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Apnea Positive Pressure Long-Term Efficacy Study
This study is currently recruiting patients
Verified by National Heart, Lung, and Blood Institute (NHLBI) April 2006
| Sponsored by: |
National Heart, Lung, and Blood Institute (NHLBI) |
| Information provided by: |
National Heart, Lung, and Blood Institute (NHLBI) |
| ClinicalTrials.gov Identifier: |
NCT00051363 |
Purpose
The purpose of this study is to determine the effectiveness of nasal continuous positive airway pressure (CPAP) therapy for the treatment of obstructive sleep apnea syndrome (OSAS).
| Condition |
Intervention |
Phase |
Lung Diseases Sleep Apnea Syndromes Sleep |
Device: Positive Pressure Respiration |
Phase III |
Study Type: Interventional Study Design: Treatment, Randomized
Official Title: APPLES: Apnea Positive Pressure Long-Term Efficacy Study
Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):
Primary Outcomes: Effect of CPAP on neurocognitive function (measured at Month 6) Secondary Outcomes: Attention and psychomotor (A/P) function; Learning and memory (L/M) function; Executive and frontal-lobe (E/F) function; Sleepiness/Alertness; Mood; Quality of Life (all measured at Month 6)
Expected Total Enrollment:
1100
Study start: September 2002
BACKGROUND:
Nasal CPAP therapy is in widespread use as the primary treatment for OSAS, a sleep-related breathing disorder affecting more
than 15 million Americans. The therapeutic effectiveness of CPAP in providing significant, stable, and long-term neurocognitive
or other functional benefits to patients with OSAS has not been systematically investigated.
DESIGN NARRATIVE:
The study is a randomized, blinded, sham-controlled, multi-center trial of CPAP therapy. The principal aims of the study
are: 1) to assess the long-term effectiveness of CPAP therapy on neurocognitive function, mood, sleepiness, and quality of
life by administering tests of these indices to subjects randomly assigned to active or sham CPAP; 2) to identify specific
neurocognitive deficits associated with OSAS in a large, heterogeneous subject population; 3) to determine which deficits
in neurocognitive function in OSAS subjects are reversible and most sensitive to the effects of CPAP; 4) to develop a composite
multivariate outcome measure from the results of this study that can be used to assess the clinical effectiveness of CPAP
in improving neurocognitive function, mood, sleepiness, and quality of life; and 5) to use functional magnetic resonance
imaging to compare cortical activation before and after CPAP therapy, and to assess whether this change is associated with
improvement in specific neurocognitive task performance. The primary endpoint of the study is the effect of six months of
CPAP treatment on neurocognitive function. A total of 1100 subjects (550 per treatment group) will be enrolled from the patient
populations at five sites (Stanford University; University of Arizona; Harvard Medical School; St. Luke's Hospital, Missouri;
St. Mary's Hospital, Washington).
Eligibility
Ages Eligible for Study:
18 Years and above,
Genders Eligible for Study:
Both
Criteria
Inclusion Criteria:
- Male or female adults age 18 years or older with a diagnosis of OSAS using clinical criteria defined by the study protocol
- Study participation may require seven or more laboratory visits over six months
Exclusion Criteria:
- Prior treatment for OSAS with continuous positive airway pressure or surgery
- Potential sleep apnea complications that may affect the health or safety of the participant, including low blood oxygen, recent
near-miss or prior automobile accident due to sleepiness, congestive heart failure, history of angina, coronary artery disease,
myocardial infarction or stroke, cardiac rhythm disturbance, and chronic neurological disorders affecting neurocognitive abilities
or daily function
- The use of hypnotics, anxiolytics, sedating antidepressants, anticonvulsants, sedating antihistamines, stimulants or other
medications likely to affect neurocognitive function and/or alertness
- Respiratory disease requiring medications (unless on stable medications for 2 months)
- Cancer, unless in remission for greater than one year and not taking exclusionary medications
- Self-reported renal failure
- Pregnancy anytime during a subject's participation
- Psychiatric illness, as defined by a DSM-IV diagnosis, except for depression or mild anxiety
- Narcolepsy, idiopathic hypersomnolence, DSM-IV chronic insomnia, restless legs syndrome, or rapid eye movement (REM) behavior
disorder
- Current use of diurnal or nocturnal supplemental oxygen
- Significant vision, hearing, or coordination problems
- Difficulty understanding or speaking English
- Currently working night or rotating shifts
- Consumption of >10 caffeinated beverages per day (approximately 1,000 mg per day)
- Smokers whose habit interferes with the overnight polysomnogram or with the battery of testing during the day
- Consumption of >2 alcoholic beverages per day
- Any illicit drug usage or marijuana usage >1/wk
- Any individual in the household currently on CPAP or on CPAP in the past
- A score of 26 or less on the Mini Mental State Examination (MMSE)
Location
and Contact
Information
Please refer to this study by ClinicalTrials.gov identifier
NCT00051363
ArizonaUniversity of Arizona AHSC, Tucson,
Arizona,
85724,
United States; Recruiting
CaliforniaStanford University School of Medicine, Palo Alto,
California,
94305,
United States; Recruiting
MassachusettsBrigham & Women's Hospital, Boston,
Massachusetts,
02459,
United States; Recruiting
MissouriSt. Luke's Hospital, Chesterfield,
Missouri,
63017,
United States; Recruiting
WashingtonSt. Mary Medical Center, Walla Walla,
Washington,
99362,
United States; Recruiting
Kevin Hurburt
509-522-5845
hurlke@smmc.com
Richard Simon, Principal Investigator
Study chairs or principal investigators
William Dement, Principal Investigator, Stanford University
More Information
Study ID Numbers:
150; U01 HL068060
Last Updated:
May 16, 2006
Record first received:
January 9, 2003
ClinicalTrials.gov Identifier:
NCT00051363Health Authority: United States: Federal Government ClinicalTrials.gov processed this record on 2006-10-18
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