Mechanisms of Pharyngeal Collapse in Sleep Apnea, Study D
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Purpose
In obstructive sleep apnea (OSA), the upper airway recurrently closes during sleep. The mechanisms that lead to airway closure are not completely understood. Some studies have shown that there is progressive narrowing of the pharyngeal airway across breaths during expiration (Progressive Expiratory Narrowing, PEN) preceding an obstructive apnea. The investigators will assess the viscoelastic properties of the pharyngeal airway and its role in PEN.
| Condition | Intervention |
|---|---|
|
Sleep Apnea |
Other: Induced central apneas |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label |
| Official Title: | Mechanisms of Pharyngeal Collapse in Sleep Apnea, Study D |
- Upper airway elasticity [ Time Frame: 10 - 40 seconds ] [ Designated as safety issue: No ]
The investigators will determine elasticity of the upper airway during induced central apneas by dividing the change in airway pressure by the change in airway cross-sectional area.
The time frame for the outcome of this study is equal to the duration of the induced central sleep apnea (usually less than 40 seconds).
| Estimated Enrollment: | 40 |
| Study Start Date: | December 2012 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Viscoelastic properties of the airway | Other: Induced central apneas |
Detailed Description:
In obstructive sleep apnea, the upper airway recurrently closes during sleep. The mechanisms that lead to airway closure are not completely understood. Some studies have shown that there is progressive narrowing of the pharyngeal airway across breaths during expiration (Progressive Expiratory Narrowing, PEN) preceding an obstructive apnea.
The investigators will test how the viscoelastic properties of the airway influence PEN. To this end, the investigators will visualize the pharynx of sleep apnea patients using a thin endoscope and will induce central apneas during sleep. Pharyngeal cross-sectional area will be recorded during incremental changes in pharyngeal pressure during central apneas.
Eligibility| Ages Eligible for Study: | 21 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
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 hydrochloride
- For women: Pregnancy
Contacts and Locations| Contact: Pedro R Genta, MD | (617) 732-6541 | pgenta@partners.org |
| Contact: Lauren B Hess, BS | (617) 732-8976 | lhess1@partners.org |
| United States, Massachusetts | |
| Brigham and Women's Hospital | Recruiting |
| Boston, Massachusetts, United States, 02115 | |
| Contact: Pedro R Genta, MD 617-732-6541 pgenta@partners.org | |
| Contact: Lauren B Hess, BS (617) 732-8976 lhess1@partners.org | |
| Sub-Investigator: Pedro R Genta, MD | |
| Principal Investigator: | David A Wellman, MD | Brigham and Women's Hospital |
More Information
No publications provided
| Responsible Party: | David Andrew Wellman, Principal Investigator, Brigham and Women's Hospital |
| ClinicalTrials.gov Identifier: | NCT01733784 History of Changes |
| Other Study ID Numbers: | 2012P000957D, 1R01HL102321-01A1 |
| Study First Received: | November 14, 2012 |
| Last Updated: | December 10, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Brigham and Women's Hospital:
|
Sleep Apnea Pathophysiology |
Additional relevant MeSH terms:
|
Apnea Sleep Apnea Syndromes Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory |
Signs and Symptoms Sleep Disorders, Intrinsic Dyssomnias Sleep Disorders Nervous System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013