Effects of Obstructive Sleep Apnea Treatment by Fixed CPAP and by Auto-CPAP (Somnosmart2)

NCT ID: NCT00633711

Last Updated: 2011-06-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

17 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-03-31

Study Completion Date

2010-03-31

Brief Summary

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The main purpose of this study is to investigate if treatment of obstructive sleep apnea syndrome (OSAS) by continuous positive airway pressure (CPAP) given by a traditional CPAP device administering a fixed air pressure, or by one automatic CPAP device ("Somnosmart2", Weinmann, Hamburg) administering variable pressures, have different effects on sympathetic nervous system tone (as reflected by urinary excretion of norepinephrine and its catabolite normetanephrine) and on blood pressure.

Detailed Description

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A nocturnal home cardiorespiratory recording will performed for diagnosis of OSA. During the same night, patients will be asked to collect their urines. Twentyfour-hour ambulatory BP monitoring (ABPM) will be performed starting from the next morning. After analysis of the polygraphic recording, subjects with AHI \<15 will be excluded from the study, while CPAP will be proposed as a treatment to the other patients.

Before starting treatment, a full night standard polysomnography will be performed: in subjects assigned to fixed CPAP for attended CPAP titration; in the other subjects during application of the Somnosmart2 device, to verify if obstructive events are adequately eliminated by it.

After analysis of polysomnography, patients will be given a fixed CPAP or the auto-CPAP device for nocturnal home use. Two months later, compliance to treatment will be verified measured by the in-built time counter of the devices. Then, cardiorespiratory monitoring during application of the device used for treatment, nocturnal urine collection and 24-hour ABPM will be repeated.

Conditions

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Obstructive Sleep Apnea Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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fixed CPAP

Group Type ACTIVE_COMPARATOR

fixed continuous positive airway pressure (CPAP)

Intervention Type DEVICE

CPAP at a constant level, whose efficacy on respiratory disorders has been determined by nocturnal titration.

Home nocturnal usage. Two-month treatment.

Auto-CPAP

Auto-CPAP Weinmann "Somnosmart2"

Group Type EXPERIMENTAL

Automatic (variable, automatically controlled) pressure CPAP

Intervention Type DEVICE

CPAP at a variable level according to instantaneous patients' needs for treatment of sleep respiratory disorders, as evaluated by machine's software.

Home nocturnal usage. Two-month treatment.

Interventions

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Automatic (variable, automatically controlled) pressure CPAP

CPAP at a variable level according to instantaneous patients' needs for treatment of sleep respiratory disorders, as evaluated by machine's software.

Home nocturnal usage. Two-month treatment.

Intervention Type DEVICE

fixed continuous positive airway pressure (CPAP)

CPAP at a constant level, whose efficacy on respiratory disorders has been determined by nocturnal titration.

Home nocturnal usage. Two-month treatment.

Intervention Type DEVICE

Other Intervention Names

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Automatic CPAP "SOMNOsmart2", Weinmann, Hamburg Germany fixed CPAP, constant level CPAP

Eligibility Criteria

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Inclusion Criteria

* Obstructive sleep apnea syndrome deserving CPAP treatment

Exclusion Criteria

* current pharmacological treatment
Minimum Eligible Age

25 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Weinmann Geräte für Medizin GmbH + Co. KG

INDUSTRY

Sponsor Role collaborator

Fondazione C.N.R./Regione Toscana "G. Monasterio", Pisa, Italy

OTHER_GOV

Sponsor Role lead

Responsible Party

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National Research Council, Inst. of Biomedicine and Molecular Immunology, Italy

Principal Investigators

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Oreste Marrone, MD

Role: PRINCIPAL_INVESTIGATOR

Fondazione C.N.R./Regione Toscana "G. Monasterio", Pisa, Italy

Locations

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National Research Council - Institute of Biomedicine and Molecular Immunology (CNR - IBIM)

Palermo, , Italy

Site Status

Countries

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Italy

References

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Patruno V, Aiolfi S, Costantino G, Murgia R, Selmi C, Malliani A, Montano N. Fixed and autoadjusting continuous positive airway pressure treatments are not similar in reducing cardiovascular risk factors in patients with obstructive sleep apnea. Chest. 2007 May;131(5):1393-9. doi: 10.1378/chest.06-2192.

Reference Type BACKGROUND
PMID: 17494789 (View on PubMed)

Bazzano LA, Khan Z, Reynolds K, He J. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension. 2007 Aug;50(2):417-23. doi: 10.1161/HYPERTENSIONAHA.106.085175. Epub 2007 Jun 4.

Reference Type BACKGROUND
PMID: 17548722 (View on PubMed)

Alajmi M, Mulgrew AT, Fox J, Davidson W, Schulzer M, Mak E, Ryan CF, Fleetham J, Choi P, Ayas NT. Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung. 2007 Mar-Apr;185(2):67-72. doi: 10.1007/s00408-006-0117-x. Epub 2007 Mar 28.

Reference Type BACKGROUND
PMID: 17393240 (View on PubMed)

Haentjens P, Van Meerhaeghe A, Moscariello A, De Weerdt S, Poppe K, Dupont A, Velkeniers B. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med. 2007 Apr 23;167(8):757-64. doi: 10.1001/archinte.167.8.757.

Reference Type BACKGROUND
PMID: 17452537 (View on PubMed)

Parati G, Lombardi C, Narkiewicz K. Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk. Am J Physiol Regul Integr Comp Physiol. 2007 Oct;293(4):R1671-83. doi: 10.1152/ajpregu.00400.2007. Epub 2007 Jul 25.

Reference Type BACKGROUND
PMID: 17652356 (View on PubMed)

Narkiewicz K, Somers VK. Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand. 2003 Mar;177(3):385-90. doi: 10.1046/j.1365-201X.2003.01091.x.

Reference Type BACKGROUND
PMID: 12609010 (View on PubMed)

Other Identifiers

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CNR-IBIM-001

Identifier Type: -

Identifier Source: org_study_id

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