CPAP vs ASV for Insomnia

Insomnia Clinical Trial

— P2P  

Official title:

PAP to PAP: CPAP vs ASV for Insomnia Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02365064
• Other study ID #: 682031-1_MA20150206
• Status: Completed
• Phase: N/A
• Start date: February 2015
• Est. completion date: December 1, 2017

Study information

• Verified date: May 2021
• Source: ResMed
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The study will determine which of two different types of positive airway pressure (PAP therapy) modes are more effective in reducing sleep breathing events in chronic insomnia patients and in decreasing insomnia severity.

Description:

Patients presenting to the sleep clinic with a primary complaint of insomnia will be potential participants for this study. Following diagnostic polysomnography (PSG) testing, insomnia patients diagnosed with SDB and meeting inclusion criteria will be randomized to a PAP treatment arm, CPAP or ASV. Participants will complete titration studies with their assigned PAP mode and attend clinical follow-up appointments over a 14-16 week timeframe. Titration PSG studies will assess PAP pressure needs to ensure that patients are receiving optimal therapy at all times during this study. PAP adaptation barriers will be addressed as they arise during the study, because it is important that participants are able to use PAP therapy nightly during participation in this protocol. Baseline scores on insomnia severity, sleep quality, subjective insomnia parameters, sleep related impairment, and quality of life will be compared to outcome measures at the 4 month mark. Pre-treatment and post-treatment objective improvements on sleep studies will also be compared including sleep breathing indices, sleep consolidation indices, and objective data download information.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 78
• Est. completion date: December 1, 2017
• Est. primary completion date: August 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Primary complaint of insomnia when presenting at clinic

• Diagnosis of moderate to severe insomnia through the Insomnia Severity Index (ISI) with a score = 15

• Meet diagnostic criteria of Insomnia Disorder (per American Academy of Sleep Medicine)

• Diagnosis of SDB, either OSA as determined by an AHI = 5 events/hour or UARS with a RDI = 15 events/hour and AHI < 5 events/hour

• Naïve to treatment for sleep-disordered breathing (SDB), including CPAP, APAP, ASV; mandibular repositioning devices (MRDs), and any other nasal or oral therapy with a primary indication of treating SDB

• Able to fully understand study information in English and sign informed consent

Exclusion Criteria:

• Primary complaint of sleep-disordered breathing or issues with apneas during sleep

• Severe respiratory disorder or severe sleep disorder such as restless leg syndrome (RLS), idiopathic hypersomnia, or narcolepsy

• BMI > 30 kg/m2

• Epworth Sleepiness Scale (ESS) score = 10

• Frequent napping behavior, such as a few times a week or more

• Anticipated changes to start or stop sedative or psychotropic medications during the course of the trial

• Medical history of congestive heart failure (CHF) or other potentially unstable cardiac disease as well as chronic lung diseases or other debilitating medical conditions that manifest as more prominent in the patient's health compared to their sleep complaints

• Daily use of opiate medications

• Known contraindications to PAP therapy as listed in the indication for use

• Requires a CPAP (fixed) pressure > 20 cm H2O

• Inability to comply with study procedures

Related Conditions & MeSH terms

• Insomnia
• Sleep Apnea Syndromes
• Sleep Initiation and Maintenance Disorders
• Sleep-Disordered Breathing

Intervention

Device:
• AirCurve 10 ASV
Device is able to provide both ASV therapy and CPAP therapy modes.

Locations

Country	Name	City	State
United States	Maimonides Sleep Arts & Sciences	Albuquerque	New Mexico

Sponsors (1)

Lead Sponsor	Collaborator
ResMed

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Insomnia Severity Index	Change in insomnia severity from baseline to 4 months as measured by subjective questionnaire. The Insomnia Severity Index has seven questions. The seven answers are added up for a total score. Scores range from 0 - 28. A higher score indicates a more severe degree of insomnia.	Baseline and 4 months
Secondary	Sleep Quality Rating	8 point Likert scale for change in subjective sleep quality from baseline to 4 months. Lower scores indicated more positive sleep quality. A score 0 indicates excellent sleep quality, and a score of 7 indicates very poor sleep quality	Baseline and 4 months
Secondary	Global Morning Rating	Change in subjective rating from baseline to 4 months based on a 0-100% scale. Lower scores equal a more positive experience	4 months
Secondary	Sleep Onset Latency	Change in from baseline to 4 months in sleep onset time (minutes)	4 months
Secondary	Wake After Sleep Onset (WASO)	Change from baseline to 4 months for WASO in minutes	4 months
Secondary	Sleep Efficiency	Change from baseline to 4 months in sleep efficiency (total sleep time/time in bed)	4 months