- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02365064
CPAP vs ASV for Insomnia (P2P)
August 13, 2021 updated by: ResMed
PAP to PAP: CPAP vs ASV for Insomnia Randomized Controlled Trial
The study will determine which of two different types of positive airway pressure (PAP therapy) modes are more effective in reducing sleep breathing events in chronic insomnia patients and in decreasing insomnia severity.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Patients presenting to the sleep clinic with a primary complaint of insomnia will be potential participants for this study.
Following diagnostic polysomnography (PSG) testing, insomnia patients diagnosed with SDB and meeting inclusion criteria will be randomized to a PAP treatment arm, CPAP or ASV.
Participants will complete titration studies with their assigned PAP mode and attend clinical follow-up appointments over a 14-16 week timeframe.
Titration PSG studies will assess PAP pressure needs to ensure that patients are receiving optimal therapy at all times during this study.
PAP adaptation barriers will be addressed as they arise during the study, because it is important that participants are able to use PAP therapy nightly during participation in this protocol.
Baseline scores on insomnia severity, sleep quality, subjective insomnia parameters, sleep related impairment, and quality of life will be compared to outcome measures at the 4 month mark.
Pre-treatment and post-treatment objective improvements on sleep studies will also be compared including sleep breathing indices, sleep consolidation indices, and objective data download information.
Study Type
Interventional
Enrollment (Actual)
78
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
New Mexico
-
Albuquerque, New Mexico, United States, 87109
- Maimonides Sleep Arts & Sciences
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Primary complaint of insomnia when presenting at clinic
- Diagnosis of moderate to severe insomnia through the Insomnia Severity Index (ISI) with a score ≥ 15
- Meet diagnostic criteria of Insomnia Disorder (per American Academy of Sleep Medicine)
- Diagnosis of SDB, either OSA as determined by an AHI ≥ 5 events/hour or UARS with a RDI ≥ 15 events/hour and AHI < 5 events/hour
- Naïve to treatment for sleep-disordered breathing (SDB), including CPAP, APAP, ASV; mandibular repositioning devices (MRDs), and any other nasal or oral therapy with a primary indication of treating SDB
- Able to fully understand study information in English and sign informed consent
Exclusion Criteria:
- Primary complaint of sleep-disordered breathing or issues with apneas during sleep
- Severe respiratory disorder or severe sleep disorder such as restless leg syndrome (RLS), idiopathic hypersomnia, or narcolepsy
- BMI > 30 kg/m2
- Epworth Sleepiness Scale (ESS) score ≥ 10
- Frequent napping behavior, such as a few times a week or more
- Anticipated changes to start or stop sedative or psychotropic medications during the course of the trial
- Medical history of congestive heart failure (CHF) or other potentially unstable cardiac disease as well as chronic lung diseases or other debilitating medical conditions that manifest as more prominent in the patient's health compared to their sleep complaints
- Daily use of opiate medications
- Known contraindications to PAP therapy as listed in the indication for use
- Requires a CPAP (fixed) pressure > 20 cm H2O
- Inability to comply with study procedures
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Continuous Positive Airway Pressure
Continuous positive airway pressure (CPAP) intervention as active comparator.
Provides a fixed pressure for both inspiration and expiration.
|
Device is able to provide both ASV therapy and CPAP therapy modes.
Other Names:
|
Experimental: Adaptive Servo-Ventilation
Adaptive servo-ventilation (ASV) positive airway pressure as experimental intervention.
Provides a higher pressure for inspiration and a lower pressure for expiration with changes in the pressure support level to meet a target minute ventilation.
|
Device is able to provide both ASV therapy and CPAP therapy modes.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Insomnia Severity Index
Time Frame: Baseline and 4 months
|
Change in insomnia severity from baseline to 4 months as measured by subjective questionnaire.
The Insomnia Severity Index has seven questions.
The seven answers are added up for a total score.
Scores range from 0 - 28.
A higher score indicates a more severe degree of insomnia.
|
Baseline and 4 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sleep Quality Rating
Time Frame: Baseline and 4 months
|
8 point Likert scale for change in subjective sleep quality from baseline to 4 months.
Lower scores indicated more positive sleep quality.
A score 0 indicates excellent sleep quality, and a score of 7 indicates very poor sleep quality
|
Baseline and 4 months
|
Global Morning Rating
Time Frame: 4 months
|
Change in subjective rating from baseline to 4 months based on a 0-100% scale.
Lower scores equal a more positive experience
|
4 months
|
Sleep Onset Latency
Time Frame: 4 months
|
Change in from baseline to 4 months in sleep onset time (minutes)
|
4 months
|
Wake After Sleep Onset (WASO)
Time Frame: 4 months
|
Change from baseline to 4 months for WASO in minutes
|
4 months
|
Sleep Efficiency
Time Frame: 4 months
|
Change from baseline to 4 months in sleep efficiency (total sleep time/time in bed)
|
4 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Barry Krakow, MD, Sleep & Human Health Institute
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 1, 2015
Primary Completion (Actual)
August 1, 2017
Study Completion (Actual)
December 1, 2017
Study Registration Dates
First Submitted
February 10, 2015
First Submitted That Met QC Criteria
February 17, 2015
First Posted (Estimate)
February 18, 2015
Study Record Updates
Last Update Posted (Actual)
September 9, 2021
Last Update Submitted That Met QC Criteria
August 13, 2021
Last Verified
May 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 682031-1_MA20150206
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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