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 #
2R01HL085188-05A1
Application #
8698091
Study Section
Respiratory Integrative Biology and Translational Research Study Section (RIBT)
Program Officer
Laposky, Aaron D
Project Start
2006-07-01
Project End
2019-03-31
Budget Start
2014-09-01
Budget End
2015-03-31
Support Year
5
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of California San Diego
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Deacon-Diaz, Naomi; Malhotra, Atul (2018) Inherent vs. Induced Loop Gain Abnormalities in Obstructive Sleep Apnea. Front Neurol 9:896
Mahajan, Sanjiv; Gupta, Kartik; Sinha, Sanjeev et al. (2018) Effect of kidney transplantation on sleep-disordered breathing in patients with End Stage Renal Disease: a polysomnographic study. Sleep Med 45:140-145
Light, Matthew; McCowen, Karen; Malhotra, Atul et al. (2018) Sleep apnea, metabolic disease, and the cutting edge of therapy. Metabolism 84:94-98
Hepokoski, Mark L; Bellinghausen, Amy L; Bojanowski, Christine M et al. (2018) Can We DAMPen the Cross-Talk between the Lung and Kidney in the ICU? Am J Respir Crit Care Med 198:1220-1222
Gupta, Ankit; Quan, Stuart F; Oldenburg, Olaf et al. (2018) Sleep-disordered breathing in hospitalized patients with congestive heart failure: a concise review and proposed algorithm. Heart Fail Rev 23:701-709
Hepokoski, Mark L; Malhotra, Atul; Singh, Prabhleen et al. (2018) Ventilator-Induced Kidney Injury: Are Novel Biomarkers the Key to Prevention? Nephron 140:90-93
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
Malhotra, Atul; Morrell, Mary J; Eastwood, Peter R (2018) Update in respiratory sleep disorders: Epilogue to a modern review series. Respirology 23:16-17
Pépin, Jean-Louis D; Woehrle, Holger; Liu, Dongquan et al. (2018) Adherence to Positive Airway Therapy After Switching From CPAP to ASV: A Big Data Analysis. J Clin Sleep Med 14:57-63
Sánchez-de-la-Torre, Alicia; Soler, Xavier; Barbé, Ferran et al. (2018) Cardiac Troponin Values in Patients With Acute Coronary Syndrome and Sleep Apnea: A Pilot Study. Chest 153:329-338

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