Obstructive Sleep Apnea Clinical Trial
Official title:
Prospective, Randomized, Placebo Controlled Trial Assessing the Effects of Ezopiclone on the Quality of Overnight Polysomnography and CPAP Titration
Patients often have difficulty sleeping during overnight sleep testing in a lab environment. The purpose of this study is to determine if taking a sleep aid will improve sleep and therefore the quality of the sleep study.
The increasing awareness of sleep-disordered breathing (i.e obstructive sleep apnea) has
created a growing demand for polysomnography (sleep study), resulting in excessive waiting
times in many laboratories. Sleep centers have therefore needed to develop methods to
improve their efficiency. Unfortunately many patients find it difficult to fall asleep in
the unfamiliar environment of a laboratory setting (the "first-night effect"), circumstances
that may prolong falling alseep and staying sleep. Likewise, intolerance of continuous
positive airway pressure (CPAP) may also reduce the quality of the sleep study. Poor quality
studies may lead to an inability to make a diagnosis or adequately titrate CPAP therapy.
Unsatisfactory studies may need to be repeated.
Sleep aids (hypnotics) are commonly used to treat both acute and chronic insomnia. These
agents have minimal side-effects and do not disrupt normal sleep architecture or alter
respiratory events. These attributes make such agents ideal for use to improve the quality
of sleep studies and enhance the efficiency of sleep centers.
In a recent retrospective review, we found that the use of a hypnotic prior to the sleep
study resulted improved patient satisfaction and improved quality of the sleep study with
significantly less studies needing to be repeated. Although promising, these results must be
validated with a prospective, randomized, placebo-controlled trial.
Eszopiclone (Lunesta) is a new non-narcotic, non-benzodiazepine hypnotic agent which
received FDA approval on December 15, 2004 for the treatment of acute and chronic insomnia.
Multiple clinical trials have found that eszopiclone decreases sleep latency, improves sleep
efficiency/maintenance and reduces wake time after sleep onset (WASO). Given its efficacy in
promoting sleep onset and sleep maintenance and its excellent safety profile, this agent
should be ideal as a pre-study sedative. The purpose of this study is to validate the use of
Lunesta in improving the quality of overnight sleep studies.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Diagnostic
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