Obstructive Sleep Apnea Clinical Trial
Official title:
Initiation of Auto-adjusting Continuous Positive Airway Pressure (CPAP) for Management of Newly Diagnosed Obstructive Sleep Apnea (OSA) in Hospitalized Patients: A Pilot Study
This study will test the following hypotheses:
1. Treatment of newly diagnosed Obstructive Sleep Apnea (OSA) in acutely ill patients with
auto-adjusting Continuous Positive Airway Pressure (CPAP) would result in fewer
in-hospital complications, as compared to no treatment (primary outcome).
2. Treatment of newly identified OSA in acutely ill patients with auto-adjusting CPAP would
result in shorter length of stay, lower re-admission rate, better blood pressure (BP)
control, better long term compliance with OSA treatment, as compared to no treatment
(secondary outcomes).
This will be a pilot study performed as a randomized controlled prospective study of patients
admitted to the general medical floors at MetroHealth Medical Center (MHMC). This study will
be an add-on investigation to an original funded study: "Evaluation of Screening Tools for
Obstructive Sleep Apnea (OSA) in Hospitalized Medical Patients: A Validation Study" (the
STOMP study).
In the STOMP study, patients admitted Sunday through Thursday (day or night) to MHMC who meet
inclusion/exclusion criteria and are willing to participate in the study will complete the
STOMP study by undergoing an in-hospital PSG (within 48 hours of admission to the medical
floor). Those who's PSG shows clinically significant OSA (an apnea-hypopnea index (AHI) > 5)
will be approached for participation in this study. It is anticipated that at least 50
patients from the STOMP study will be eligible for randomization into this study.
Participants will be randomized into an auto-adjusting Continuous Positive Airway Pressure
(ACPAP) (ResMed S9) arm or a standard therapy arm (control - no specific therapy for OSA
other than possibly supplemental nocturnal oxygen if deemed necessary by the clinicians
caring for the patient). Those randomized to ACPAP will continue this therapy until they
undergo a repeat diagnostic sleep study (PSG) and then, if indicated, a titration PSG as an
outpatient. Those in the standard therapy arm will receive no specific treatment for their
OSA until they undergo a a repeat diagnostic study and then, if indicated, a full night
titration PSG as an outpatient. Once the titration PSG has taken place, subjects will be
changed to fixed CPAP and followed for an additional 6-8 weeks to assess compliance with
therapy.
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