Perelman School of Medicine at the University of Pennsylvania

Center for Sleep and Circadian Neurobiology

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Sleep Apnea Global Interdisciplinary Consortium

The Sleep Apnea Global Interdisciplinary Consortium conducts research projects worldwide on a variety of topics related to the common disorder, obstructive sleep apnea. Major foci of activity include personalized medicine approaches, craniofacial risk factors, and genetics of OSA.

About

This consortium was established in 2011. It is designed to conduct collaborative research on sleep apnea worldwide. It is focused on a number of specific issues and the wide variety of ethnic groups who are part of this provides a rich base for studies of the role of ethnicity.

Sites involved include University of Pennsylvania, Ohio State University, University of Iceland, Charite, Berlin, San Paolo, Brazil, Korea, Taiwan, University of Sydney, University of Western Australia, Perth.

Data bases to manage projects are hosted in the CTSA at Ohio State (A. Drake) and managed by the statistical team at the University of Pennsylvania (G. Maislin, B. Keenan). There are multiple working groups, monthly calls of all investigators and an annual 2-day meeting that is held in different countries.

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Institutions & Researchers

Chang Gung Memorial Hospital — Taipei, Taiwan
  • Ning Hung Chen (Sleep Medicine)
  • Yu-Sheng Lin (Cardiologist)
  • Li Pang Chuang (Sleep Medicine)
Charité University Hospital  — Berlin, Germany
  • Thomas Penzel (ECG signals)
  • Bernd Sanner (Cardiology)
Korea University —  Seoul, South Korea
  • Chol Shin (Sleep Medicine)
  • Jinyoung Kim (Nursing, Snoring)
  • Seung Ku Lee (Computational Analyses, Statistics)
Universidade Federal de São Paulo — São Paulo, Brazil
  • Sergio Tufik (Sleep Medicine)
  • Lia Bittencourt (Sleep Medicine)
Landspitali University Hospital — Reykjavík, Iceland
  • Thorarinn Gislason (Sleep Medicine)
  • Bryndis Benediktsdottir (Sleep Medicine)
  • Erna Sif Arnardottir (Sleep Medicine, Snoring)
The Ohio State University — Columbus, United States
  • Ulysses Magalang (Sleep Medicine)
  • Jesse Mindel (Neurology, EEG signals)
  • Amy Drake (REDcap)
University of Pennsylvania — Philadelphia, United States
  • Allan I. Pack (Sleep Medicine)
  • Richard Schwab (Sleep Medicine)
  • Julio Chirinos (Cardiology)
  • Diane C. Lim (Sleep Medicine)
  • Jinyoung Kim (Nursing, Snoring)
  • Olivia Veacth (Genetics)
  • Diego Mazzotti (Genetics, Computational Analyses, Statistics)
  • Greg Maislin (Computational Analyses, Statistics, Data Management)
  • Brendan Keenan (Computational Analyses, Statistics, Data Management)
  • Frances Pack (Clinical Coordinator)
  • Karen McLaughlin (Administrator)
University of Sydney — Sydney, Australia 
  • Peter Cistulli (Sleep Medicine)
  • Philip deChazal (Respiratory signals)
  • Kate Sutherland (Craniofacial Analyses)
University of Western Australia — Perth, Australia
  • Bhajan Singh (Sleep Medicine)
  • Nigel McArdle (Sleep Medicine)

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Publications

The consortium initially did a few studies to assess reliability of scoring of respiratory events during sleep in multiple international centers. These studies were led by Dr. Magalang. They showed that for common metrics of sleep apnea severity, there is reliability of scoring both for in-laboratory studies and home studies. For these measures it removes the need for centralized scoring in multi-center studies thereby substantially reducing costs.

Magalang UJ, Arnardottir ES, Chen NH, Cistulli PA, Gíslason T, Lim D, Penzel T, Schwab R, Tufik S, Pack AI; SAGIC Investigators.. Agreement in the Scoring of Respiratory Events Among International Sleep Centers for Home Sleep Testing. J Clin Sleep Med. 2016 Jan;12(1):71-7. PubMed PMID: 26350603; PubMed Central PMCID: PMC4702196.

Iftikhar IH, Valentine CW, Bittencourt LR, Cohen DL, Fedson AC, Gíslason T, Penzel T, Phillips CL, Yu-sheng L, Pack AI, Magalang UJ. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens. 2014 Dec;32(12):2341-50; discussion 2350. PubMed PMID: 25243523; PubMed Central PMCID: PMC4291165.

Magalang UJ, Chen NH, Cistulli PA, Fedson AC, Gíslason T, Hillman D, Penzel T, Tamisier R, Tufik S, Phillips G, Pack AI; SAGIC Investigators.. Agreement in the scoring of respiratory events and sleep among international sleep centers. Sleep. 2013 Apr 1;36(4):591-6. Erratum in: Sleep. 2014 Sep;37(9):1575. PubMed PMID: 23565005; PubMed Central PMCID: PMC3612261.

Sutherland K, Schwab RJ, Maislin G, Lee RW, Benedikstdsottir B, Pack AI, Gislason T, Juliusson S, Cistulli PA. Facial phenotyping by quantitative photography reflects craniofacial morphology measured on magnetic resonance imaging in Icelandic sleep apnea patients. Sleep. 2014 May 1;37(5):959-68. PubMed PMID: 24790275; PubMed Central PMCID: PMC3985099.

The consortium developed a questionnaire that is being used at all SAGIC sites. In addition, there are working groups who meet at least monthly to move along various parts of the overall research program. The working groups are as follows:

Questionnaire Development: T. Gislason, N. McArdle, B. BeneditksdottirDefinition of Extreme Phenotypes: U. Magalang, J. Mindel, D. Mazzotti, G. MaislinCraniofacial and Intraoral Photography: P. Cistulli, R. Schwab, K. SutherlandPhysiological Signal Analysis: T. Penzel, P. DeChazal, D. Lim, E. ArnardottirGenetic Analysis: A. Pack, O. Veatch, D. Mazzotti, B. Keenan

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Annual Meetings

The consortium holds annual meetings in different locations. Past meetings have been in Brazil, Germany, Taiwan and the United States. A meeting is planned for 2017 in Australia. The most recently meeting was in May, 2016 in Napa, California.

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Currently the consortium is recruiting patients with OSA and collecting the following information: questionnaires, craniofacial photographs, intraoral photographs, clinical information, presence of comorbidities, Epworth Sleepiness Score, sleep study data, DNA (either from blood or saliva). Funds have been identified to allow genotyping of 4,000 of these samples.Currently we have recruited over 2,000 subjects with OSA across these multiple sites.

Craniofacial photographs are analyzed by the group at the University of Sydney, intraoral photographs are analyzed at the University of Pennsylvania, data base for all variables is developed in RedCap at Ohio State University (A. Drake, U. Magalang). It is hosted on a server at Ohio State University. All questionnaires have been translated into multiple languages. The data base and statistical analysis are managed by the team at the University of Pennsylvania (G. Maislin, B. Keenan).