Sleep apnoea and respiratory physiology - FHMRI Sleep Health

Our transdisciplinary sleep and respiratory physiology research, including clinical trials, aims to better understand obstructive sleep apnoea (OSA) and respiratory disorders, identify novel therapeutic targets, and develop new personalised therapies that are better targeted to underlying mechanisms.

We partner with clinicians within the Southern Adelaide Local Health Network (SALHN), primarily at the Flinders Medical Centre. Our leading research includes multimillion-dollar National Health and Medical Research Council (NHMRC) funded projects.

OUR RESEARCH

Our work has made a significant contribution to advancing the understanding of the underlying physiological mechanisms that contribute to sleep related breathing disorders such as obstructive sleep apnea and is helping to refocus the therapeutic agenda for chronic sleep health conditions. This includes developing and testing a range of new therapies including both devices related to OSA and novel pharmacotherapies.

This research is also aligned with our sleep health treatment clinic.

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^{Pictured: Emeritus Professor Doug McEvoy AM, immediate past Director of Adelaide Institute for Sleep Health (now FHMRI Sleep Health) was made a Member of the Order of Australia for his outstanding contributions to sleep and respiratory research and sleep medicine. His vision and stewardship has seen FHMRI Sleep Health become one of the world’s leading sleep research centres.}

Current research projects include:

Development of new pharmacotherapies for sleep apnoea Clinical trials involving pharmacotherapies related to OSA. Currently there are no approved pharmacotherapies to treat OSA. We are leading multiple multi-centre drug studies and phase one trials aimed at reducing OSA severity and about to commence a worldwide trial aimed at reducing body weight in obese people with OSA.
Investigation of the physiological mechanisms of OSA and disordered breathing in lung diseases. The respiratory muscles are activated over 20,000 times a day for breathing and we are developing new methods to assess inefficient breathing in lung disease.
New developments in physiological signal analysis and algorithm design.
Development and testing of alternative devices to improve the range of OSA treatments such as the mandibular advancement splint.
Upper airway reconstructive surgery and post operative care and follow up for OSA.
Improving treatments in co-morbid conditions such as chronic inflammatory lung disease (COPD), Multiple sclerosis (MS) and in atrial fibrillation (AF).

^{Pictured: FHMRI Sleep Health – Nick Antic Sleep Laboratory physiology research bedroom (courtesy of Cheeseman Architects)}

Read Annual Sleep Health Report

Featured publications

A novel model to estimate key obstructive sleep apnea endotypes from standard polysomnography and clinical data and their contribution to obstructive sleep apnea severity Dutta, R., Delaney, G., Toson, B., Jordan, A. S., White, D. P., Wellman, A. & Eckert, D. J., Apr 2021, In: Annals of the American Thoracic Society. 18, 4, p. 656-667 12 p.

Addition of zolpidem to combination therapy with atomoxetine-oxybutynin increases sleep efficiency and the respiratory arousal threshold in obstructive sleep apnoea: A randomized trial Messineo, L., Carter, S. G., Taranto-Montemurro, L., Chiang, A., Vakulin, A., Adams, R. J., Carberry, J. C. & Eckert, D. J., Sep 2021, In: Respirology. 26, 9, p. 878-886 9 p.

All-Cause Mortality in People with Co-Occurring Insomnia Symptoms and Sleep Apnea: Analysis of the Wisconsin Sleep Cohort Lechat, B., Loffler, K. A., Wallace, D. M., Reynolds, A., Appleton, S. L., Scott, H., Vakulin, A., Lovato, N., Adams, R., Eckert, D. J., Catcheside, P. G. & Sweetman, A., 13 Oct 2022, In: Nature and Science of Sleep. 14, p. 1817-1828 12 p.

Cognitive behavioural therapy for insomnia reduces sleep apnoea severity: a randomised controlled trial Sweetman, A., Lack, L., McEvoy, R. D., Antic, N. A., Smith, S., Chai-Coetzer, C. L., Douglas, J., O'Grady, A., Dunn, N., Robinson, J., Paul, D., Eckert, D. & Catcheside, P. G., Apr 2020, In: ERJ Open Research. 6, 2, p. 1-9 9 p., 00161-2020.

Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease Loffler, K. A., Heeley, E., Freed, R., Meng, R., Bittencourt, L. R., Gonzaga Carvalho, C. C., Chen, R., Hlavac, M., Liu, Z., Lorenzi-Filho, G., Luo, Y., McArdle, N., Mukherjee, S., Yap, H. S., Zhang, X., Palmer, L. J., Anderson, C. S., McEvoy, R. D., Drager, L. F. & SAVE Substudy Investigators, Aug 2020, In: Diabetes care. 43, 8, p. 1859-1867 9 p.

Comorbid insomnia and sleep apnoea is associated with all-cause mortality Lechat, B., Appleton, S., Melaku, Y. A., Hansen, K., McEvoy, R. D., Adams, R., Catcheside, P., Lack, L., Eckert, D. J. & Sweetman, A., 1 Jul 2022, In: European Respiratory Journal. 60, 1, 11 p., 2101958.

Composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular mortality in older community-dwelling men Baumert, M., Immanuel, S. A., Stone, K. L., Harrison, S. L., Redline, S., Mariani, S., Sanders, P., Doug McEvoy, R. & Linz, D., 21 Jan 2020, In: European Heart Journal. 41, 4, p. 533-541 9 p., ehy838.

Dose-dependent effects of mandibular advancement on upper airway collapsibility and muscle function in obstructive sleep apnea Bamagoos, A. A., Cistulli, P., Sutherland, K., Ngiam, J., Burke, P. GR., Bilston, L. E., Butler, J. E. & Eckert, D. J., 1 Jun 2019, In: Sleep. 42, 6, 10 p., zsz049.

Effect of multilevel upper airway surgery vs medical management on the apnea-hypopnea index and patient-reported daytime sleepiness among patients with moderate or severe obstructive sleep apnea: The SAMS randomized clinical trial MacKay, S., Carney, A. S., Catcheside, P. G., Chai-Coetzer, C. L., Chia, M., Cistulli, P. A., Hodge, J. C., Jones, A., Kaambwa, B., Lewis, R., Ooi, E. H., Pinczel, A. J., McArdle, N., Rees, G., Singh, B., Stow, N., Weaver, E. M., Woodman, R. J., Woods, C. M., Yeo, A., & 1 others, 4 Sep 2020, In: JAMA - Journal of the American Medical Association. 324, 12, p. 1168-1179 12 p.

Effect of obstructive sleep apnoea and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome (ISAACC study): a randomised controlled trial Spanish Sleep Network, Apr 2020, In: The Lancet Respiratory Medicine. 8, 4, p. 359-367 9 p.

ERS statement on respiratory muscle testing at rest and during exercise Laveneziana, P., Albuquerque, A., Aliverti, A., Babb, T., Barreiro, E., Dres, M., Dubé, B. P., Fauroux, B., Gea, J., Guenette, J. A., Hudson, A. L., Kabitz, H. J., Laghi, F., Langer, D., Luo, Y. M., Neder, J. A., O'Donnell, D., Polkey, M. I., Rabinovich, R. A., Rossi, A., & 5 others, 1 Jun 2019, In: European Respiratory Journal. 53, 6, 34 p., 1801214.

Multinight Prevalence, Variability, and Diagnostic Misclassification of Obstructive Sleep Apnea Lechat, B., Naik, G., Reynolds, A., Aishah, A., Scott, H., Loffler, K. A., Vakulin, A., Escourrou, P., McEvoy, R. D., Adams, R. J., Catcheside, P. G. & Eckert, D. J., 1 Mar 2022, In: American Journal of Respiratory and Critical Care Medicine. 205, 5, p. 563-569 7 p

New and Emerging Approaches to Better Define Sleep Disruption and Its Consequences Lechat, B., Scott, H., Naik, G., Hansen, K., Nguyen, D. P., Vakulin, A., Catcheside, P. & Eckert, D. J., 7 Oct 2021, In: Frontiers in Neuroscience. 15, 17 p., 751730.

Novel avenues to approach non-CPAP therapy and implement comprehensive obstructive sleep apnoea care Pépin, J. L., Eastwood, P. & Eckert, D. J., Jun 2022, In: The European Respiratory Journal. 59, 6, 22 p., 2101788.

Polysomnographic endotyping to select patients with obstructive sleep apnea for oral appliances Bamagoos, A. A., Cistulli, P. A., Sutherland, K., Madronio, M., Eckert, D. J., Hess, L., Edwards, B. A., Wellman, A. & Sands, S. A., 1 Nov 2019, In: Annals of the American Thoracic Society. 16, 11, p. 1422-1431 10 p.

