Active clinical trials for "Sleep Apnea Syndromes"

To determine whether, in obese children with moderate-severe Obstructive Sleep Apnea who are prescribed Positive Airway Pressure(PAP) therapy, increased hours of PAP usage per night over a one-year period is associated with a greater improvement in HOMA-IR

Objective: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a common sleep disorder requiring the time and money consuming full polysomnography to be diagnosed. Alternative methods for initial evaluation are sought. The investigators aim was the prediction of Apnea-Hypopnea Index (AHI) in patients suspected to suffer from OSAHS using two models based on nonlinear analysis of three biosignals during sleep. Methods: One hundred patients referred to a Sleep Unit underwent full polysomnography. Three nonlinear indices (Largest Lyapunov Exponent, Detrended Fluctuation Analysis and Approximate Entropy) were extracted from three biosignals (airflow from a nasal cannula, thoracic movement and Oxygen saturation) providing input to a data mining application for the creation of predictive models for AHI.

The objective of this protocol is the evaluation of our clinical screening program for sleep disorders in patients with heart failure. These patients have very high prevalence of Sleep Disordered Breathing (SDB), including central and obstructive sleep apnea. There is also strong evidence that SDB, if unrecognized and untreated, will worsen heart failure and may leads to serious complications. Effective treatment of SDB results in improvement in heart failure and functional status. So far there are no guidelines in the area of screening in this patient population. The only test that would reliably rule out or confirm SDB is the polysomnography (PSG) this test is expensive and technically demanding. With the current approach to diagnosis and treatment of SDB, it routinely takes up to 5-6 months between the emergence of clinical suspicion of SDB and the initiation of appropriate treatment with CPAP. This delay and cost of this traditional approach, is a significant obstacle to providing highly needed care to this very vulnerable population. In OSU we have a state of the art Heart Failure Program and a Sleep Heart program that was created to develop an approach to prompt diagnosis and treatment of SDB in our heart failure patients. We designed an algorithm that employs validated questionnaires and FDA approved devices. We need, however to validate our algorithm against the gold standard: the PSG. Furthermore, we need to analyze the prevalence and risk factors of each sleep disorder in light of the recent changes in the management of heart failure, which may have influenced the risk factors and prevalence as we knew them. This protocol includes a combination of clinically indicated procedures, and others that are repeated for validation purposes. The accumulation and analysis of data is also done for research purposes.

The purpose of the study is to: recruit subjects with untreated sleep apnea; assess overnight changes in their blood and urine chemicals review the overnight changes in blood and urine chemicals after they have been treated for sleep apnea assess the overnight changes in blood and urine chemicals in healthy individuals with no sleep problems compare the amount of fat in the belly using a Magnetic Resonance Imaging (MRI) scanner on all subjects

Oral appliances, which can maintain patients' jaw forwards during sleep, become more popular in treating obstructive sleep apnea (OSA). However, the exact mechanism of mandible forward on upper airway is not completely known. In this study we will use both static and dynamic MRI to study the 3D morphological changes and dynamic behavior of the upper respiratory tract at different mandible posits. Because in asian society non-obese OSA patients are not uncommonly seen, in this study we focus only on non-obese severe OSA patients.

The aim of this study was to analyze the effectiveness of the Epworth's sleepiness scale as a recourse aid in the diagnosis of the syndrome of obstructive sleep apnea. 475 patients attended this study, that sought the CESF to probable diagnosis of some sleep disorder. The data were collected from records, wich are of questionnaires, including the ESE, prepared by the CESF professionals and responded, previously, by the own patients. The study compared the result obtained in the scale of Epworth with the data of polysomnography. The analysis of data was performed using the SPSS, based on descriptive and inferential statistics, being used the average considering the standard deviation, and, to the crossing of variables, was used the chi-square test of Pearson, considering as significant statistically values of p<0.05. The results showed that gender, age and BMI are predisposing factors to SOSA.

Impact of air pollution on the autonomic nervous system activity and presence of sleep apnea in older subjects.

It is known that a significant proportion of patients with heart failure have sleep disordered breathing (SDB). Some of these patients will have Central Sleep Apnoea which is one form of SDB. The SERVE-HF study aims to look at the effect of a breathing support machine, or ventilator called Adaptive Servo-ventilation (ASV) on mortality in heart failure patients with central sleep apnoea. In this related sub-study the investigators want to look at how the ASV machine has its effect. The investigators will be carrying out tests in the laboratory to measure various aspects of the way that breathing is controlled to measure the effect that ASV has on patients. In addition measurements looking at activity levels will be made using an actiwatch device worn by patients for 14 consecutive days and nights. Healthy controls will be recruited to all parts of this protocol (ie measurements at baseline and 3 months) to allow comparison of data between patients and controls.

Specific Aim To verify the differentially expressed genes and pathways between normal and OSA patients, and OSA patients before and after CPAP treatment. Genes with changes in expression of more than two-fold between normal and OSA patients as well as OSA patients before and after CPAP treatment were thought as confirmed and were selected for further validation study. To correlate the confirmed genes with the clinical presentations and CPAP effects in another 50 OSAS subjects to validate the altered gene expressions and pathways involved. To investigate the correlation of genes confirmed from RT-PCR (identified gene), another 50 OSAS subjects are included in the study. We analyze the correlation between identified gene and the clinical manifestations and CPAP effect in these 50 OSAS patients. To establish a cell model to investigate the differentially expressed genes and the putative biological pathways involved in OSA syndrome. To investigate the functions of genes identified in the first and second year (gene of interest), we establish a cell model with human monocyte cell line U937. We investigate the function of gene of interest through overexpress or knockdown. Objectives The objectives of this project are to confirm the gene profiled from comparing normal and OSA patients as well as OSA patients before and after CPAP treatment, to investigate the correlation between altered gene expression and clinical presentations and CPAP effects of the OSAS and to identify and confirm corresponding pathway. This study will enhance our understanding of the individual constitution on widely different clinical characteristics and therapeutic variations. All these efforts will also help us to interpret its molecular mechanisms and develop prediction and diagnosis strategies of OSAS. The long-term objectives are to develop therapeutic strategy other than CPAP of OSAS.

To determine if there are anatomic and physical characteristics that distinguish pre-adolescent children with sleep disordered breathing and if the sleep disordered breathing is associated with adverse effects on school and neurocognitive performance.