Obstructive Sleep Apnea Clinical Trial
Official title:
A Randomized Study to Compare Polysomnography With Overnight Home Oximetry and Auto – CPAP for Diagnosis and Nasal CPAP Titration in Patients With a High Probability of Obstructive Sleep Apnea.
This study will look at an alternative new pathway for diagnosis and treatment based on simple procedures in the patient’s own home compared with the current conventional laboratory based pathway. The purpose is to determine whether all patients with OSA require the more elaborate laboratory procedures, or whether a subgroup can be managed more simply.
The research question we are exploring is whether the conventional approach is better in
terms of successful treatment, compliance with treatment, and quality of life. There will be
2 arms to the study. Subject will be randomly assigned to either one of the following two
treatment options: 1) the conventional investigation and nasal CPAP treatment pathway
comprising 2 overnight sleep studies, one for diagnosis and one for determining the required
level of nasal CPAP treatment 2) experimental pathway that uses a simplified home study
(overnight oximetry), together with a machine that automatically adjusts the nasal CPAP
pressure to the required amount, and a careful follow-up during the first 2 weeks of
treatment.
Procedures: The study protocol will require the subject to complete the following procedures
which are part of routine clinical practice: History and Physical Examination by a
physician, Home Oximetry (This simple test involves wearing an oxygen probe gently wrapped
around subject’s finger during a night’s sleep to continuously measure the amount of oxygen
in blood and detect obstructions of subject’s breathing. The probe is easily applied by the
subject and requires no supervision), Spirometry (simple non-invasive breathing test),
Standardized Sleepiness Questionnaires, Orientation and Education regarding nasal CPAP
therapy, and compliance monitoring, Overnight polysomnography (This is the procedure that
requires subject to spend a night in the sleep laboratory with a variety of painless and
non-invasive monitoring devices attached to the body. The purpose is to obtain detailed
information about subject’s sleep quality, breathing, heart function, and body movements
during sleep. Subject will be continuously monitored by a trained technologist during this
procedure.). The following procedures are not routine and subject may be required to
complete some or all of them depending on which pathway assigned to. Follow-up visits to the
Clinic on Days 7 and 14 of nasal CPAP treatment for adjustments of nasal CPAP pressure as
required (this could also be done at home), Repeat Home Oximetry as required, Quality of
Life Questionnaire.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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