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Sponsored by: |
National Heart, Lung, and Blood Institute (NHLBI) |
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Information provided by: | National Heart, Lung, and Blood Institute (NHLBI) |
ClinicalTrials.gov Identifier: | NCT00607893 |
Sleep-disordered breathing (SDB) is a condition in which a person experiences frequent breathing pauses during sleep, also known as sleep apnea. There is evidence that the recurrent sleep arousal and associated shortage of oxygen in the body may increase risk for cardiovascular disease (CVD). It is believed that treatment with continuous positive airway pressure (CPAP) may reduce certain risk factors for heart disease, including markers of inflammation and oxidative stress. This study will evaluate the effectiveness of CPAP in reducing CVD risk factors in people with SDB.
Condition | Intervention |
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Sleep Apnea Syndromes Oxidative Stress Cardiovascular Diseases |
Device: Continuous Positive Airway Pressure (CPAP) Device: Sham CPAP |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Outcomes Assessor), Placebo Control, Parallel Assignment, Efficacy Study |
Official Title: | Oxidative Stress in Sleep Apnea and Cardiac Disease |
Estimated Enrollment: | 250 |
Study Start Date: | September 2006 |
Estimated Study Completion Date: | July 2011 |
Estimated Primary Completion Date: | July 2011 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Sham Comparator
Participants will receive sham continuous positive airway pressure for a 2 month period
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Device: Sham CPAP
Participants will use the lower pressure CPAP every night for 8 weeks.
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2: Experimental
Participants will receive continuous positive airway pressure for a 2 month period
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Device: Continuous Positive Airway Pressure (CPAP)
Participants will use the higher pressure CPAP, as determined by an in-laboratory attended titration study, every night for 12 weeks.
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It is estimated that 18 million Americans are affected by SDB. SDB involves repeated sleep arousal caused by breathing difficulties. These frequent sleep disruptions may cause a person to experience daytime drowsiness, impaired mental functioning, and trouble concentrating or staying alert. SDB is also associated with an increased risk of certain cardiovascular diseases, such as high blood pressure and heart disease. Researchers believe that increased oxidative stress and inflammation associated with SDB may play a role in the physiologic pathway linking SDB and CVD. However, more information on the SDB-CVD relationship is needed to be able to identify risk factors for CVD and to discover the best means of treatment. CPAP, a current treatment for SDB, acts by delivering air through a mask during sleep. CPAP helps improve overnight breathing and quality of sleep and may, in turn, decrease oxidative stress and associated CVD risks. This study will compare the effectiveness of CPAP versus placebo CPAP in reducing CVD risk factors, such as oxidative stress markers, in people with SDB.
Participation in this study will last between 2.5 and 4 months and will include four to five study visits. During the first study visit, participants will undergo a CPAP titration study, which will involve appropriate CPAP mask fitting and an overnight sleep test to determine the best CPAP pressure, as well as a lower placebo pressure, for each participant. Participants will also be provided educational information on diet, sleep, and the use of CPAP as a treatment for sleep apnea. After the titration study, participants will be asked to wear their fitted CPAP mask every night for the next 2 weeks, during which they will use the lower (placebo) pressure one week and use the higher pressure the other week. During this time, a technician will contact participants every 3 to 4 days to address any questions or problems with the CPAP equipment.
One month later, participants who were able to tolerate and use CPAP most nights will attend Visit 2. This second visit will include an overnight sleep study without wearing the CPAP mask; blood and saliva collection; cheek brushing for genetic material; tests on diabetes, artery stiffness, and circulation; body fat measurements; and questionnaires. Participants will then be randomly assigned to use either the higher pressure CPAP or the lower pressure CPAP for 8 weeks. Visit 3 will occur 1 week after beginning CPAP treatment and will include a fasting blood test. During treatment, participants will be periodically contacted by a technician to check on equipment status.
Upon completing treatment, participants will undergo repeat tests from Visit 2, except that they will wear the CPAP mask in the overnight sleep test. This fourth study visit will mark the completion of treatment for participants assigned to the lower pressure CPAP. Participants assigned to the higher pressure CPAP will be asked to use CPAP for 4 more weeks. These participants will return at the end of the 4 weeks for a final visit, which will include a repeat sleep study and other testing.
Ages Eligible for Study: | 20 Years to 75 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
Contact: Sandra Stennis, BS | 216-368-0083 | sds76@case.edu |
Contact: Reena Mehra, MD, MS | 216-844-5128 | reena.mehra@case.edu |
United States, Ohio | |
University Hospitals Case Medical Center | Recruiting |
Cleveland, Ohio, United States, 44106 | |
Contact: Sandra Stennis, BS 216-368-0083 sds76@case.edu | |
Contact: Reena Mehra, MD, MS 216-844-8489 mehrar@ameritech.net | |
Principal Investigator: Reena Mehra, MD, MS |
Principal Investigator: | Reena Mehra, MD, MS | University Hospitals Case Medical Center |
Responsible Party: | University Hospitals Case Medical Center ( Reena Mehra, MD, MS ) |
Study ID Numbers: | 562, K23 HL079114 |
Study First Received: | January 25, 2008 |
Last Updated: | August 13, 2009 |
ClinicalTrials.gov Identifier: | NCT00607893 History of Changes |
Health Authority: | United States: Federal Government |
Sleep-Disordered Breathing |
Signs and Symptoms Sleep Apnea Syndromes Heart Diseases Respiratory Tract Diseases Apnea Respiration Disorders |
Dyssomnias Sleep Disorders Signs and Symptoms, Respiratory Stress Sleep Disorders, Intrinsic |
Sleep Apnea Syndromes Disease Apnea Nervous System Diseases Respiration Disorders Stress Dyssomnias Sleep Disorders |
Sleep Disorders, Intrinsic Signs and Symptoms Pathologic Processes Respiratory Tract Diseases Syndrome Signs and Symptoms, Respiratory Cardiovascular Diseases |