Predictors of long-term adherence to continuous positive airway pressure in patients with obstructive sleep apnea and cardiovascular disease Van Ryswyk, E., Anderson, C. S., Antic, N. A., Barbe, F., Bittencourt, L., Freed, R., Heeley, E., Liu, Z., Loffler, K. A., Lorenzi-Filho, G., Luo, Y., Masdeu Margelef, M. J., McEvoy, R. D., Mediano, O., Mukherjee, S., Ou, Q., Woodman, R., Xilong, Z. & Chai-Coetzer, C. L., 6 Oct 2019, In: SLEEP. 42, 10, 9 p., zsz152.

The noradrenergic agent reboxetine plus the antimuscarinic hyoscine butylbromide reduces sleep apnoea severity: a double-blind, placebo-controlled, randomised crossover trial Lim, R., Messineo, L., Grunstein, R. R., Carberry, J. C. & Eckert, D. J., 1 Sep 2021, In: Journal of Physiology. 599, 17, p. 4183-4195 13 p.

Variability of Sleep Apnea Severity and Risk of Atrial Fibrillation: The VARIOSA-AF Study Linz, D., Brooks, A. G., Elliott, A. D., Nalliah, C. J., Hendriks, J. M. L., Middeldorp, M. E., Gallagher, C., Mahajan, R., Kalman, J. M., McEvoy, R. D., Lau, D. H. & Sanders, P., Jun 2019, In: JACC: Clinical Electrophysiology. 5, 6, p. 692-701 10 p.

Zolpidem increases sleep efficiency and the respiratory arousal threshold without changing sleep apnoea severity and pharyngeal muscle activity Messineo, L., Eckert, D. J., Lim, R., Chiang, A., Azarbarzin, A., Carter, S. G. & Carberry, J. C., 15 Oct 2020, In: Journal of Physiology. 598, 20, p. 4681-4692 12 p.

Resources

Sleep Health Foundation website

The sleep Health Foundation website has a number of resources and fact sheets relevant to sleep disorders.

Australian Sleep Association website

The Australian Sleep Association website has a number of resources and information relevant to sleep disorders.

GROUP MEMBERS

Professor Danny Eckert, Director FHMRI Sleep Health, Matthew Flinders Professor

Research theme Co-lead

Professor Eckert leads a comprehensive basic sciences and translational research program that focuses on identification of the causes of sleep apnea, optimisation of existing therapies, and development of new tailored therapies. He is most well-known for his pioneering respiratory phenotyping work which has led to a new precision medicine therapeutic framework to understand and treat OSA and for his research on the role of arousal mechanisms on sleep apnea pathogenesis and novel pharmacotherapy. He has published more than 170 articles in the leading sleep and respiratory medicine and other cross-disciplinary and general medical journals.

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Senior Research Fellow Anna Hudson
Research theme Co-lead

Dr Anna Hudson is an NHMRC research funded senior researcher with a particular interest in respiratory mechanics. Dr Hudson is currently involved in investigating neural control of breathing and developing new models of non-invasive measurement of respiratory mechanics, particularly to define inefficient breathing in lung disease.

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Professor Robert Adams

Professor Peter Catcheside

Assoc. Prof Sutapa Mukherjee

Assoc. Prof Ching Li Chai-Coetzer

Emeritus Professor Doug McEvoy AM

Research Fellow Amal Osman

Research Fellow Kelly Loffler

Research Fellow Ganesh Naik

Bastien Lechat, Research Associate

Ms Alison Leviton, Research Assistant

Ms Charmaine O’Reilly, Assistant Laboratory Manager and Clinical Trial Coordinator

Ms Carolin Tran, Sleep Laboratory Manager and Clinical Trials Coordinator

Dr Alison Pinczel, Research Assistant

Ms Alison Teare, Research Assistant

Dr Tom Altree, PhD Candidate

Dr Simon Proctor, PhD Candidate

Emma Thomas, PhD Candidate

Josh Fitton, PhD Candidate

PhD Candidate Dr Alex Barnes
PhD Candidate Cricket Fauska

WORK WITH US

We have long-term international and Australian sleep health partnerships across universities, South Australian Local Health Network and with industry groups. Please contact a research directly to discuss opportunities.

CONTACT

Please contact a researcher directly by following the link to their individual contact pages above. Alternatively, you can email aish.sleeplab@flinders.edu.au

aish.sleeplab@flinders.edu.au