Aging Influence on the Development of Sleep Apnea

衰老对睡眠呼吸暂停发展的影响

• 批准号: 6949678
• 负责人: Atul Malhotra
• 金额: $ 20.8万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6949678
• 关键词: age difference; bioimaging /biomedical imaging; biomechanics; electroencephalography; electromyography; esophagus motility /pressure; human old age (65+); human subject; lung; magnetic resonance imaging; pathologic process; patient oriented research; respiratory airway pressure; respiratory airway volume; sleep apnea; young adult human (21-34)

DESCRIPTION (provided by applicant): Candidate: The candidate plans a career as an independent clinical investigator focusing on patient-oriented research in sleep disorders with an emphasis on the biology of aging. Environment: Harvard University provides a superb environment for this award. The Sleep Disorders Laboratories and Hebrew Rehabilitation Center for Aging have extensive expertise in sleep physiology and the biology of aging respectively. Didactic training and research seminars will be provided through the School of Public Health, HRCA, and the HMS Division of Aging. Research: OSA is a common disease with substantial morbidity. Recent data suggest that OSA has major neurocognitive and cardiovascular sequelae, with the elderly being particularly predisposed. Sleep apnea pathogenesis likely involves abnormalities in upper airway anatomy, pharyngeal dilator muscle dysfunction, ventilatory control instability and other factors. To date, little is known about the influence of aging on sleep apnea pathogenesis, since few investigators have assessed these variables in combination using state of the art techniques. We plan to perform a cross sectional study evaluating all variables known to be important in apnea pathogenesis. We will study both older and younger individuals with known OSA, as well as age-matched controls. We will study 20 subjects/patients from each of these 4 categories to assess the impact of aging on the variables of interest. We plan to use statistical techniques to perform multivariate analyses using anatomical and physiological variables to predict pharyngeal mechanics. Furthermore, we are developing a computational (finite element) model to assess the effect of various factors on pharyngeal mechanics. We plan to determine the variables most influenced by aging and use the statistical and computational modeling techniques to assess how they impact pharyngeal mechanics. In so doing, we will identify potential targets for intervention to reduce the sequelae of sleep apnea in the elderly. The principal investigator will continue didactic training in the biology of aging to complement previous training in respiratory physiology. As well, he has joined the Division of Aging at Harvard Medical School and will regularly attend research seminars and conferences in order to further understand the aging process. Furthermore, he will attend national meetings dedicated to the pursuit of aging mechanisms and geriatric medicine. Ultimately, our goal is to improve our understanding of the aging mechanisms underlying the development of sleep apnea, as well as to improve the quality of life of elderly patients who are either afflicted with sleep apnea or at risk of its occurrence.

描述（由申请人提供）： 候选人：候选人计划成为一名独立的临床研究者，专注于以患者为导向的睡眠障碍研究，重点是衰老生物学。环境：哈佛大学为该奖项提供了优越的环境。睡眠障碍实验室和希伯来衰老康复中心分别在睡眠生理学和衰老生物学方面拥有丰富的专业知识。教学培训和研究研讨会将通过公共卫生学院、HRCA 和 HMS 老龄化部门提供。研究：OSA 是一种发病率很高的常见疾病。最近的数据表明，OSA 具有严重的神经认知和心血管后遗症，其中老年人尤其容易出现这种后遗症。睡眠呼吸暂停的发病机制可能涉及上气道解剖异常、咽扩张肌功能障碍、通气控制不稳定等因素。迄今为止，人们对衰老对睡眠呼吸暂停发病机制的影响知之甚少，因为很少有研究人员使用最先进的技术综合评估这些变量。我们计划进行一项横断面研究，评估所有已知在呼吸暂停发病机制中重要的变量。我们将研究患有已知 OSA 的老年人和年轻人，以及年龄匹配的对照。我们将研究这 4 个类别中每一类的 20 名受试者/患者，以评估衰老对感兴趣变量的影响。我们计划使用统计技术利用解剖学和生理学变量进行多变量分析来预测咽部力学。此外，我们正在开发一个计算（有限元）模型来评估各种因素对咽部力学的影响。我们计划确定受衰老影响最大的变量，并使用统计和计算建模技术来评估它们如何影响咽部力学。在此过程中，我们将确定潜在的干预目标，以减少老年人睡眠呼吸暂停的后遗症。首席研究员将继续进行衰老生物学的教学培训，以补充之前的呼吸生理学培训。此外，他还加入了哈佛医学院衰老研究部，并将定期参加研究研讨会和会议，以进一步了解衰老过程。此外，他还将参加致力于研究衰老机制和老年医学的全国会议。最终，我们的目标是提高对睡眠呼吸暂停发展背后的衰老机制的理解，并提高患有睡眠呼吸暂停或有发生睡眠呼吸暂停风险的老年患者的生活质量。