Sleep Apnea, Obstructive Clinical Trial
Official title:
A Novel Method of Restoring Menstrual Cyclicity or Ovulatory Function in PCOS Patients: The Use of CPAP to Improve More Than Sleep Quality
The purpose of this study is to determine if treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure in women with both OSA and polycystic ovarian syndrome will improve the regularity of the women's menstrual cycles.
Women seeking fertility treatment at the University of Louisville will be screened for
polycystic ovarian syndrome (PCOS) based on history and then blood work if history suggests
PCOS. After establishing a diagnosis of PCOS based on the National Institute of Health
criteria, they will be screened for impaired glucose tolerance, Class III obesity, and
obstructive sleep apnea [using the Epworth Sleepiness Scale (ESS) as the initial screen]. For
those women that screen positive on the ESS, they will be referred to the University of
Louisville Physicians Sleep Center for a formal sleep study. Only patients with PCOS, severe
obstructive sleep apnea, impaired glucose tolerance, and Class III obesity will qualify for
enrollment in the study. Once enrolled, patients will be encouraged to use continuous
positive airway pressure (CPAP, standard of care for treatment of obstructive sleep apnea)
for at least six months. During those six months, patients will be asked to track their
menstrual cycles and whether they took progesterone to induce a withdrawal bleed during that
time period. The use of ovulation predictor kits to help determine ovulation status will be
encouraged, but not required for the study.
During initial evaluation, patients seeking fertility care having a clinical presentation
concerning for PCOS have their blood drawn for evaluation of thyroid stimulating hormone,
free and total testosterone, antimullerian hormone, and 2 hour glucose tolerance test. At the
conclusion of six months of CPAP therapy, patients will be asked to repeat the above blood
tests for comparison to baseline values.
Women can continue to attempt pregnancy during the study time period if they desire.
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