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The most common types of chronic cardio-respiratory disorders are chronic obstructive pulmonary disorder (COPD), heart failure, high blood pressure, and sleep apnea. These disorders, especially COPD and heart failure, are the leading causes of death worldwide. They are also the independent predictors of morbidity, reduced quality of life, increased hospital admissions and increased mortality. For example, the Global Burden of Disease study predicts that COPD will be the third leading cause of death by 2020.

Chronic cardio-respiratory disorders share common risk factors such as older age, lack of activity, smoking, and obesity. The symptoms of these diseases, such as shortness of breath and coughing, often worsen during sleep. One potential reason for this is that sleep is associated with physiological changes in respiration, such as humoral factors and a reduction in respiratory muscle tone and lung volume. Another potential reason is that lying down during sleep causes body fluids to shift from the legs to the heart, lungs and neck. This fluid accumulation in the lungs and neck then causes narrowing of the airway; however, little is known about the mechanistic link between sleep, fluid shifts and exacerbated respiratory disease.

To address this gap, SleepdB, a sound-proof laboratory has been developed to examine sleep-disordered breathing at Toronto Rehab. Leveraging novel and non-invasive acoustic monitoring technologies, SleepdB is the first laboratory in the world dedicated to understanding the intricate interplay between sleep, body fluid shifts and respiratory disease. The facility will also develop novel technologies for the long-term monitoring of physiological signals during sleep, with the ultimate goal to improve disease management and prevent exacerbation and hospitalization.

The lab comprises the following major groups of equipment:

  • an acoustical chamber large enough to contain a bed and monitoring equipment;
  • sleep assessment devices including polysomnography;
  • respiratory function assessment equipment such as a specially-configured forced oscillation technique device to measure airway resistance;
  • ultrasound imaging with elastography to visualize cardiopulmonary function and tissue stiffness; and

a fluid measurement and data acquisition module to integrate and synchronize all of the measurements highlighted above. This combination of infrastructure is entirely unique to SleepdB and will complement existing clinical laboratories to assess sleep apnea and cardiovascular diseases at TRI.