M.D.'s research probes apnea causes

Do genetics play a role in determining who is prone to obstructive sleep apnea? And is the severity of OSA linked to certain physiological traits? These are among two of the key questions sleep specialist Dr. Charles Atwood is trying to find out in his ongoing research. Atwood, associate professor of medicine at the University of Pittsburgh's division of pulmonary, allergy, and critical care medicine, says he is interested in learning about "every imaginable aspect" of the sleep disorder that is widely believed to be the root cause of serious health threats like heart disease and stroke. "Some of the most important research questions in the field right now have to do with understanding the genetics of sleep apnea," he said. "There have been connections made for some time. Cranial facial features can also be a factor in whether someone is susceptible to apnea. Diagnostic scans of the face and upper airway can give us more information about how people breathe and some of the influential variables as well." Although he considers advancement of sleep diagnostic equipment to be "at a little bit of a slow point," Atwood said he is interested in apnea screening devices being developed by respiratory manufacturers ResMed and Respironics. "There is a move toward very simple devices to detect people that primarily have significant sleep apnea," Atwood said. "It is not clear whether these simple screeners detect milder forms of the disease, but it's intriguing that these companies are thinking about designing products that primarily detect the more severe form of the disease." While Atwood says he isn't totally convinced that at-home sleep test results are an adequate substitute for freestanding sleep labs, he isn't dismissing them, either. "I'm keeping an open mind about it," he said. "Some of the portable technology is promising, but more research needs to be done to find out how it fits in." Atwood himself is embarking on a detailed study of portable systems to be carried out at Veterans Administration hospitals in Pittsburgh and Philadelphia over the next three years.