Diagnosis and Treatment of Sleep Apnea in Cerebrovascular Disease (Go To Sleep)
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Purpose
Sleep apnea is common among veterans with cerebrovascular disease (stroke or transient ischemic attack [TIA]), leads to hypertension, and is associated with recurrent stroke and death. Although continuous positive airway pressure (CPAP) safely treats sleep apnea, few veterans with cerebrovascular disease are diagnosed with sleep apnea or offered treatment.
| Condition | Intervention | Phase |
|---|---|---|
|
Obstructive Sleep Apnea Stroke Transient Ischemic Attack Hypertension |
Procedure: CPAP Therapy for Newly Diagnosed Obstructive Sleep Apnea (OSA) |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Diagnosis and Treatment of Sleep Apnea in Cerebrovascular Disease |
- Sleep apnea diagnosis rate [ Time Frame: One year ] [ Designated as safety issue: No ]
- Sleep apnea treatment rate [ Time Frame: One year ] [ Designated as safety issue: No ]
- Rate of sleep apnea treatment [ Time Frame: One year ] [ Designated as safety issue: No ]
| Enrollment: | 225 |
| Study Start Date: | December 2008 |
| Study Completion Date: | September 2011 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm 1
The intervention group received unattended polysomnography and auto-titrating CPAP if sleep apnea was diagnosed
|
Procedure: CPAP Therapy for Newly Diagnosed Obstructive Sleep Apnea (OSA)
Continuous Positive Airway Pressure (CPAP) is provided for those patients who are diagnosed with OSA.
|
|
Arm 2
The control group received usual clinical care which may include receipt of sleep diagnostic and therapeutic services
|
Procedure: CPAP Therapy for Newly Diagnosed Obstructive Sleep Apnea (OSA)
Continuous Positive Airway Pressure (CPAP) is provided for those patients who are diagnosed with OSA.
|
Detailed Description:
The project seeks to evaluate whether a diagnostic and therapeutic intervention strategy among veterans with cerebrovascular disease and hypertension using unattended polysomnography and auto-titrating CPAP with a targeted adherence evaluation and educational protocol results in: an improved rate of diagnosed sleep apnea, an improved rate of treated sleep apnea, and lowered mean 24-hour systolic blood pressure. Secondary aims include: to determine whether the intervention strategy reduces the number of antihypertensive medications; to collect data supporting a cost-effectiveness evaluation if the intervention strategy is effective; and to determine whether the intervention strategy reduces daytime sleepiness.
Eligibility| Ages Eligible for Study: | 40 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Stroke or Transient Ischemic Attack Hypertension
Exclusion Criteria:
- Prior diagnosis of sleep apnea or other sleep disorder
- Life expectancy < 6 months or Hospice
- Non-English speaker
- Unable/unwilling to use mask
- Inability to give informed consent
- Oxygen dependent COPD
- Chronic renal failure with dialysis
- Active Suicidal Ideation
Contacts and Locations| United States, Connecticut | |
| VA Connecticut Health Care System (West Haven) | |
| West Haven, Connecticut, United States, 06516 | |
| United States, Indiana | |
| Richard L. Roudebush VA Medical Center | |
| Indianapolis, Indiana, United States, 46202-2884 | |
| Principal Investigator: | Dawn M. Bravata, MD | Richard Roudebush VA Medical Center, Indianapolis |
More Information
Publications:
| Responsible Party: | Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT00984308 History of Changes |
| Obsolete Identifiers: | NCT00807417 |
| Other Study ID Numbers: | IIR 06-233 |
| Study First Received: | September 24, 2009 |
| Last Updated: | April 18, 2013 |
| Health Authority: | United States: Federal Government |
Keywords provided by Department of Veterans Affairs:
|
sleep apnea hypertension brain ischemia |
Additional relevant MeSH terms:
|
Apnea Ischemic Attack, Transient Cerebrovascular Disorders Hypertension Sleep Apnea Syndromes Stroke Sleep Apnea, Obstructive Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory |
Signs and Symptoms Brain Ischemia Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases Sleep Disorders, Intrinsic Dyssomnias Sleep Disorders |
ClinicalTrials.gov processed this record on May 23, 2013