THE BREATHING PATTERNS OF NEWBORNS MAY BE INTERRUPTED BY CENTRAL APNEAS, I.

THE BREATHING PATTERNS OF NEWBORNS MAY BE INTERRUPTED BY CENTRAL APNEAS, I.E., COMPLETE CESSATION OF RESPIRATORY EFFORTS OR OBSTRUCTIVE APNEAS, I.E., LACK OF VENTILATION DUE TO UPPER AIRWAY OBSTRUCTION WHILE RESPIRATORY MUSCLE CONTRACTIONS CONTINUE TO TAKE PLACE. SUCH APNEAS ARE THOUGHT TO PLAY A MAJOR ROLE IN SUDDEN INFANT DEATH SYNDROME. ALTHOUGH A VARIETY OF MONITORS ARE AVAILABLE TO DETECT CENTRAL APNEAS, NONE ARE SUFFICIENTLY SIMPLE TO USE OR RELIABLE ENOUGH TO DETECT OBSTRUCTIVE APNEAS. RESPIRATORY MUSCLE EFFORTS DURING OBSTRUCTIVE APNEAS ARE BEST DETECTED BY CHANGES OF INTRAPLEURAL PRESSURE, BUT HERETOFOR THIS REQUIRED INSERTION OF AN ESOPHAGEAL BALLOON CATHETER WHICH IS TOO INVASIVE FOR LONG TERM MONITORING. INTRAPLEURAL PRESSURE SWINGS IN THE ABSENCE OF AIRFLOW AT THE NOSE AND MOUTH ESTABLISH THE DIAGNOSIS OF OBSTRUCTIVE APNEAS. EXTERNAL MONITORING DEVICES PLACED AROUND THE RIB CAGE OR ABDOMEN ARE GENERALLY EFFECTIVE FOR DETECTING CENTRAL APNEAS BUT MIGHT FALSELY RECORD NORMAL BREATHING DURING OBSTRUCTIVE APNEA. THE PROPOSAL FOR PHASE I IS TO DEVELOP EFFECTIVE HARDWARE AND SOFTWARE TO ACCOMPLISH SUCH A GOAL. FOR PHASE 2, IT IS ANTICIPATED THAT FIELD TRIALS WILL FURTHER REFINE THE METHODOLOGY. THE TECHNIQUES ARE BASED UPON TRANSDUCER KNOWLEDGE DEVELOPED BY RESPITRACE CORPORATION ALONG WITH AN IMPORTANT DISCOVERY ON THE RELATIONSHIP OF CRANIAL BONE MOVEMENTS TO THE RESPIRATORY CYCLE. MOVEMENTS OF CRANIAL BONES DETECTED BY SURFACE INDUCTIVE PLETHYSMOGRAPHY CLOSELY RESEMBLE INTRAPLEURAL PRESSURE SWINGS IN NEWBORN PUPPIES AND LAMBS. THE PROTOTYPE DEVICE HAS A LOW SIGNAL TO NOISE RATIO AND AN UNACCEPTABLE OSCILLATOR MODULE MASS FOR NEWBORN HUMANS. THE PHASE 1 PROPOSAL WILL DEAL WITH IMPROVING CHARACTERISTICS OF THE DEVICE AND DEVELOPING A NASAL AIRFLOW MONITORING SYSTEM WITH SUITABLE MICROPROCESSOR SYSTEM ALGORITHMS FOR RESPIRATORY MONITORING IN HOSPITAL AND HOME ENVIRONMENTS.