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Motor Plasticity, Intermittent Hypoxia and Sleep Apnea

2019-07-18 10:31:18 | BioPortfolio

Summary

The purpose of this study is to learn about the effect of sleep apnea and low oxygen on muscle strength and lung function in people with chronic spinal cord injury.

Description

The overall goal of this pilot project is to determine the effect of obstructive sleep apnea (OSA) and its associated chronic intermittent hypoxia (CIH) on neuroplasticity, and respiratory, and motor functions in subjects with chronic spinal cord injury (SCI), exposed to acute intermittent hypoxia (AIH). We will further explore changes in the biomarkers of AIH in the setting of OSA and SCI.

Specific Aim 1: Determine whether there is a baseline difference in pulmonary and motor function in subjects with chronic SCI with and without OSA.

Hypothesis 1: We hypothesize that subjects with moderate to severe OSA and chronic SCI will have worse pulmonary function (measured by forced vital capacity [FVC], and maximum inspiratory pressure [MIP]), and hand grip strength (measured by force and EMG activation of hand muscles) compared with SCI subjects without OSA.

Specific Aim 2: Determine whether moderate to severe OSA, attenuates the respiratory and motor response to AIH in chronic SCI.

Hypothesis 2: We hypothesize that subjects with moderate to severe OSA and chronic SCI will have no change in baseline pulmonary function, and hand grip strength, when exposed to a 3-day AIH protocol. By contrast, SCI subjects without OSA will show an improvement in all measured outcomes.

Specific Aim 3: Determine whether there is a difference in levels of AIH biomarkers including BDNF and VEGF in subjects with chronic SCI with and without OSA.

Hypothesis 3: We hypothesize that compared with subjects without OSA, those with moderate to severe OSA and chronic SCI will have lower BDNF, and higher VEGF at baseline with no change in these biomarker levels when exposed to a 3-day AIH protocol. By contrast, SCI subjects without OSA will show an increase in baseline VEGF and BDNF levels when exposed to the AIH protocol.

Study Design

Conditions

Sleep Apnea, Obstructive

Intervention

Induced Acute Intermittent Hypoxia (AIH), AIH mask

Location

University of Miami
Miami
Florida
United States
33136

Status

Not yet recruiting

Source

University of Miami

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-07-18T10:31:18-0400

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Medical and Biotech [MESH] Definitions

A condition associated with multiple episodes of sleep apnea which are distinguished from obstructive sleep apnea (SLEEP APNEA, OBSTRUCTIVE) by the complete cessation of efforts to breathe. This disorder is associated with dysfunction of central nervous system centers that regulate respiration. This condition may be idiopathic (primary) or associated with lower brain stem lesions; chronic obstructive pulmonary disease (LUNG DISEASES, OBSTRUCTIVE); HEART FAILURE, CONGESTIVE; medication effect; and other conditions. Sleep maintenance is impaired, resulting in daytime hypersomnolence. Primary central sleep apnea is frequently associated with obstructive sleep apnea. When both forms are present the condition is referred to as mixed sleep apnea (see SLEEP APNEA SYNDROMES). (Adams et al., Principles of Neurology, 6th ed, p395; Neurol Clin 1996;14(3):611-28)

Disorders characterized by multiple cessations of respirations during sleep that induce partial arousals and interfere with the maintenance of sleep. Sleep apnea syndromes are divided into central (see SLEEP APNEA, CENTRAL), obstructive (see SLEEP APNEA, OBSTRUCTIVE), and mixed central-obstructive types.

HYPOVENTILATION syndrome in very obese persons with excessive ADIPOSE TISSUE around the ABDOMEN and DIAPHRAGM. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic HYPOXIA; HYPERCAPNIA; POLYCYTHEMIA; and long periods of sleep during day and night (HYPERSOMNOLENCE). It is a condition often related to OBSTRUCTIVE SLEEP APNEA but can occur separately.

A disorder characterized by recurrent apneas during sleep despite persistent respiratory efforts. It is due to upper airway obstruction. The respiratory pauses may induce HYPERCAPNIA or HYPOXIA. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur. Frequent partial arousals occur throughout sleep, resulting in relative SLEEP DEPRIVATION and daytime tiredness. Associated conditions include OBESITY; ACROMEGALY; MYXEDEMA; micrognathia; MYOTONIC DYSTROPHY; adenotonsilar dystrophy; and NEUROMUSCULAR DISEASES. (From Adams et al., Principles of Neurology, 6th ed, p395)

Dyssomnias (i.e., insomnias or hypersomnias) associated with dysfunction of internal sleep mechanisms or secondary to a sleep-related medical disorder (e.g., sleep apnea, post-traumatic sleep disorders, etc.). (From Thorpy, Sleep Disorders Medicine, 1994, p187)

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