Obstructive Sleep Apnea Clinical Trial
Official title:
Hypnotics to Improve Polysomnography Yield: Eszopiclone vs Ramelteon?
This study is being conducted to determine if eszopiclone is as effective as ramelteon when used as a pre-medication (sleeping pill) in sleep studies performed to diagnose and treat sleep apnea.
Many Veterans suffer from sleep disordered breathing with a high prevalence of undiagnosed
obstructive sleep apnea. One test that can be effective in the diagnosis of sleep apnea is
the polysomnogram (PSG). Split-night PSG consists of a diagnostic phase in the first half of
the night and a continuous positive airway pressure titration (CPAP) in the second half of
the night. CPAP is the standard, most effective therapy for obstructive sleep apnea. Due to
the unfamiliar sleep environment of the laboratory and instrumentation that must be used
(application of electroencephalogram leads), patients are frequently not able to sleep
adequately. In these cases, the PSG must be repeated. Oral hypnotic agents are often used as
a pre-medication to increase the yield of PSG in an attempt to decrease the need for repeat
studies.
Numerous data is available on the effects of premedication with oral short-acting hypnotics
on PSG quality and efficacy of CPAP titration. In one study, eszopiclone, a
nonbenzodiazepine gaba-receptor agonist short-acting hypnotic, has been shown to improve PSG
quality and CPAP titration. Another short-acting hypnotic, ramelteon, was recently approved
by FDA but the effects of ramelteon in improving PSG quality and efficacy of CPAP titration
are unclear. The advantage of ramelteon over eszopiclone is the lack of drug dependency or
abuse potential. This study aims to evaluate the efficacy of ramelteon compared to
eszopiclone when administered prior to split-night PSG and CPAP titration.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Diagnostic
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