- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00623246
Evaluating Behavioral Treatments to Improve Adherence to Continuous Positive Airway Pressure (CPAP) Therapy in People With Obstructive Sleep Apnea (The BREATHE Study) (BREATHE)
Motivating Adherence to CPAP in Obstructive Sleep Apnea
Study Overview
Status
Intervention / Treatment
Detailed Description
OSA is a common sleep disorder that is characterized by a brief collapse and blockage of the upper airway during sleep. This blockage prevents air from flowing properly into the lungs and causes pauses in breathing. Symptoms include loud snoring, choking or gasping during sleep, and abnormal daytime sleepiness. If left untreated, OSA can lead to heart disease, high blood pressure, and stroke. The most common treatment for OSA is CPAP therapy, in which a mask is worn over the nose during sleep and pressurized air flows through the mask to keep the throat open. Unfortunately, CPAP treatment adherence is often poor. Previous research studies showed that people receiving motivational enhancement therapy (MET) or educational therapy (ED) adhered better to CPAP treatment than did people not receiving MET or ED therapy. However, even for people who received MET or ED, adherence usually diminished after 12 months. It appears that patterns of treatment adherence are often set early and people who maintain adherence within the first week of treatment have a greater chance of maintaining long-term adherence. Using enhanced, more intense versions of MET and ED that are delivered when CPAP therapy begins, this study will evaluate the effectiveness of MET and ED at improving CPAP treatment adherence in people with OSA.
This study will enroll people with OSA. Participants will be randomly assigned to a 12-week MET group, a 12-week ED group, or a standard clinical care group, with all treatments beginning at the time participants start CPAP therapy. All participants will attend a baseline study visit to undergo weight and blood pressure measurements; assessments of cognitive functioning, mood, daytime sleepiness, functional outcomes, and attitudes toward therapy; and an optional blood collection. At baseline and Week 1, participants in the MET and ED groups will take part in two 45-minute, face-to-face counseling sessions. During these sessions, participants in the MET group will receive motivational counseling from study staff, and participants in the ED group will receive educational information about OSA from study staff. At Months 1 and 3, participants will receive two phone calls from study staff. The MET group will receive motivational counseling during these calls, with a focus on building self-efficacy and providing personalized feedback on health and adherence patterns. The ED group will receive educational information and feedback on problem-solving and adherence during the calls. Throughout the study, all participants will have their CPAP adherence electronically monitored on a daily basis. Participants who fail to meet the minimum standard of CPAP adherence will receive up to four additional phone calls during the study. At Months 3, 6, and 12, all participants will attend study visits for repeat baseline measurements.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Colorado
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Denver, Colorado, United States, 80206
- National Jewish Medical and Research Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- OSA confirmed by polysomnography (PSG)
- CPAP is the prescribed form of treatment for OSA
- Judged by sleep physician to respond to CPAP
Exclusion Criteria:
- Apnea/hypoxia index (AHI) less than 15 and no daytime functional symptoms or associated cardiovascular disease
- Diagnosis of another sleep disorder that causes arousals from sleep
- Past treatment for OSA
- Current substance abuse problem
- Diagnosis of a serious medical condition that would interfere with involvement in the study
- History of a major psychiatric disorder, other than depression
- Change in antidepressant medication in the 3 months before study entry
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: 1
Participants will receive motivational enhancement therapy (MET) for 12 weeks.
|
MET will involve motivational counseling sessions and phone calls, with a focus on building self-efficacy and providing personalized feedback on health and adherence patterns based on CPAP adherence monitoring.
|
Active Comparator: 2
Participants will receive educational therapy (ED) for 12 weeks.
|
ED will involve sessions and phone calls that include educational information, problem-solving, and adherence feedback from study staff.
|
No Intervention: 3
Participants will receive standard clinical care.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Adherence to CPAP
Time Frame: Measured at Months 3, 6, and 12
|
Measured at Months 3, 6, and 12
|
Cognitive function
Time Frame: Measured at Months 3, 6, and 12
|
Measured at Months 3, 6, and 12
|
Subjective sleepiness
Time Frame: Measured at Months 3, 6, and 12
|
Measured at Months 3, 6, and 12
|
Quality of life
Time Frame: Measured at Months 3, 6, and 12
|
Measured at Months 3, 6, and 12
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Blood pressure
Time Frame: Measured at Months 3, 6, and 12
|
Measured at Months 3, 6, and 12
|
Cytokines and inflammatory markers
Time Frame: Measured at Month 3
|
Measured at Month 3
|
Attitudes toward CPAP use (transtheoretical model [TTM] and social cognitive theory [SCT] model variables)
Time Frame: Measured at Months 3, 6, and 12
|
Measured at Months 3, 6, and 12
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Mark S. Aloia, PhD, National Jewish Health
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 560
- R01HL067209 (U.S. NIH Grant/Contract)
- 2R01HL067209 (U.S. NIH Grant/Contract)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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