Evaluating the Relationship Between Sleep-Disordered Breathing and Daytime Alertness
Relating Sleep Disordered Breathing to Daytime Function
調査の概要
詳細な説明
Individuals with OSA can experience up to 300 sleep disruptions each night, which may result in excessive daytime sleepiness (EDS), one of the most common symptoms of OSA. EDS can have serious consequences, including motor vehicle accidents, poor school performance, and work-related accidents and performance issues. The most common treatment for OSA is CPAP therapy. This involves wearing a mask over the nose while sleeping; air then flows through the mask into the nose to maintain a level of pressure that keeps the breathing passages open. CPAP therapy typically results in fewer sleep and breathing disruptions during the night, which may increase an individual's alertness levels during the day. The purpose of this study is to evaluate the relationship between severity of sleep-disordered breathing and daytime alertness levels in adults with and withoutout symptoms of OSA.
This study will involve three to five study visits over a 2- to 3-month period. During the first 3 days, participants will record their sleep habits in a diary and will wear a device that measures breathing, oxygen levels, and sleep position. All participants will then take part in a 1-night inpatient stay at the sleep center lab during which brain, eye, muscle, heart, and breathing activity will be monitored. Participants with a confirmed diagnosis of OSA will stay at the sleep lab one additional night for observation while using a CPAP machine. The following day, tests to measure alertness, ease of falling asleep, and sleepiness levels will be administered. Participants will then use the CPAP machine at home for 4-6 weeks; each machine will be set at an appropriate level for the participant, and will record breathing patterns and pressure. Participants will receive weekly phone calls for monitoring purposes. At the end of Week 4, participants will return to the sleep lab for one additional night of CPAP monitoring, followed by alertness and sleep testing. Those with severe OSA will use the CPAP machine at a newly adjusted level for 5 additional days and return for repeat testing. All participants who have been compliant with CPAP will return to the lab for overnight sleep testing without the CPAP machine and for alertness testing.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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New York
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New York、New York、アメリカ、10016
- NYU Sleep Disorders Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Experiences symptoms of OSA, including snoring and sleepiness
- Stable medical history with no change in medications that could affect sleepiness
Exclusion Criteria:
- Suspected diagnosis of a sleep disorder other than OSA (i.e., periodic leg movements, narcolepsy, insomnia, central sleep apnea, sleep hypoventilation syndrome)
- Medically unstable health conditions (e.g., heart attack, congestive heart failure)
- Use of psychotropic medications that cause sedation in the 3 months prior to study entry
- Recent or confirmed history of recreational drug use or alcohol abuse
- Pregnant
- Inability to communicate verbally, write, or read
- Visual, hearing, or cognitive impairment
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
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Continuous Positive Airway Pressure (CPAP)
Participants will use a CPAP machine if they are found to have sleep apnea.
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Positive airway pressure delivered via a nasal mask titrated to a therapeutic level to eliminate all sleep disordered breathing to be used every night for 4-6 weeks.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Subjective Sleepiness
時間枠：Baseline, CPAP( 4 -6 weeks), Off CPAP ( 2 nights)
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Measured using the Epworth sleepiness scale (ESS).
The Epworth sleepiness scale is used in the assessment of daytime sleepiness and measures the general level of sleepiness.The ESS presents the subject with eight situations and asks how likely they are to fall asleep (0= never, 1 =slight chance of dozing, 2= moderate chance of dozing and 3 =high chance of dozing) in these situations.
The sum of the 8 answers is used as the score and ranges from 0 (not sleepy) to 24 (extremely sleepy), and a score of greater than 10 is an indication that a person may be excessively sleepy.
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Baseline, CPAP( 4 -6 weeks), Off CPAP ( 2 nights)
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Objective Sleepiness
時間枠：Measured at baseline, on CPAP (4-6 weeks), CPAP withdrawal (2 nights)
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Multiple Sleep Latency Test (MSLT) measures the latency to sleep onset in minutes.
The shorter the latency to sleep the more sleepy the subject.
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Measured at baseline, on CPAP (4-6 weeks), CPAP withdrawal (2 nights)
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Vigilance
時間枠：Baseline, CPAP (4-6 weeks), CPAP withdrawal (2 nights)
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Vigilance is measured using the psychomotor vigilance task which is a portable reaction time test that is contained in a small, programmable, portable electronic box that requires only a single switch to start.
The task consists of responding to a small bright red light stimulus by pressing a response button as soon as the stimulus appears.
This stops the stimulus counter and displays the reaction time (RT) in milliseconds for a 2-second period and the task duration is 20 minutes.
The subject is instructed to press the button as soon as each stimulus appears in order to keep the reaction time as low as possible.
The PVT yields highly informative metrics on the capacity for sustained attention including the frequency of lapses (reaction time > 500 milliseconds).
The higher the number of lapses the greater the impairment.
Well rested (non-sleepy) subjects have almost no lapses(<2) during the 20min test.
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Baseline, CPAP (4-6 weeks), CPAP withdrawal (2 nights)
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Indu Ayappa, PhD、NYU School of Medicine
出版物と役立つリンク
一般刊行物
- Somiah M, Taxin Z, Keating J, Mooney AM, Norman RG, Rapoport DM, Ayappa I. Sleep quality, short-term and long-term CPAP adherence. J Clin Sleep Med. 2012 Oct 15;8(5):489-500. doi: 10.5664/jcsm.2138.
- Young LR, Taxin ZH, Norman RG, Walsleben JA, Rapoport DM, Ayappa I. Response to CPAP withdrawal in patients with mild versus severe obstructive sleep apnea/hypopnea syndrome. Sleep. 2013 Mar 1;36(3):405-12. doi: 10.5665/sleep.2460.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
睡眠時無呼吸、閉塞性の臨床試験
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University Hospital, Bonnわからない合併症 | 睡眠時無呼吸 (Apnea Hypopnea Index > 5/h として定義) | 頭蓋内動脈瘤のサイズ | 血圧の薬 | 合併症（くも膜下出血）ドイツ
Continuous Positive Airway Pressure (CPAP)の臨床試験
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University of VirginiaONY; LMA North America終了しました