Sleep Apnea Syndrome and Community Acquired Pneumonia (NEBULOSA)
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Purpose
The association of sleep apnea-hypopnea syndrome (SAHS) with the infections of the lower airway has not been studied. The aspiration of secretions of the upper airway and the colonization by microorganisms is considered a main event in most of the cases of community acquired pneumonia (CAP) , and specially in the nosocomial pneumonia. The silent aspiration to the lower airway is a common phenomenon in normal subjects during the sleep and some studies has reported that the patients with SAHS present an increase of the risk to pharyngeal aspirations. In fact, the presence of nasal and bronchial inflammation in patients with SAHS is a recognized event. The patients with SAHS could have a risk increased to develop pneumonia due to predisposition to the pharyngeal microaspiration to lower airways during the sleep and other mechanical factors associated. The prevalence of SAHS in patients with CAP could be increased as regards the data published for the same Spanish population. The presence of an apnea-hypopnea index (AHI) could be a risk factor not only to to CAP but to to present a unfavorable clinical evolution in comparison to patients with CAP with a normal AHI. The aim of this study will establish a relation between SAHS and the pneumonia risk.
| Condition | Intervention |
|---|---|
|
Sleep Apnea Syndrome Polygraphy Community Acquired Pneumonia Infections |
Device: abbreviated polysomnography |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Prevalence of Sleep Apnea-hypopnea Syndrome in Patients With Community Acquired Pneumonia, Prospective and Comparative Case-control Study |
- To evaluate the prevalence of sleep anea-hypopnea syndrome in patients with community acquired pneumonia, defined by an apnea-hypopnea index more to 12 measured by respiratory polygraphy [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- To evaluate if the apnea-hypopnea index is a factor risk to community acquired pneumonia [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- To evaluate if a high apnea-hypopnea index is observed in patients with community acquired pneumonia and if is maintained after the pneumonia resolution [ Time Frame: 2 years ] [ Designated as safety issue: No ]
| Enrollment: | 123 |
| Study Start Date: | April 2006 |
| Study Completion Date: | December 2008 |
| Primary Completion Date: | December 2008 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Control Group (B): Other Infections
Other infections admitted to the hospital
|
Device: abbreviated polysomnography
Both groups will be studied with in-hospital respiratory polygraphy during the sleep. The group A will be studied with another respiratory polygraphy in the home one month after the resolution of CAP. Some questionnaires to measure the sleepiness (Epworth test), FOSQ test, in-home sleepiness questionnaire and symptoms questionary will be obtained in Group A and B
Other Names:
|
|
Community Acquired Pneumonia (Group A)
Patients admitted to hospital with Community Acquired Pneumonia defined by respiratory symptoms, fever and lung infiltrates
|
Device: abbreviated polysomnography
Both groups will be studied with in-hospital respiratory polygraphy during the sleep. The group A will be studied with another respiratory polygraphy in the home one month after the resolution of CAP. Some questionnaires to measure the sleepiness (Epworth test), FOSQ test, in-home sleepiness questionnaire and symptoms questionary will be obtained in Group A and B
Other Names:
|
Detailed Description:
This is a prospective comparative case control study to compare the prevalence of sleep apnea-hypopnea syndrome in patients with community acquired pneumonia (CAP).
Patients hospitalized with CAP (Group A)will be studied with respiratory polygraphy during the sleep and a second respiratory polygraphy will be conducted in home after the curation of the pneumonia (one month). During the admission, etiological study including blood cultures, serology, urinary antigens for legionella and S, pneumoniae, sputum cultures and other invasive techniques as bronchoscopy when appropriate will be obtained. Questionnaires related with sleep apnea-hypopnea syndrome will be obtained consisting in Epworth test, symptoms questionnaires and FOSQ test.
Group B are patients with other infections as urinary, bone, pelvic infections excluding upper or lower respiratory infections. Respiratory polygraphy will be performed in this group as in the group A obtaining the same questionnaires.
We compare the variables of respiratory polygraphy, questionnaires scores, percentage of patients with an AHI > 12 between both groups and we compare the variables obtained in the respiratory polygraphy performed in hospital and at home in the group A to evaluate if the condition of an altered AHI was previous to the CAP episode. We will obtain the prevalence of sleep apnea-hypopnea patients in both groups and we compare factor risks (COPD, diabetes mellitus, bronchial asthma, etc) between A and B. Finally multivariable analysis is conducted to evaluate the contribution of the AHI to CAP, as other recognize factor risk.
Both groups are paired by age, sex and body mass index
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Patients admitted to hospital with the diagnosis of community acquired pneumonia, excluding nosocomial pneumonia compared to patients with other infections excluding respiratory infections, admitted to hospital, paired by age, sex and body mass index
Group A:
Inclusion Criteria:
- Hospital admission and Community acquired pneumonia
Exclusion Criteria:
- Nosocomial infections
- Low level of conscientiousness
- Neurological disease
- Impossibility to complete the questionnaires
Group B
Inclusion Criteria:
- Hospital admission and other infections different to respiratory infections
Contacts and Locations| Spain | |
| Sección de Neumología. Hospital Universitario San Juan de Alicante | |
| San Juan de Alicante, Alicante, Spain, 03550 | |
| Study Director: | Eusebi Chiner, MD | Head of Pneumology Section |
| Principal Investigator: | Mónica Llombart, MD | Consultant |
More Information
No publications provided
| Responsible Party: | Eusebi Chiner/ Pneumology Chairman Hospital Universitario San Juan de Alicante, Hospital Universitario San Juan de Alicante |
| ClinicalTrials.gov Identifier: | NCT01071421 History of Changes |
| Other Study ID Numbers: | NEBULOSA PROJECT |
| Study First Received: | February 18, 2010 |
| Last Updated: | February 18, 2010 |
| Health Authority: | Spain: Comité Ético de Investigación Clínica |
Keywords provided by Hospital Universitario San Juan de Alicante:
|
Sleep apnea syndrome community acquired pneumonia prevalence |
Additional relevant MeSH terms:
|
Apnea Pneumonia Sleep Apnea Syndromes Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory Signs and Symptoms |
Lung Diseases Respiratory Tract Infections Sleep Disorders, Intrinsic Dyssomnias Sleep Disorders Nervous System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013