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SLEEP APNEA
Coordinator
Dr. Josep M. Montserrat
Sleep apnea. new target populations
SAHS is a common condition affecting 4-6% of the adult population and 2% of infants, while over 50% of the elderly population experience more than 10 events per hour . Repetitive episodes of upper airway obstruction disrupt the sleep architecture, induce episodes of hypoxia normoxia, and activate the sympathetic system and trigger systemic inflammation and endothelial dysfunction . SAHS is typically associated with excessive daytime sleepiness, snoring, and witnessed apneas . It is considered a cardiovascular risk factor
(hypertension) as it also induces metabolic deregulation . An incremental mortality has been described .
At this point in time the whole research picture in Sleep Apneas is about to change in several very important ways . In fact, some changes have occurred . Our data and those from other groups have now provided a good – or at least basic – guide to the management of most SAHS patients . Nevertheless, new works need to be done in a number of directions . Future research must embrace new mechanisms, clinical studies and technological approaches but also studies of transference to the health system to ensure cost- effective procedures, as well as transference to companies to ensure returns on research capital . Nowadays, a return on research capital is considered an essential component of a company’s productivity and growth as well as Medicine 2 procedures are .
Furthermore, all the research to date has been performed on the adult population while other populations have been almost ignored . The major aim of our new programme is to address this imbalance by investigating even more prevalent populations of SAHS, such as those associated with age (elderly or children), obesity such as the obesity hypoventilation syndrome, as well as other forms that have only recently come to light – such as cancer-related SAHS and acute coronary disease with SAHS . All these topics could open up exciting new avenues of research .
The USA agency for Healthcare Research and Quality (AHRQ) (No . 12-EHC031-EF February 2012 published a list of recommendations with respect to future research needs . In our project we address many of these questions with some differences . The research we have undertaken coincides with the recommendations of AHRQ especially those related to future research needs for the diagnosis and treatment of Obstructive Sleep Apnea (OSA) . These recommendations reflect very closely not only our past research but also our current research in progress as well as the one proposed . This programme tries to combine basic and clinical research together with cost-effectiveness, translational, transference and technological aspects to be able to produce return on the research capital invested as well as to use Medicine2 procedures .
Key Questions need to be addressed:
1. Diagnosis
• Different diagnostic tests, subgroups of population or patients with different characteristics . • How is phased testing working in sleep apnea diagnosis? . Role of new technologies . • Long-term consequences and impact in the clinical management • Studies facing clinical and basic aspects for the better understanding and the better management . • To develop networks in order to detect better the patients (family and physicians among others) .
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