Sleep Apnea Biomarkers and Adherence to Continuous Positive Airway Pressure (BIOSA)
2026年8月26日 更新者：Bughin Francois、Clinique du Millenaire
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.
調査の概要
詳細な説明
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.
研究の種類
観察的
入学 (推定)
200
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究連絡先
- 名前：Francois FB Bughin, MD, PhD
- 電話番号：0033761783081
- メール：fbughin@hotmail.com
研究場所
-
-
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Montpellier、フランス、34000
- 募集
- Clinique Millenaire
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コンタクト：
- Francois FB Bughin, Study Principal Investigator
- 電話番号：0033761783081
- メール：fbughin@hotmail.com
-
-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
いいえ
サンプリング方法
非確率サンプル
調査対象母集団
Adults with newly diagnosed obstructive sleep apnea syndrome and an indication for continuous positive airway pressure therapy, recruited from approximately 10 sleep medicine centers in France.
Participants are treated according to routine clinical practice and followed for 3 months to assess CPAP adherence, symptoms, quality of life, and sleep apnea biomarkers.
説明
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
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
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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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.
他の名前：
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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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Association Between Baseline Hypoxic Burden and CPAP Adherence at 3 Months
時間枠：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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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Distribution of Baseline Sleep Apnea Biomarkers
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：Baseline and 3 months after CPAP initiation
|
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.
|
Baseline and 3 months after CPAP initiation
|
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ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- 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.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2026年2月18日
一次修了 (推定)
2026年12月31日
研究の完了 (推定)
2027年9月30日
試験登録日
最初に提出
2026年8月10日
QC基準を満たした最初の提出物
2026年8月26日
最初の投稿 (実際)
2026年8月28日
学習記録の更新
投稿された最後の更新 (実際)
2026年8月28日
QC基準を満たした最後の更新が送信されました
2026年8月26日
最終確認日
2026年8月1日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- BIOSA
- 2025-A01061-48 (その他の識別子：French National Agency for the Safety of Medicines and Health Products (ANSM))
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個々の参加者データ (IPD) を共有する予定はありますか?
未定
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いいえ
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いいえ
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