Determinants of Age-specific Breathing Instability During Sleep
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 92
- 试验地点
- 2
- 主要终点
- Apneic Threshold (AT) and Carbon-dioxide (CO2) Reserve
研究概览
简要总结
The purpose for this research protocol was to examine the role of breathing control mechanisms that determine the development of sleep-disordered breathing in the elderly. This proposal focused on key factors that contribute to the control of ventilation in elderly adults during sleep. The investigators studied the age-specific changes in ventilatory control in older and young adults during NREM sleep.
详细描述
Sleep apnea-hypopnea syndrome (SAS) is a relatively common disorder in the US population with significant adverse health consequences. Despite the high prevalence of SAS in elderly individuals, the underlying mechanisms have remained elusive. Specifically, the investigators do not know whether the high prevalence of sleep apnea in older adults is due to increased central breathing instability. This proposal focused on investigating age-specific differences in the susceptibility to central breathing instability in adults.
This project had the following specific objectives:
- To determine age-specific changes in the hypocapnic apneic threshold during NREM sleep in elderly vs young individuals.
- To determine age-specific changes in long-term facilitation during sleep in elderly versus young individuals.
Procedure: The investigators determined the susceptibility to central breathing instability by mechanically ventilating the subjects during NREM sleep using non-invasive pressure support ventilation. The investigators compared the hypocapnic apneic threshold in old (age>60 years) and young (age 18-50 years) individuals who were healthy. The investigators also measured the parameters over a continuum of age from 18 to 89 years.
- The investigators investigated whether there was a difference in the susceptibility to long term facilitation of ventilation between young and old healthy individuals in response to episodic hypoxia, while maintaining isocapnia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 89 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Healthy older and young adults
排除标准
- •Pregnancy,
- •history of active coronary artery disease-including stable and unstable angina,
- •recent myocardial infarction,
- •history of congestive heart failure,
- •excessive daytime sleepiness with Epworth Sleepiness Scale of >15
- •patient with OSA- (Obstructive sleep apnea) on therapy
- •depression,
- •schizophrenia,
- •untreated hypothyroidism,
- •diabetes on insulin,
- •seizure disorder,
- •intrinsic renal and liver disorders,
- •failure to give informed consent,
- •patients with evidence of pulmonary diseases based on history and abnormal pulmonary function testing, including obstructive (ratio of predicted forced expiratory volume to forced vital capacity, <80% predicted) or restrictive lung disorders (total lung capacity <80% predicted) with resting oxygen saturation of <96% and kyphoscoliosis (chest wall deformities)
- •patients on certain medications including, opiates derivatives, stimulants, antidepressants, tranquilizers, anti-psychotic agents, theophylline and other central nervous system altering medications
- •history of alcohol or recreational drug use will also serve as grounds for exclusion,
- •patients with body mass index (BMI) >34kg/m2
- •subjects with sleep apnea are already using continuous positive airway pressure for more than 7 days as therapy
结局指标
主要结局
Apneic Threshold (AT) and Carbon-dioxide (CO2) Reserve
时间窗: 4-6 wks for each participant
The AT was defined as the end-tidal (PETCO2) that demarcated the central apnea closest to the eupneic PETCO2. The CO2 reserve was defined as the difference in PETCO2 between eupnea and AT.
Long-term Facilitation (LTF) of Ventilation, Minute Ventilation Was Measured in Older Adults Only
时间窗: 4-6 wks for each participant
Episodic hypoxia (EH) leads to sustained elevation of the ventilatory motor output, referred to as LTF, an excitatory mechanism characterized by a sustained elevation in ventilatory motor output following EH. Minute ventilation during recovery period after multiple trials of EH. This is reported in older adults on this grant.
次要结局
- Hypoxic Ventilatory Response(4-6 wks for each participant)
- Brief Hyperoxia Response(4-6 wks for each participant)