DEVELOPMENT OF CANINE MODEL FOR THE STUDY OF OBSTRUCTIVE SLEEP APNEA

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DEVELOPMENT OF CANINE MODEL FOR THE STUDY OF
OBSTRUCTIVE SLEEP APNEA

• Hamza Osto
• Liliya Goroshko
• Geeta  Venkateshwith
• Dr. Osamah Rawashdeh
• Dr. Robert Hammond

6/26/09
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Outline

• Sleep apnea basics
• Current treatments for obstructive sleep apnea
• SIBHI Project goals of Summer 2009
• Options for Detecting Sleep Stage
• Current Status
• References

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What is Sleep Apnea?

• Sleep apnea is a disorder characterized by
  a reduction or cessation (pause of breathing,
  airflow) during sleep.
• Three types of apnea
• Central sleep apnea
• Mixed sleep apnea
• Obstructive sleep apnea

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Central and Mixed sleep apnea

• Central Sleep Apnea
• Breathing starts and stops throughout night
• brain doesn't send proper signals to the muscles
  that control your breathing
• Mixed Sleep Apnea
• a transition from central to obstructive features
  during the events themselves
• Very rare

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Obstructive Sleep Apnea (OSA)

• Muscles and tissues in rear of throat collapse
• Complete/partial obstruction of airway
• 84 of people with sleep apnea have OSA

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Factors Contributing to OSA

• The occurrence of obstruction is depends
  not only to deep stage of sleep and the
  resulting relaxation, but also due to
• Obesity-Fat deposits around upper airway may
  obstruct breathing
• High blood pressure OSA is more common with
  people with high blood pressure
• Diabetes- type 2 diabetes caused by obesity,
  lack of exercise
• Men are at higher risk- Have more body mass in
  torso region, so more mass in throat region is
  found
• Over age of 40- Ability of brain signals to keep
  the throat muscles stiff during sleep gets
  limited, so the airway is more likely narrow or
  collapse
• Genetics-one may inherit a naturally narrow
  throat or small jaw structure or large tonsils or
  adenoids which can block your airway.

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OSA Side Effects

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Treatments for Obstructive Sleep Apnea

• Positional therapy
• Apneas tend to be worse when sleeping on the
  back (the supine position) as gravity makes it
  more likely for the tongue and other tissue to
  collapse and block the airway. Hence, not
  sleeping on the back may reduce the number of
  apneas.
• Avoiding alcohol and other CNS depressants
• Weight loss
• For overweight people, especially those with
  mild cases, losing weight can be an effective
  treatment.
• Continuous Positive Airway Pressure (CPAP)

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Treatments for Obstructive Sleep Apnea, contd

• Oral appliances
• Oral appliances, sometimes called dental
  appliances, are intended to treat apnea by
  keeping the airway open in one of three ways.
• Surgery
• The intention of surgery is to create a more open
  airway so obstructions are less likely to occur.

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Overall Goal

• Using a dog as a test subject, create a device
  that will mimic the effects of obstructive sleep
  apnea by occluding the airway.
• The device should contain a computer controlled
  procedure capable of closing and opening a valve
  implanted into the dogs trachea.

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Project Proposal
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Motivation For Current Work

• In 1994, Dr. Kimoff and other scientists in
  Toronto, Ontario, built a canine model for
  inducing obstructive sleep apnea.
• Shortcomings of this project
• Limited functionality
• Underfunding
• Vague conclusion
• Improvements of previous project in our current
  work
• Latest sensing devices
• Implantable sensors
• Silent electromechanically valves

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Objectives for the SIBHI 2009
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• 1. Development of a sleep-phase sensing system.
• 2. Development of the data acquisition and
  control system.
• 3. System evaluation.

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Different Sleep phases
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There are five stages of sleep phases in a sleep
cycle in human / animal. The REM sleep state is
one of the sleep stages when throat muscles
relaxes completely and occurrence of sleep apnea
is most. For laboratory purpose, OSA is induced
in REM sleep state.
There are five stages of sleep phases in a
sleep cycle in human /animal. The REM sleep
phase is the one when throat muscles relaxes
completely and occurrence of sleep apnea is
most. The OSA is induced in REM sleep phase for
laboratory purpose.
There are five stages of sleep phases in a
sleep cycle in human /animal. The REM sleep
phase is the one when throat muscles relaxes
completely and occurrence of sleep apnea is
most. The OSA is induced in REM sleep phase for
laboratory purpose.
There are five stages of sleep phases in a
sleep cycle in human /animal. The REM sleep
phase is the one when throat muscles relaxes
completely and occurrence of sleep apnea is
most. The OSA is induced in REM sleep phase for
laboratory purpose.
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Options for detecting sleep state

• oXbo alarm clock -wakes you when you're in the
  shallowest stages of sleep.
• Watch-PAT 100(peripheral arterial tone )- finger
  tip sensor that detects REM sleep state.
• Ultrasonic Oscillosensor- detects the sleep
  state by detecting even low frequency vibrations
  in sleep state.

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Options for Detecting Sleep State, contd.

• Piezo Eye Film - generate a electric signals and
  responds to changes in mechanical stress with the
  up and down movement of the eyelids in REM sleep
  stage.
• Kvasar Dream mask- has IR sensors and 940nm LEDs
  are used to look through the eyelid and pupil
  movement and changes in reflected IR is measured.

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SIBHI 2009 Idea for detecting sleep state

• REM eyeliner sleep phase detection
• When dogs reach REM sleep, their eyelids move up
  and down rapidly.
• If eyeliner is applied to the dogs eye lid, then
  an algorithm can be created which can highlight
  the movement of the eyelid. This in turn will
  notify the examiner when the dog is in REM,
  because the computer will be able to recognize
  the pattern of the eyelid.

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Trachea Airflow Control

• Developed hardware using an actuator controlled
  by the Dragon12 microcontroller. The canines
  implanted trachea will be attached to the linear
  actuator.
• When a command is sent through user interfacing,
  the linear actuator pinches the tracheal tube.
• Controlling the motor by potentiometer

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Next Steps

• Algorithm to control the airflow by the actuator
• User interface
• Choosing wireless transceivers
• Develop REM Eyeliner algorithm

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References

• http//www.cfs-recovery.org/sleep_apnea.htm
• http//www.sleepapnea.org/info/index.html
• http//www.sleepapnea.org/
• http//www.nhlbi.nih.gov/health/dci/Diseases/Sleep
  Apnea/
• SleepApnea_WhatIs.html
• http//www.sleepdisorderchannel.com/osa/index.shtm
  l
• http//www.axbo.com/axbo/CMS/CMS.aspx?LanguageE
• http//www.pubmedcentral.nih.gov/articlerender.fcg
  i?artid2276832

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Cohort of 2009