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Obstructive Sleep Apnea (OSA), Sleepiness, and Activity in Diabetes Management (OSA_DM)

6. november 2017 opdateret af: Eileen R. Chasens

OSA, Sleepiness, and Activity in Diabetes Management

Daily physical activity is important to achieve glucose control in persons with type 2 diabetes. The purpose of this study is to explore if obstructive sleep apnea and its daytime symptom, excessive sleepiness, act as barriers to physical activity. We will examine if treatment of obstructive sleep apnea with continuous positive airway pressure results in increased physical activity in persons with type 2 diabetes.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Obstructive sleep apnea (OSA) is a serious disorder characterized by episodic obstruction of the pharyngeal airway accompanied by cessation or reduction in airflow. Untreated OSA has a negative impact 24 hours a day, disrupting nighttime sleep and causing excessive daytime sleepiness that interferes with functioning. Recent studies suggest that OSA and type 2 diabetes (T2DM) not only co-exist but that OSA may adversely affect glucose homeostasis. While physical activity is recognized as beneficial to persons with T2DM, OSA severity or daytime sleepiness may act to hinder persons with T2DM from participating in physical activity. The primary aim of this pilot/feasibility study is to obtain preliminary data to facilitate further hypothesis development and enhance the feasibility of conducting a double blind, randomized, placebo-controlled study to examine physical activity in subjects with T2DM and OSA who are treated with CPAP compared to subjects on sham-CPAP. The secondary aims are to explore: 1) the interrelationships of OSA severity, daytime sleepiness, and physical activity on glucose variability at baseline; 2) average pre-post therapy changes in glucose variability in subjects treated with CPAP compared to subjects receiving sham-CPAP, and 3) pre to post therapy changes in weight, diet, residual sleepiness and mood in subjects treated with CPAP compared to subjects receiving sham-CPAP.

The primary endpoint of the study, physical activity, will be measured by the Bodymedia SenseWear Pro Armband® to determine activity counts. The endpoint for glucose variability will be measured by the Medtronic Continuous Glucose Monitoring System (CGMS). Adherence to CPAP will be measured by a Smart Card® inserted in subjects' CPAP machines. We will limit the sample of subjects who are randomized to CPAP or sham-CPAP to persons with an adequate sleep duration pre-treatment (> 6 hours), with moderate or severe OSA and with EDS to have a more homogenous, profoundly affected sample for this pilot study. The information that will result from the proposed study on of the effect of OSA and EDS on glucose variability has the potential to lead to the development of improved behavioral interventions in persons with diabetes. In addition, this study contains measures of diet and mood to begin to elucidate the possible effects of OSA and EDS on diabetes management.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

23

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Forenede Stater, 15261
        • University of Pittsburgh

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

40 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • T2DM (verified by primary care provider (PCP) or medication for T2DM)
  • AHI (from PSG) greater than > 15
  • A1c < 9.0%
  • Epworth Sleepiness Sca;e > 10 (Baseline Assessment)
  • Able to ambulate independently or with a cane
  • Age 40-65 years
  • BMI< 45
  • No acute medical and psychiatric illness in past 3 months
  • Self-reported sleep duration of at least 6 hours
  • No changes in medications, including diabetic medications, in last 3 months
  • Telephone access
  • Able to perform study tests (e.g., speak, read and write in English)
  • Willing to be randomized to CPAP or sham-CPAP

Exclusion Criteria:

  • Diagnosis of another sleep disorder, in addition to OSA,
  • Oxygen or Bi-level positive airway pressure required for treatment of OSA
  • An oxygen saturation <75% for >10% of the diagnostic PSG or if subject has oxygen saturation <75% for >25% of the first 4 h of the diagnostic PSG
  • Any individual in the household currently or with history of CPAP treatment
  • Type 1 or gestational diabetes
  • Prescribed insulin for treatment of type 2 diabetes
  • Regular use (> 3 times/week) of hypnotic or alerting medications
  • History of a near-miss or automobile accident due to sleepiness
  • Employed in transportation-related safety sensitive occupation such as an airline pilot, truck driver, or train engineer
  • Currently working night or rotating shifts
  • Routine consumption of alcohol as determined by >2 drinks day
  • Known allergy to medical adhesives or dermatological conditions that would preclude wearing CGMS
  • Swim or water aerobics >once a week
  • Participation in contact sports or activity that may damage CGMS device or cause injury from monitor
  • Claustrophobia that prevents wearing the CPAP mask
  • Pregnancy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: 1 subjects treated with CPAP
Continuous Positive Airway Pressure treatment (CPAP)
Enhed: Continuous Positive Airway Pressure (CPAP)
Mask worn over nose to splint open the airway with positive pressure to prevent the subject from holding their breath (apneas).
Sham-komparator: 2 subjects treated with sham-CPAP
Sham Continuous Positive Airway Pressure treatment (sham-CPAP)
Enhed: Sham- Continuous Positive Airway Pressure (Sham-CPAP)
Mask worn over nose to splint open the airway with positive pressure to prevent the subject from holding their breath (apneas).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Physical Activity, Steps Walked
Tidsramme: after one-month treatment
Steps walked measured by the Bodymedia SenseWear Pro Armband®Data collected from the main study period
after one-month treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Fructosamine
Tidsramme: after one-month
Change in fructosamine level from baseline to one month: data from main study period
after one-month
Change in Sleep Quality
Tidsramme: after one month
From Pittsburgh Sleep Quality Index; scores range from 0 to 21 with higher scores worse sleep quality; data from main study period
after one month
Change in Daytime Sleepiness During Main Study Period
Tidsramme: after one month
Daytime Sleepiness measured by the Epworth Sleepiness Scale; measured from 0 to 24; higher scores indicate worse sleepiness
after one month
Change in Vigor-Activity During Main Study Period
Tidsramme: after one month
Vigor-Activity from Profiles of Mood Scale; scores range from 0 to 32 with higher scores indicating higher vigor/activity
after one month
Fatigue/Inertia
Tidsramme: after one month
Fatigue/Inertia from the Profile of Moods Subscale; scores range from 0 to 28; higher scores indicate more fatigue/inertia
after one month

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Eileen R. Chasens

Efterforskere

  • Ledende efterforsker: Eileen R. Chasens, DSN, University of Pittsburgh

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. april 2009

Primær færdiggørelse (Faktiske)

1. april 2012

Studieafslutning (Faktiske)

1. april 2012

Datoer for studieregistrering

Først indsendt

3. december 2008

Først indsendt, der opfyldte QC-kriterier

3. december 2008

Først opslået (Skøn)

4. december 2008

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. november 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

6. november 2017

Sidst verificeret

1. november 2017

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • R21HL089522-01A2 (U.S. NIH-bevilling/kontrakt)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Søvnapnø, obstruktiv

Kliniske forsøg med Continuous Positive Airway Pressure (CPAP)

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