Mechanisms of Pharyngeal Collapse in Sleep Apnea, Study A
| Status: | Completed |
|---|---|
| Conditions: | Insomnia Sleep Studies, Pulmonary |
| Therapuetic Areas: | Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 21 - 65 |
| Updated: | 4/2/2016 |
| Start Date: | December 2012 |
| End Date: | December 2014 |
| Contact: | Pedro R Genta, MD |
| Email: | pgenta@partners.org |
| Phone: | (617) 732-6541 |
Mechanisms of Pharyngeal Collapse in Sleep Apnea
In obstructive sleep apnea, the upper airway recurrently closes during sleep. The mechanisms
that lead to airway closure are not completely understood. While the airway of some people
narrows and airflow decreases during inspiration due to increasing inspiratory effort,
others maintain constant airflow throughout inspiration. Airway neuromuscular reflexes may
protect against airway narrowing that occurs due to increasing inspiratory effort. To test
this hypothesis, the investigators will initially measure airway neuromuscular reflex and
inspiratory flow and then attenuate neuromuscular reflex through topical pharyngeal
anesthesia to observe the effects on inspiratory flow.
that lead to airway closure are not completely understood. While the airway of some people
narrows and airflow decreases during inspiration due to increasing inspiratory effort,
others maintain constant airflow throughout inspiration. Airway neuromuscular reflexes may
protect against airway narrowing that occurs due to increasing inspiratory effort. To test
this hypothesis, the investigators will initially measure airway neuromuscular reflex and
inspiratory flow and then attenuate neuromuscular reflex through topical pharyngeal
anesthesia to observe the effects on inspiratory flow.
The mechanisms that lead to airway closure are not completely understood. While the airway
of some people narrows and airflow decreases during inspiration due to increasing
inspiratory effort, others maintain constant airflow throughout inspiration (negative effort
dependence, NED). The investigators hypothesize that upper airway neuromuscular reflexes may
protect against narrowing that occurs due to increasing inspiratory effort. Topical
oropharyngeal anesthesia has been shown to reduce neuromuscular reflexes. Thus, the
investigators also hypothesize that patients with stable inspiratory flow will develop NED
once the reflexes have been impaired with topical anesthetic. The investigators plan to:
1. measure upper airway muscle EMG to assess how it corresponds to the presence or absence
of NED. This aim will allow us to test the hypothesis that robust upper airway muscle
reflexes can protect against NED.
2. reduce upper airway muscle activity and reflexes by topical oropharyngeal anesthesia.
This will allow us to test the hypothesis that attenuated upper airway muscle activity
induced by topical anesthesia can induce NED.
of some people narrows and airflow decreases during inspiration due to increasing
inspiratory effort, others maintain constant airflow throughout inspiration (negative effort
dependence, NED). The investigators hypothesize that upper airway neuromuscular reflexes may
protect against narrowing that occurs due to increasing inspiratory effort. Topical
oropharyngeal anesthesia has been shown to reduce neuromuscular reflexes. Thus, the
investigators also hypothesize that patients with stable inspiratory flow will develop NED
once the reflexes have been impaired with topical anesthetic. The investigators plan to:
1. measure upper airway muscle EMG to assess how it corresponds to the presence or absence
of NED. This aim will allow us to test the hypothesis that robust upper airway muscle
reflexes can protect against NED.
2. reduce upper airway muscle activity and reflexes by topical oropharyngeal anesthesia.
This will allow us to test the hypothesis that attenuated upper airway muscle activity
induced by topical anesthesia can induce NED.
Inclusion Criteria:
- Normal subjects or patients with OSA
Exclusion Criteria:
- Any unstable cardiac condition (other than well controlled hypertension) or pulmonary
problems.
- Any medication known to influence breathing, sleep/arousal or muscle physiology
- Concurrent sleep disorders (insomnia, narcolepsy, central sleep apnea or parasomnia)
- Claustrophobia
- Inability to sleep supine
- Allergy to lidocaine or oxymetazoline HCl
- For women: Pregnancy
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