Sleep Apnea Biomarkers and Adherence to Continuous Positive Airway Pressure (BIOSA)
Impact of Obstructive Sleep Apnea Biomarkers on Adherence to Continuous Positive Airway Pressure: Role of Pulse Wave Amplitude Drop Index, Hypoxic Burden, and Heart Rate Variability
Obstructive sleep apnea (OSA) is commonly assessed using the apnea-hypopnea index, although this measure does not fully reflect cardiovascular risk or the physiological impact of the disease. Emerging biomarkers, including sleep apnea-specific hypoxic burden, pulse wave amplitude drop index, and heart rate response, may provide additional information on cardiovascular vulnerability.
This prospective multicenter observational study will investigate the association between these biomarkers, measured from the diagnostic sleep study, and adherence to continuous positive airway pressure (CPAP) therapy after three months. Symptoms, quality of life, clinical characteristics, and changes in biomarkers under continuous positive airway pressure will also be evaluated.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
This is a prospective, longitudinal, multicenter observational cohort study involving adults with newly diagnosed obstructive sleep apnea for whom continuous positive airway pressure therapy is indicated as part of routine clinical care.
At baseline, demographic and clinical characteristics, medical history, current treatments, symptom questionnaires, and results from diagnostic respiratory polygraphy or polysomnography will be collected. Hypoxic burden, pulse wave amplitude drop index, and heart rate response will be calculated from the initial sleep recording. Continuous positive airway pressure will be prescribed according to standard clinical practice.
At 12 weeks, with a permitted window of plus or minus four weeks, adherence data will be obtained from the continuous positive airway pressure device. Clinical information and questionnaires will be collected again. Participants requiring a follow-up sleep study as part of routine care may undergo respiratory polygraphy or polysomnography while receiving continuous positive airway pressure, allowing assessment of biomarker changes under treatment.
The principal analysis will examine associations between baseline biomarkers and continuous positive airway pressure adherence. Secondary analyses will assess biomarker distributions according to clinical characteristics, associations with symptoms and quality of life, and changes in biomarkers during treatment.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Francois FB Bughin, MD, PhD
- Numero di telefono: 0033761783081
- Email: fbughin@hotmail.com
Luoghi di studio
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Montpellier, Francia, 34000
- Reclutamento
- Clinique Millenaire
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Contatto:
- Francois FB Bughin, Study Principal Investigator
- Numero di telefono: 0033761783081
- Email: fbughin@hotmail.com
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- Newly diagnosed obstructive sleep apnea with an indication for continuous positive airway pressure therapy
- Age older than 18 years
- Written informed consent obtained
Exclusion Criteria:
- Continuous positive airway pressure treatment during the preceding 3 months
- Medical contraindication to continuous positive airway pressure therapy
- Concomitant condition likely to affect adherence to continuous positive airway pressure, including severe cognitive impairment or an unstable psychiatric disorder
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Numero di gruppi/coorti
Coorti e interventi
Gruppo / CoorteGruppo / Coorte |
Intervento / TrattamentoIntervento / Trattamento |
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Patients with newly diagnosed obstructive sleep apnea
Adults with newly diagnosed obstructive sleep apnea and a clinical indication for continuous positive airway pressure therapy.
Treatment is prescribed according to routine clinical practice.
Participants are followed for three months to evaluate treatment adherence, symptoms, quality of life, and sleep apnea biomarkers.
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Continuous positive airway pressure prescribed as part of routine clinical care according to applicable clinical recommendations.
The study does not assign the treatment or its settings.
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Association Between Baseline Hypoxic Burden and CPAP Adherence at 3 Months
Lasso di tempo: Baseline to 3 months after CPAP initiation
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Association between hypoxic burden measured during the baseline diagnostic sleep study and mean nightly CPAP use during the 30 days preceding the 3-month visit.
CPAP adherence will also be categorized as less than 4 hours per night versus 4 hours or more per night.
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Baseline to 3 months after CPAP initiation
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Distribution of Baseline Sleep Apnea Biomarkers
Lasso di tempo: BASELINE
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Distribution of hypoxic burden, pulse wave amplitude drop index, and heart rate response measured or calculated from the baseline respiratory polygraphy or polysomnography.
Results will be described according to sex, age, body mass index, medical history, cardiovascular history, and current treatments.
