What’s your research focused on?
I look at better understanding sleep problems – obstructive sleep apnea and hypoventilation. I am especially interested in sleep-disordered breathing problems in children with obesity and neuromuscular conditions. My research focuses on new diagnostic tools to detect sleep problems and the use of technologies to treat them.
What’s innovative about your research?
I’m looking at creative strategies – like using neck circumference – to figure out who is at risk. The gold-standard test is still a sleep study in the CHEO sleep lab, and we will not replace that; but because the wait list is very long we need things to help us bump kids up the priority list or to better understand who is at risk.
Why are you looking at neck circumference?
Adults having a large neck size have increased risk of obstructive sleep apnea, but no one yet has looked at this in kids because no one knows what’s a normal neck size in children (it changes as you get older and with gender.) We collaborated with Statistics Canada to use the Canadian Health Measure Survey and collect data on neck circumference in children of all ages across the country. Now we’ve constructed a growth curve for neck circumference for any given age and sex. It should publish soon – we’re really excited about this new potential diagnostic tool.
After you determine who is at risk, what’s next?
We need to better understand the impact of available treatments, so right now we’re looking at the impact of treating kids with continuous and bi-level positive airway pressure devices worn at night. In addition, we want to know how sleep-disordered breathing affects other co-morbidities such as heart problems, blood pressure issues, increased glucose levels, quality of life, and so on.
What kind of outcome are you hoping for?
I think it’s a challenge to treat kids with continuous and bi-level positive airway pressure devices because many patients don’t tolerate it or don’t adhere to it. But if the benefits were evidence-based, patients and doctors alike might stick with it. We will hopefully also uncover some tools and tricks to help patients better adhere to this therapy.
We’re looking at breath-stacking exercises called “lung volume recruitment” for children and teens with Duchenne Muscular Dystrophy and how that impacts loss of lung function over time. Last year we published retrospective data that showed after you introduce breath-stacking there’s a 90% reduction in the rate of decline of lung function! Now we’re going to test this in randomized control trials with children across Canada.View full profile