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AISH Physiology Research Group

respiratory/sleep pathophysiology, sleep apnoea, treatments, sensory processes, respiratory reflexes...

AISH Physiology Research Group Staff 2017

Research Summary

The AISH (Adelaide Institute for Sleep Health) Physiology Research Group works directly alongside clinical researchers in the Sleep Health Service, Southern Adelaide Local Health Network, on clinical translational research projects designed to improve outcomes for a range of sleep problems; such as obstructive sleep apnoea (repeated obstructive breathing events in sleep), insomnia, sleep hypoventilation in patients with respiratory muscle weakness and environmental noise disturbances to sleep.

AISH is one of the leading clinical sleep research laboratories in Australia with major research interests in respiratory physiology, respiratory sensory and reflex mechanisms, neurocognitive performance, insomnia and noise impacts on sleep. Through collaborations with clinicians, engineers, psychologists, the Cooperative Research Centre (CRC) for Alertness, Safety and Productivity (www.alertnesscrc.com), and other initiatives, AISH research is focussed on understanding mechanisms underlying sleep and respiratory problems, and developing new methods to improve outcomes for patients through better personalised treatments tailored to individual variability in underlying sleep problem causes and consequences..

 

Research Projects

Breathing becomes much more stable in deep sleep, even in most patients with severe obstructive sleep apnoea (OSA). However, the mechanisms underlying this effect are unknown. Current and ongoing projects are designed to investigate factors that may help explain this effect; such as changes in breathing effort and upper airway muscle control changes, and changes in arousal propensity and breathing responses to arousal across sleep. A better understanding of these mechanisms could help with the design of new treatments to help stabilise upper airway function and breathing in OSA.

The expansion of wind farm facilities in Australia has been associated with widespread community complaints regarding noise, sleep disturbance and adverse health effects. This 5-year collaborative study is testing how much windfarm noise disturbs sleep compared to traffic noise, a better understood noise known to disturb sleep according to noise levels.

Obstructive sleep apnoea (OSA) and snoring are typically worse in the supine versus non-supine sleep postures and a significant group of patients could theoretically be effectively treated by simply avoiding back sleeping. Classic supine-discomfort (e.g. tennis-ball) treatments can be effective, but most patients abandon treatment due to the inherent discomfort of this approach. An ongoing collaborative study is trialling if a simple non-discomfort approach compared to current best-practice treatment is clinically effective and acceptable for the clinical management of this patient group.

Insomnia and OSA occur together much more than expected for 2 separate conditions overlapping purely by chance. OSA could worsen insomnia by making the transition into established sleep more difficult than normal, and insomnia could worsen OSA by promoting more light sleep where OSA events occur most frequently. In addition, patients with insomnia and OSA may find normal treatments more difficult to tolerate than most OSA patients. Flinders University and AISH are investigating potential links between OSA and insomnia and methods for improving treatments.

The Adelaide Institute for Sleep Health and Flinders University are an integral part of a national Federal Government funded CRC for Alertness, Safety and Productivity. The CRC aims to develop a range of innovative strategies to reduce fatigue and sleepiness and related injuries, enhance workplace performance and improve sleep related health and quality of life. The CRC includes an extensive education and training program to support PhD students and postdoctoral research fellows involved in the seven-year CRC program.
AISH in involved in 4 main themes of the CRC research program;
> Improving personalised sleep medicine through ‘phenotyping’ and targeting treatments to underlying causes of abnormal breathing in sleep.
> Identifying biomarkers of sleepiness and performance deficits to help reduce accident and adverse health outcome risks.
> Developing new technologies to assess alertness impairment.
> Individualising sleep and alertness management in safety critical occupations.

This multi-centre, randomized controlled trial of airway surgery for moderate-severe symptomatic Obstructive Sleep Apnoea will establish, for the first time, whether or not upper airway surgery is clinically effective, safe and cost effective for those who have failed medical management.

Respiratory muscle weakness occurs commonly in patients with Motor Neurone Disease, and can develop at any stage of the disease. This weakness may result in shortness of breath, difficulty lying flat, unrefreshing sleep, morning headache, impaired quality of life and sleepiness.
This longitudinal observational study aims to better understand the nature of abnormal breathing patterns in MND patients towards better tailored treatments to improve patients’ breathing, sleep and quality of life.

Selected Publications

Van Ryswyk E, Weeks R, Bandick L, O'Keefe M, Vakulin A, Catcheside P, Barger L, Potter A, Poulos N, Wallace J, Antic NA (2017) A novel sleep optimisation programme to improve athletes' well-being and performance. European Journal of Sport Science, 17(2):144-151

 

Sweetman AM, Lack LC, Catcheside PG, Antic NA, Chai-Coetzer CL, Smith SS, Douglas JA, McEvoy RD (2017) Developing a successful treatment for co-morbid insomnia and sleep apnoea. Sleep Medicine Reviews, 33:28-38, Review.