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BASELINE
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Association Between Baseline Heart Rate Response and CPAP Adherence at 3 Months
Lasso di tempo: Baseline to 3 months after CPAP initiation
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Association between the heart rate response to respiratory events (delta heart rate) measured during the baseline diagnostic sleep study and mean nightly CPAP use during the 30 days preceding the 3-month visit.
CPAP adherence will also be categorized as less than 4 hours per night versus 4 hours or more per night.
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Baseline to 3 months after CPAP initiation
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Association Between Baseline Pulse Wave Amplitude Drop Index and CPAP Adherence at 3 Months
Lasso di tempo: Baseline to 3 months after CPAP initiation
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Association between the pulse wave amplitude drop index (PWAD index) measured during the baseline diagnostic sleep study and mean nightly CPAP use during the 30 days preceding the 3-month visit.
CPAP adherence will also be categorized as less than 4 hours per night versus 4 hours or more per night.
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Baseline to 3 months after CPAP initiation
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Daytime Sleepiness Assessed by the Epworth Sleepiness Scale
Lasso di tempo: Baseline and 3 months
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Daytime sleepiness will be assessed using the Epworth Sleepiness Scale at baseline and 3 months after CPAP initiation.
The total score ranges from 0 to 24, with higher scores indicating greater daytime sleepiness and therefore a worse outcome.
The change in total score between baseline and 3 months will be evaluated.
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Baseline and 3 months
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Health-Related Quality of Life Assessed Using the EuroQol 5-Dimension 5-Level Questionnaire
Lasso di tempo: baseline and 3 months
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Health-related quality of life will be assessed using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) at baseline and 3 months after CPAP initiation.
The EQ-5D-5L evaluates five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Each dimension has five response levels, ranging from 1 (no problems) to 5 (extreme problems or inability to perform the activity).
Responses will be converted into an EQ-5D-5L utility index using the French value set.
Index values range from -0.525 to 1, with higher values indicating better health-related quality of life.
The change in the utility index between baseline and 3 months will be evaluated.
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baseline and 3 months
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Goal Attainment Assessed by Goal Attainment Scaling
Lasso di tempo: baseline and 3 months
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Goal Attainment Scaling score and its change between baseline and the 3-month follow-up visit.
Attainment of the participant's individualized treatment goal will be assessed at 3 months using Goal Attainment Scaling (GAS).
Goal attainment is rated on a five-point scale ranging from -2 to +2: -2 indicates a much worse outcome than expected, -1 a somewhat worse outcome than expected, 0 the expected level of goal attainment, +1 a somewhat better outcome than expected, and +2 a much better outcome than expected.
Higher scores indicate better goal attainment and therefore a better outcome
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baseline and 3 months
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Change in Sleep Apnea-Specific Hypoxic Burden During CPAP Therapy
Lasso di tempo: baseline and 3 months
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Sleep apnea-specific hypoxic burden will be calculated from the oxygen desaturation area associated with respiratory events and expressed as percent-minutes per hour (%min/h).
The change from the baseline diagnostic sleep study to the sleep study performed during CPAP therapy at 3 months will be evaluated.
Higher values indicate a greater hypoxic burden and therefore a worse outcome.
This assessment will be performed only in participants undergoing a follow-up sleep study as part of routine care.
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baseline and 3 months
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Change in Pulse Wave Amplitude Drop Index During CPAP Therapy
Lasso di tempo: Baseline and 3 months after CPAP initiation
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The pulse wave amplitude drop index will be calculated as the number of pulse wave amplitude drops per hour of sleep or recording.
The change from the baseline diagnostic sleep study to the sleep study performed during CPAP therapy at 3 months will be evaluated.
Higher values indicate more frequent pulse wave amplitude drops.
This assessment will be performed only in participants undergoing a follow-up sleep study as part of routine care.
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Baseline and 3 months after CPAP initiation
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Change in Heart Rate Response to Respiratory Events During CPAP Therapy
Lasso di tempo: Baseline and 3 months after CPAP initiation
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Heart rate response will be measured as the mean change in heart rate associated with respiratory events (delta heart rate).
The change from the baseline diagnostic sleep study to the sleep study performed during CPAP therapy at 3 months will be evaluated.
Higher values indicate a greater heart rate response to respiratory events.
This assessment will be performed only in participants undergoing a follow-up sleep study as part of routine care.
