- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04007380
Psychosocial, Cognitive, and Behavioral Consequences of Sleep-disordered Breathing After SCI
Psychosocial, Cognitive, and Behavioral Consequences of Sleep-disordered Breathing in Spinal Cord Injured People
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
SCI is a potentially catastrophic event for individuals who may sustain motor, sensory, and autonomic deficit, as well as secondary conditions including SRBDs. The SRBDs include central, obstructive and mixed sleep apnea that can occur in up to 50% of the paraplegics and up to 91% of the motor complete tetraplegics. Although the frequency of SRBDs after SCI is much greater than in able-bodied people, this condition is still a largely under-recognized in the SCI population.
With this, the investigators hypothesize that regular use of CPAP for treatment of moderate-to-severe SRBDs in individuals living with SCI significantly improve their fatigue, depressive symptoms, anxiety, cognitive impairment, quality of life, and social and work participation. This research project will include: (i) a single-arm clinical trial to evaluate the efficacy of nightly use of CPAP for 4 consecutive months in the management of moderate-to-severe SRBDs among 24 adults with subacute to chronic, cervical or thoracic, complete or incomplete SCI; and (ii) a qualitative study of the challenges experienced by the 24 people with SCI who undergo an unattended-hospital or home-based sleep study for diagnosis of SRBDs followed by CPAP therapy.
Overall, this clinical study has the potential to ultimately improve fatigue, mood, cognition, quality of life, and social and work participation of people living with SCI, by examining under-explored links with the SRBDs.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Mitsue Aibe, MD
- Phone Number: 6285 4165973422
- Email: Mitsue.Aibe@uhn.ca
Study Contact Backup
- Name: Julio Furlan, MD
- Phone Number: 6129 4165973422
- Email: Julio.Furlan@uhn.ca
Study Locations
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Ontario
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Toronto, Ontario, Canada
- Recruiting
- Lyndhurst Centre, KITE - TRI UHN
-
Contact:
- Mitsue Aibe, MD
- Phone Number: 6285 416-597-3422
- Email: Mitsue.Aibe@uhn.ca
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- English-speaking adults 18 years of age or older
- Have traumatic cervical/thoracic (injury level at C5 to T10), severe or moderate (AIS A, B, or C) SCI who were not diagnosed with a sleep disorder prior to the injury.
- At least 2 months after injury
- Clinical warning symptoms and/or signs for SRBDs
Exclusion Criteria:
- Patients with a non-traumatic spinal cord disease at risk for neurologic progression
- Concomitant diseases of the central nervous system
- Preinjury chronic pain
- Psychiatric disorders that may prevent the participant to be compliant to the study protocol requirements
- Neuromuscular diseases
- Current substance misuse
- History of primary hypersomnia
- Hypothyroidism
- Moderate or severe iron deficiency anemia
- Active infection
- Kidney failure
- Epilepsy
- Chronic fatigue syndrome
- Vitamin B12 deficiency
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: CPAP-therapy arm
This single-arm clinical trial will examine the effects of 4-month period CPAP therapy in individuals living with SCI.
The CPAP will be adjusted according to the results of the auto-titrating CPAP testing for each participant.
|
The participants will undergo CPAP therapy for 4 consecutive months in the management of moderate-to-severe SRBDs
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Fatigue Severity Scale
Time Frame: Change in Fatigue Severity Scale from baseline to after 4-month period of CPAP therapy
|
Self-reported (or administered by an interviewer) scale where participants choose one of seven levels of agreement for each question.
Range from 9 (best outcome) to 63 (worst outcome).
The primary outcome is the difference between post-intervention and pre-intervention Fatigue Severity Scales.
|
Change in Fatigue Severity Scale from baseline to after 4-month period of CPAP therapy
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Epworth Sleepiness Score
Time Frame: Change in Epworth Sleepiness Score from baseline to after 4-month period of CPAP therapy
|
Self-reported (or administered by an interviewer) where participants answer the 8 brief questions.
Range from 0 (best outcome) to 24 (worst outcome).
This secondary outcome comprises the difference between post-intervention and pre-intervention Epworth sleepiness scores.
|
Change in Epworth Sleepiness Score from baseline to after 4-month period of CPAP therapy
|
Medical Outcomes Study Sleep Scale
Time Frame: Change in Medical Outcomes Study Sleep Scale from baseline to after 4-month period of CPAP therapy
|
Self-reported scale that consists of 12 Likert-type items assessing six dimensions of sleep problems: sleep disturbance (i.e.
difficulty initiating or maintaining sleep), snoring, respiratory problems, sleep quantity, sleep adequacy, and daytime somnolence).
Higher scores for the domains of sleep disturbance, somnolence and sleep indices indicate worse sleep disturbances, whereas lower scores for sleep quantity and sleep adequacy indicate worse sleep disturbances.
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Change in Medical Outcomes Study Sleep Scale from baseline to after 4-month period of CPAP therapy
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Depression, Anxiety & Stress Scales- 21
Time Frame: Change in Depression, Anxiety & Stress Scales- 21 from baseline to after 4-month period of CPAP therapy
|
Self-reported (or administered by an interviewer) scale where participants rate questions on depression, anxiety and stress.
Depression subscale varies from 0 (best outcome) to 21 (worst outcome).
Anxiety subscale varies from 0 (best outcome) to 21 (worst outcome).
Stress subscale varies from 0 (best outcome) to 21 (worst outcome).
This secondary outcome comprises the difference in the overall pre-intervention and post-intervention DASS-21 scores.
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Change in Depression, Anxiety & Stress Scales- 21 from baseline to after 4-month period of CPAP therapy
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Montreal Cognitive Assessment (MoCA) test
Time Frame: Change in Montreal Cognitive Assessment (MoCA) score from baseline to after 4-month period of CPAP therapy
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Cognitive test administered by an interviewer.
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Change in Montreal Cognitive Assessment (MoCA) score from baseline to after 4-month period of CPAP therapy
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Face-to-face, 1-hour interview for qualitative analysis
Time Frame: At completion of the 4-month period of CPAP therapy
|
Qualitative study of the challenges experienced by the 24 people with SCI who undergo an unattended-hospital or home-based sleep study for diagnosis of SRBDs followed by CPAP therapy.
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At completion of the 4-month period of CPAP therapy
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Julio Furlan, MD, Toronto Rehabilitation Institute
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 19-5072
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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