 

Adams RJ, Appleton SL, Vakulin A, Lang C, Martin SA, Taylor AW, McEvoy RD, Antic NA, Catcheside PG, Wittert GA (2016) Association of daytime sleepiness with obstructive sleep apnoea and comorbidities varies by sleepiness definition in a population cohort of men. Respirology, 21(7):1314-21

 

Ng JR, Aiyappan V, Mercer J, Catcheside PG, Chai-Coetzer CL, McEvoy RD, Antic N (2016) Choosing an Oronasal Mask to Deliver Continuous Positive Airway Pressure May Cause More Upper Airway Obstruction or Lead to Higher Continuous Positive Airway Pressure Requirements than a Nasal Mask in Some Patients: A Case Series. Journal of Clinical Sleep Medicine, 12(9):1227-32

 

Appleton SL, Vakulin A, Martin SA, Lang CJ, Wittert GA, Taylor AW, McEvoy RD, Antic NA, Catcheside PG, Adams RJ (2016) Hypertension Is Associated With Undiagnosed OSA During Rapid Eye Movement Sleep. Chest, 150(3):495-505

 

Appleton SL, Vakulin A, Wittert GA, Martin SA, Grant JF, Taylor AW, McEvoy RD, Antic NA, Catcheside PG, Adams RJ (2016) The association of obstructive sleep apnea (OSA) and nocturnal hypoxemia with the development of abnormal HbA1c in a population cohort of men without diabetes. Diabetes Research and Clinical Practice, 114:151-9

 

Martin SA, Appleton SL, Adams RJ, Taylor AW, Catcheside PG, Vakulin A, McEvoy RD, Antic NA, Wittert GA (2016) Nocturia, Other Lower Urinary Tract Symptoms and Sleep Dysfunction in a Community-Dwelling Cohort of Men. Urology, 97:219-226

 

Vakulin A, Dorrian J, Duggan TR, Litchfield CA, Cobb KJ, Antic NA, McEvoy RD, Baulk SD, Catcheside PG (2016) Behavioural Observation as a Means of Assessing Sleepiness Related Driving Impairment in Obstructive Sleep Apnea. Eat, Sleep, Work, 1(1):11-22

 

Jordan AS, Cori JM, Dawson A, Nicholas CL, O'Donoghue FJ, Catcheside PG, Eckert DJ, McEvoy RD, Trinder JA (2015) Arousal does not lead to reduced dilator muscle activity or elevated upper airway resistance on return to sleep in healthy individuals. Sleep, 38(1):53-9

 

Appleton SL, Vakulin A, McEvoy RD, Wittert GA, Martin SA, Grant JF, Taylor AW, Antic NA, Catcheside PG, Adams RJ (2015) Nocturnal Hypoxemia and Severe OSA are Associated with Incident Type 2 Diabetes in a Population Cohort of Men. Journal of Clinical Sleep Medicine, 11(6):609-14

 

Appleton SL, Vakulin A, McEvoy RD, Vincent A, Martin S, Grant JF, Taylor AW, Antic NA, Catcheside PG, Wittert GA, Adams RJ (2015) Undiagnosed obstructive sleep apnea is independently associated with reductions in quality of life in middle-aged, but not elderly men of a population cohort. Sleep and Breathing, 19(4):1309-16

 

Deacon NL, Catcheside PG (2015) The role of high loop gain induced by intermittent hypoxia in the pathophysiology of obstructive sleep apnoea. Sleep Medicine Reviews, 22:3-14

 

Catcheside P, Mohtar A and Reynolds K (2014) Airflow resistance and CO2 rebreathing properties of anti-asphyxia pillows designed for epilepsy. European Journal of Epilepsy, 23(6):462-467

 

Kezirian EJ, Goding JR GS, Malhotra A, O'Donoghue FJ , Zammit G, Wheatley JR, Catcheside PG, Smith PL, Schwartz AR, Walsh JH, Maddison KJ, Claman DM, Huntley T, Park SY, Campbell MC, Palme CE, Iber C, Eastwood PR, Hillman DR, Barnes M (2014) Hypoglossal nerve stimulation improves obstructive sleep apnoea: 12-month outcomes. Journal of Sleep Research, 23(1):77-83

 

Vakulin A, Catcheside PG, Baulk SD, Antic NA, Banks S, Dorrian J, McEvoy RD (2014) Individual Variability and Predictors of Driving Simulator Impairment in Patients with Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine, 10(6):647-655

 

Rose AR, Catcheside PG, McEvoy RD, Paul D, Kapur D, Peak E, Vakulin A, Antic NA (2014) Sleep disordered breathing and chronic respiratory failure in patients with chronic pain on long term opioid therapy. Journal of Clinical Sleep Medicine, 10(8):847-852

 

Chai-Coetzer CL, Antic NA, Rowland LS, Reed RL, Esterman A, Catcheside PG, Eckermann S, Vowles N, Williams H, Dunn S, McEvoy RD (2013) Effect of primary care versus specialist sleep center management of obstructive sleep apnea on daytime sleepiness and quality of life: A randomised trial. Journal of the American Medical Association (JAMA), 309:997-1004

 

Opie GM, Catcheside PG, Usmani ZA, Ridding MC, Semmler JG (2013) Motor cortex plasticity induced by theta burst stimulation is impaired in patients with obstructive sleep apnoea. European Journal of Neuroscience, 37:1844:1852

 

Catcheside PG (2010) Predictors of continuous positive airway pressure adherence. F1000 Medicine Reports, 2:70; http://f1000.com/reports/medicine/content/2/70

 


Investigators

  • Peter Catcheside, BSc (Hons), PhD

    Doug McEvoy, BMedSc, MBBS, FRACP, MD

    Nick Antic, MBBS, FRACP, PhD

    Vinod Aiyappan, MBBS, MD, MRCP (UK), FRACP

    Andrew Vakulin, BSc (Hons), PhD

    Nicole Lovato, BPsyc (Hons), PhD

    David Stevens, BAppSc, PhD

    Gorica Micic, BBehavSci (Hons), PhD

    Branko Zajamsek, BEng, PhD

Support Staff

  • Trish Sechser, Research Administrative Officer

    Leanne Cox, Executive Assistant

    Dr Alison Pinczel, PhD, Research Assistant

    Amanda O'Grady, Research Assistant

    Melanie Heath, Research Assistant

Students

  • Laura Gell, PhD Student

  • Isabella Ellison, Honours Student


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