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David Pollard White, MD
Senior Physician, Brigham and Women's Hospital
Professor of Medicine, Part-time, Harvard Medical School

Brigham and Women's Hospital
Department of Medicine
Sleep Medicine
75 Francis Street
Boston, MA 02115

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Research Narrative:

The research in my laboratory primarily addresses understanding the pathophysiology of obstructive sleep apnea and other disorders of breathing during sleep.  In approaching this disorder there are three principal areas of investigation:  1) airway anatomy, 2) upper airway muscle control, and 3) the general control of breathing.  First, regarding upper airway anatomy, we have previously and are currently studying the airway using MRI and CT methodologies with a particular focus on the influence of aging, obesity and androgens on pharyngeal anatomy.  We have also developed a computational (finite element) model of the human upper airway to aid in understanding physiology and to develop new therapies.  Second, motor control of the upper airway has been the principal focus of my laboratory for at least the last 10 years.  We have defined the normal activation pattern and function of a number of pharyngeal muscles and subsequently determined the influence of state (sleep) on these muscles.  Muscle performance in patients with sleep apnea has also been compared to normal controls in defining the pathophysiology of airway collapse during sleep.  How these muscles respond to standard respiratory stimuli (chemistry, negative pressure) has also been defined awake and asleep.  Finally, gender and hormone influences on muscle function has been assessed in an attempt to understand the strong male predominance in this disorder.  Third, we have investigated the influence of sleep on a number of the major controllers of respiration and the relationship between ventilatory control measures and the development of sleep disordered breathing.  The combination of studies described above has substantially improved our understanding of the pathogenesis of sleep apnea and other breathing abnormalities during sleep.

Emory University School of Medicine, 1975, MD