The Impact of Sleep Disordered Breathing in People who use Opioids

睡眠呼吸障碍对阿片类药物使用者的影响

• 批准号: 10677835
• 负责人: Jeremy Elliot Orr
• 金额: $ 16.99万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677835
• 关键词: Acetazolamide; Address; Adverse effects; Affect; American; Apnea; Ataxia; Award; Breathing; Brief Pain Inventory; California; Caring; Central Sleep Apnea; Chest; Chronic; Clinical Research; Clinical Trials; Complex; Continuous Positive Airway Pressure; Critical Care; Cross-Over Trials; Data; Development Plans; Disease; Doctor of Medicine; Dose; Event; Excess Mortality; Faculty; Failure; Fellowship; Foundations; Funding; Goals; Health; Hypoventilation; Impairment; Individual; Knowledge; Laboratories; Link; Measures; Mediating; Medical; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Moods; Morbidity - disease rate; National Research Service Awards; Opioid; Overdose; Oxygen; Pain; Pathogenesis; Patients; Persistent pain; Pharmaceutical Preparations; Pharmacotherapy; Physicians; Physiology; Placebos; Polysomnography; Public Health; Pulmonology; Quality of life; Randomized; Recreation; Research; Research Personnel; Research Support; Respiration Disorders; Respiratory physiology; Risk; Science; Scientist; Signal Transduction; Sleep; Sleep Apnea Syndromes; Sleep disturbances; Societies; Specialist; Supervision; Symptoms; Techniques; Treatment Failure; United States Dept. of Health and Human Services; United States National Institutes of Health; Universities; adverse outcome; career development; chronic pain; chronic pain patient; comorbidity; comparative effectiveness; efficacy evaluation; high risk population; improved; improvement on sleep; indexing; individualized medicine; member; mortality; mortality risk; opioid use; opioid user; patient oriented; patients who use opioids; personalized approach; poor health outcome; poor sleep; prescription opioid; primary outcome; professor; prospective; public health emergency; randomized trial; research and development; respiratory; secondary outcome; sleep physiology; sleep quality; sleep regulation; statistics; symptomatic improvement; treatment as usual; treatment risk; treatment strategy; trial design; ventilation

Project Summary/Abstract This proposal details a five-year research and career development plan for Jeremy E. Orr, M.D., a specialist in pulmonology and critical care medicine, and Assistant Professor of Medicine at the University of California, San Diego. His research has been supported by a National Research Service Award fellowship and currently an American Thoracic Society Foundation award. The overall focus of his research is understanding the importance of breathing issues during sleep in patients using chronic opioid medications, and identifying treatment strategies for these complex breathing issues that will improve health. This K23 award will provide necessary support for Dr. Orr to gain expertise in patient-oriented clinical research, applied physiology of sleep disordered breathing, and clinical trials. Dr. Orr has assembled a comprehensive team of mentors to support his research and career development. His primary mentor, Dr. Atul Malhotra, is a world expert in sleep disordered breathing (SDB) and applied respiratory physiology, with a strong track record of mentoring and promoting junior faculty to become independent investigators. Dr. Robert Owens is a NIH-funded physician-scientist with expertise in advanced techniques to measure SDB physiology, and will serve as a “hands-on” co-mentor. Additional members of the team are Dr. Sonia Jain (statistics and trials), Dr. Mark Wallace (opioids and pain), Dr. Shamim Nemati (signal analysis), and Dr. Frank Powell (control of breathing). Patients with chronic pain who use chronic opioids are at increased risk for poor health including ongoing pain, poor sleep, decreased quality of life, and an increased risk of mortality. Opioids are known to have effects on breathing which may lead to SDB, an under-recognized factor potentially contributing to adverse outcomes in these patients. SDB contributes to sleep disruption and impairments in oxygen levels, but has been little studied in this high-risk group of patients using opioids. In a broad group of subjects with chronic pain who use chronic opioids, this research will determine whether treatment of SDB with continuous positive airway pressure (CPAP) leads to improved sleep quality, as well as investigating other symptoms including pain in these patients (Aim 1). CPAP treatment may not be effective in some patients due to unstable breathing (due to opioids), so techniques to identify such individuals will be investigated, including new measures of breathing instability. For patients with persistent SDB despite CPAP, treatment options are limited. The research will evaluate whether a medication (acetazolamide) that helps to reduce the instability of breathing will help to resolve SDB (Aim 2). This research will provide Dr. Orr with a strong foundation to become an independent investigator studying the impact, pathogenesis and treatment of SDB in those using chronic opioids.

项目摘要/摘要 该建议详细介绍了杰里米·E·奥尔（Jeremy E. Orr）的五年研究和职业发展计划，医学博士 肺病学和重症监护医学，加州大学SAN分校的医学助理教授 迭戈。 美国胸科社会基金会奖。 使用慢性阿片类药物的患者睡眠睡眠期间的兄弟，并确定治疗策略 对于这些将改善健康的共同面包架问题。 ORR博士获得以患者为导向的临床研究的专业知识 和临床试验。 发展。 应用呼吸生理学，具有指导和促进初级教师的良好记录 独立调查员罗伯特·欧文斯（Robert Owens）博士是NIH资助的医师科学家 测量SDB生理学的技术，并将作为“动手”同事。 团队是Sonia Jain博士（统计和试验），Mark Wallace博士（阿片类药物和痛苦），Shamim Nemati博士（信号） 分析）和弗兰克·鲍威尔（Frank Powell）博士（呼吸控制）。 健康状况不佳的风险增加，包括持续的疼痛，睡眠不良，生活质量降低以及风险增加 众所周知，因素类药物对可能导致SDB的破坏有影响，这是一个被识别的因素不足的因素 有可能导致这些特定性的不利结果。 氧气的损伤水平，但在这个人中很少研究 大量患有慢性疼痛的受试者使用慢性阿片类药物，这项研究将决定是否治疗 具有连续正气压（CPAP）的SDB的SDB导致睡眠质量提高，并且在遗迹上 其他症状包括这些患者的疼痛（AIM 1）。 由于呼吸不稳定（由于阿片类药物），因此将研究以确定此类人的技术， 尽管CPAP，治疗 选择有限。 呼吸的不稳定将使地狱地狱SDB（AIM 2）提供博士。 成为一个独立的辅助者，研究使用SDB的影响，病原体和治疗 慢性阿片类药物。

项目成果

Effectiveness of long-term noninvasive ventilation measured by remote monitoring in neuromuscular disease.

通过远程监测测量神经肌肉疾病长期无创通气的有效性。

• DOI: 10.1183/23120541.00163-2023
• 发表时间: 2023
• 期刊: ERJ open research
• 影响因子: 4.6
• 作者: Orr,JeremyE;Chen,Kenneth;Vaida,Florin;Schmickl,ChristopherN;Laverty,ChamindraG;Ravits,John;Lesser,Daniel;Bhattacharjee,Rakesh;Malhotra,Atul;Owens,RobertL
• 通讯作者: Owens,RobertL