomized to receive """"""""conservative"""""""" medical therapy (CMT) or CMT plus nasal CPAP therapy. We will utilize simple statistics, as well as multivariate techniques, to determine the relationship between SRRD (and associated hypoxemia, sleep fragmentation, and physiological sleepiness) to: a) intellectual abilities, attention and vigilance, psychomotor performance, learning and memory, and executive functions, and b) to general health status and function. Potential benefits of treatment specific for sleep apnea in subjects with mild and moderate SRRD will also be determined after two months of CPAP therapy. These data will provide new information about the health effects of mild and moderate sleep apnea that are needed for appropriate clinical decision making and utilization of health care resources.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Specialized Center (P50)
Project #
2P50HL042215-06
Application #
3780737
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
6
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Type
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Ward, Nicole L; Moore, Elizabeth; Noon, Kristen et al. (2007) Cerebral angiogenic factors, angiogenesis, and physiological response to chronic hypoxia differ among four commonly used mouse strains. J Appl Physiol 102:1927-35
Hans, M G; Nelson, S; Pracharktam, N et al. (2001) Subgrouping persons with snoring and/or apnea by using anthropometric and cephalometric measures. Sleep Breath 5:79-91
van Lunteren, E; Moyer, M (2001) Auxotonic contractile responses of rat tracheal and bronchial airway smooth muscle. Pulm Pharmacol Ther 14:443-53
Moyer, M; van Lunteren, E (2001) Effect of temperature on endplate potential rundown and recovery in rat diaphragm. J Neurophysiol 85:2070-5
van Lunteren, E; Moyer, M; Dick, T E (2001) Modulation of diaphragm action potentials by K(+) channel blockers. Respir Physiol 124:217-30
Adams, N; Strauss, M; Schluchter, M et al. (2001) Relation of measures of sleep-disordered breathing to neuropsychological functioning. Am J Respir Crit Care Med 163:1626-31
van Lunteren, E; Manubay, P (2001) Inotrophic effects of the K(+) channel blocker TEA on dystrophic (mdx and dy/dy) mouse diaphragm. Respir Physiol 125:249-54
Manubay, P; van Lunteren, E (2000) Effects on dystrophic (dy/dy) limb muscle of the K+ channel blocker tetraethylammonium. Neurosci Lett 283:169-72
Drake, C L; Rice, M F; Roehrs, T A et al. (2000) Scoring reliability of the multiple sleep latency test in a clinical population. Sleep 23:911-3
Strauss, M E; Thompson, P; Adams, N L et al. (2000) Evaluation of a model of attention with confirmatory factor analysis. Neuropsychology 14:201-8

Showing the most recent 10 out of 97 publications