Sleep Apnea, Central Clinical Trial
Official title:
Dynamic Carbon Dioxide Administration for Central Sleep Apnoea in Heart Failure
Normally breathing is controlled by a reflex that responds to the levels of carbon dioxide
(CO2) in the blood. In heart failure, where the heart muscle is damaged and therefore does
not pump as well, this reflex is exaggerated. The result is a vicious circle: blood CO2
levels fluctuate wildly and as a result breathing also fluctuates with patients
hyperventilating at times and briefly stopping breathing at others. During sleep this is
called central sleep apnoea (CSA).
Patients with CSA wake up throughout the night and whilst some patients are oblivious to
this, others are consciously breathless and many patients are tired during the day and feel
unable to perform their daily activities.
As part of the body's stress response to the erratic pattern of breathing, both blood
pressure and heart rate may rise to a level that is harmful in a failing heart, exacerbating
the underlying heart failure. Indeed patients who demonstrate this CSA die sooner than those
who have heart failure and stable breathing.
There are no proven specific therapies for CSA that stabilise breathing, improve sleep
quality, and prolong life. We have designed a system which delivers very small doses of CO2,
when the blood level of CO2 is predicted to be low. During short daytime recordings, using
this system, we have demonstrated that it is possible to stabilise the body's CO2 levels.
We aim to test what happens when CO2 is given overnight whilst the patient is sleeping to
see whether we can stabilise their breathing over longer durations and whether sleep quality
could be improved so that patients are less tired during the day. In addition, we would like
to measure whether the stress response is lessened if the breathing is successfully
stabilised.
n/a
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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