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Baseline and 3 months after CPAP initiation
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Collaboratori e investigatori
Sponsor
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
- Gagnadoux F, Bequignon E, Prigent A, Micoulaud-Franchi JA, Chambe J, Texereau J, Alami S, Roche F. The PAP-RES algorithm: Defining who, why and how to use positive airway pressure therapy for OSA. Sleep Med Rev. 2024 Jun;75:101932. doi: 10.1016/j.smrv.2024.101932. Epub 2024 Apr 8.
- Pinilla L, Esmaeili N, Labarca G, Martinez-Garcia MA, Torres G, Gracia-Lavedan E, Minguez O, Martinez D, Abad J, Masdeu MJ, Mediano O, Munoz C, Cabriada V, Duran-Cantolla J, Mayos M, Coloma R, Montserrat JM, de la Pena M, Hu WH, Messineo L, Sehhati M, Wellman A, Redline S, Sands S, Barbe F, Sanchez-de-la-Torre M, Azarbarzin A. Hypoxic burden to guide CPAP treatment allocation in patients with obstructive sleep apnoea: a post hoc study of the ISAACC trial. Eur Respir J. 2023 Dec 7;62(6):2300828. doi: 10.1183/13993003.00828-2023. Print 2023 Dec.
- Gerves-Pinquie C, Bailly S, Goupil F, Pigeanne T, Launois S, Leclair-Visonneau L, Masson P, Bizieux-Thaminy A, Blanchard M, Sabil A, Jaffuel D, Racineux JL, Trzepizur W, Gagnadoux F. Positive Airway Pressure Adherence, Mortality, and Cardiovascular Events in Patients with Sleep Apnea. Am J Respir Crit Care Med. 2022 Dec 1;206(11):1393-1404. doi: 10.1164/rccm.202202-0366OC.
- McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X, Mediano O, Chen R, Drager LF, Liu Z, Chen G, Du B, McArdle N, Mukherjee S, Tripathi M, Billot L, Li Q, Lorenzi-Filho G, Barbe F, Redline S, Wang J, Arima H, Neal B, White DP, Grunstein RR, Zhong N, Anderson CS; SAVE Investigators and Coordinators. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med. 2016 Sep 8;375(10):919-31. doi: 10.1056/NEJMoa1606599. Epub 2016 Aug 28.
- Azarbarzin A, Sands SA, Younes M, Taranto-Montemurro L, Sofer T, Vena D, Alex RM, Kim SW, Gottlieb DJ, White DP, Redline S, Wellman A. The Sleep Apnea-Specific Pulse-Rate Response Predicts Cardiovascular Morbidity and Mortality. Am J Respir Crit Care Med. 2021 Jun 15;203(12):1546-1555. doi: 10.1164/rccm.202010-3900OC.
- Solelhac G, Sanchez-de-la-Torre M, Blanchard M, Berger M, Hirotsu C, Imler T, Sanchez-de-la-Torre A, Haba-Rubio J, Marchi NA, Bayon V, Bailly S, Goupil F, Waeber A, Heiniger G, Pigeanne T, Gracia-Lavedan E, Zapater A, Abad J, Ordax E, Masdeu MJ, Cabriada-Nuno V, Egea C, Van Den Broecke S, Vollenweider P, Marques-Vidal P, Vaucher J, Bernardi G, Betta M, Siclari F, Barbe F, Gagnadoux F, Heinzer R. Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea. Am J Respir Crit Care Med. 2023 Jun 15;207(12):1620-1632. doi: 10.1164/rccm.202206-1223OC.
- Azarbarzin A, Sands SA, Stone KL, Taranto-Montemurro L, Messineo L, Terrill PI, Ancoli-Israel S, Ensrud K, Purcell S, White DP, Redline S, Wellman A. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study. Eur Heart J. 2019 Apr 7;40(14):1149-1157. doi: 10.1093/eurheartj/ehy624.
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Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie del sistema nervoso
- Malattie delle vie respiratorie
- Disturbi respiratori
- Disturbi del sonno e della veglia
- Apnea
- Disturbi del sonno, intrinseci
- Dissonnie
- Sindromi da apnee notturne
- Apnea notturna, ostruttiva
- Terapie
- Gestione delle vie aeree
- Terapia respiratoria
- Respirazione a pressione positiva
- Respirazione, artificiale
- Pressione continua positiva delle vie aeree
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- BIOSA
- 2025-A01061-48 (Altro identificatore: French National Agency for the Safety of Medicines and Health Products (ANSM))
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