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Effects of Treating Obstructive Sleep Apnea in Epilepsy

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Beth Ann Malow, Vanderbilt University
ClinicalTrials.gov Identifier:
NCT00047463
First received: October 7, 2002
Last updated: January 14, 2014
Last verified: January 2014
  Purpose

The purpose of this trial is to work out design issues prior to conducting a definitive phase 3 trial to determine whether treating sleep-related breathing disorders in people with epilepsy results in improvement in seizure control or an improvement in alertness during the day.


Condition Intervention Phase
Epilepsy
Sleep Apnea
Obstructive Sleep Apnea
Device: continuous positive airway pressure (CPAP)
Device: Placebo-CPAP
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: Effects of Treating Obstructive Sleep Apnea in Epilepsy

Resource links provided by NLM:


Further study details as provided by Vanderbilt University:

Primary Outcome Measures:
  • CPAP Adherence/Tolerance as Measured by Proportion of Nights [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
    This measure quantifies how well patients use their CPAP. The standard unit of measurement is proportion of nights that the CPAP is used by a participant. Data were downloaded by a card placed in the CPAP machine reflecting use over the entire 10 weeks.


Secondary Outcome Measures:
  • Ability to Blind CPAP [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
  • Need for One vs. Two Nights of Baseline Sleep Studies [ Time Frame: 1 night ] [ Designated as safety issue: No ]
  • Ability to Screen for Sleep Apnea With a Questionnaire [ Time Frame: 1 day ] [ Designated as safety issue: No ]

Enrollment: 35
Study Start Date: September 2002
Study Completion Date: July 2008
Primary Completion Date: July 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
continuous positive airway pressure (CPAP)
Device: continuous positive airway pressure (CPAP)
a mask treatment for sleep apnea
Placebo Comparator: 2
Placebo-CPAP
Device: Placebo-CPAP
Placebo-CPAP

Detailed Description:

Despite appropriate treatment with medications, individuals with epilepsy often continue to have seizures, and many suffer from excessive daytime sleepiness and poor quality of life. Evidence from case studies suggests that treatment of coexisting obstructive sleep apnea (OSA)-stoppage in breathing during sleep-can reduce the frequency of seizures in people with epilepsy that is resistant to antiepileptic medication.

In this study, individuals with symptoms of OSA and 2 or more seizures a month who meet study criteria will undergo polysomnography, a test that continuously monitors normal and abnormal physiological activity during sleep. Those individuals who test positive for OSA will be randomized to either therapeutic or placebo continuous positive airway pressure (CPAP)-a mask treatment for sleep apnea-for 10 weeks, during which time seizure frequency, daytime sleepiness, health-related quality of life, and CPAP compliance will be assessed.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age of 18 years or older.
  • A history supportive of obstructive sleep apnea.
  • Subject is able and willing to provide informed consent and to cooperate with polysomnography.
  • Four or more quantifiable seizures per month.
  • Subjects and their physicians agree to have their medication regimens optimized so that they are on the best regimen titrated to therapeutic benefit prior to the baseline phase of the study.

Exclusion Criteria:

  • Seizures secondary to drugs, alcohol, infection, neoplasia, demyelination, metabolic illness, or progressive degenerative disease.
  • Non-epileptic spells (e.g., pseudoseizures) alone or in combination with epileptic seizures.
  • Narcolepsy or another primary sleep disorder that requires intervention with medications and which may affect results of study (e.g., severe periodic limb movement disorder).
  • Effectively treated OSA or prior exposure to continuous positive airway pressure.
  • History of poor compliance with antiepileptic medications.
  • Current treatment with the vagus nerve stimulator.
  • Pregnancy.
  • A significant history of medical or psychiatric disease which may impair participation in the trial.
  • A history of alcohol or drug abuse during the one-year period prior to trial participation.
  • Evidence of medical instability (e.g., congestive heart failure, cardiac arrhythmias, pulmonary disease) due to obstructive sleep apnea.
  • Subjects who are unaware of the majority of their seizures and lack a reliable witness.
  • Greater than ten seizures a day.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00047463

Locations
United States, Michigan
University of Michigan
Ann Arbor, Michigan, United States, 48109
United States, North Carolina
University of North Carolina
Chapel Hill, North Carolina, United States, 27599
United States, Ohio
Cleveland Clinic Foundation
Cleveland, Ohio, United States, 44195
United States, Tennessee
Vanderbilt University
Nashville, Tennessee, United States, 37232
Sponsors and Collaborators
Vanderbilt University
Investigators
Principal Investigator: Beth Malow, M.D., M.S. Vanderbilt University
  More Information

Publications:
Responsible Party: Beth Ann Malow, Professor of Neurology, Vanderbilt University
ClinicalTrials.gov Identifier: NCT00047463     History of Changes
Other Study ID Numbers: IRB030633, R01NS42698
Study First Received: October 7, 2002
Results First Received: November 18, 2009
Last Updated: January 14, 2014
Health Authority: United States: Federal Government

Keywords provided by Vanderbilt University:
epilepsy
sleep apnea
obstructive sleep apnea
continuous positive airway pressure
CPAP

Additional relevant MeSH terms:
Sleep Apnea Syndromes
Sleep Apnea, Obstructive
Apnea
Epilepsy
Brain Diseases
Central Nervous System Diseases
Dyssomnias
Nervous System Diseases
Respiration Disorders
Respiratory Tract Diseases
Signs and Symptoms
Signs and Symptoms, Respiratory
Sleep Disorders
Sleep Disorders, Intrinsic

ClinicalTrials.gov processed this record on November 24, 2014