Effects of Quetiapine on Sleep and Next Day Alertness in People With Obstructive Sleep Apnea

NCT ID: NCT05303935

Last Updated: 2023-07-06

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

PHASE2

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-25

Study Completion Date

2023-04-04

Brief Summary

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Quetiapine is medication used to treat schizophrenia and bipolar disorder. Increasingly, low doses of quetiapine are prescribed "off-label" for insomnia. Quetiapine increases sleep duration with fewer interruptions, and people report feeling more rested. This accounts for why it is popular to prescribe for insomnia. Insomnia and obstructive sleep apnea (OSA) share many symptoms and differential diagnosis can be difficult. While quetiapine may improve sleep and breathing in certain people (i.e in light sleepers) an initial study indicated that quetiapine caused breathing disturbances in healthy individuals. Effects in OSA are unknown. In this placebo-controlled double blind study, participants with mild-moderate OSA will spend 2 nights in the sleep lab, one with quetiapine at a dose commonly prescribed for insomnia and one with placebo. The investigators will assess participants sleep by standard clinical sleep study, and morning alertness using questionnaires, reaction tests, and a driving simulator test.

Detailed Description

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Conditions

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Sleep Apnea, Obstructive

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Double-blind, randomized, placebo-controlled, cross-over study
Primary Study Purpose

OTHER

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Quetiapine

Quetiapine 50mg in the form of one capsule, taken before bedtime. Dosage is taken on one instance for one night only.

Group Type EXPERIMENTAL

Quetiapine 50 MG

Intervention Type DRUG

A single dose of 50mg of quetiapine taken at bedtime for one night.

Placebo

Placebo sugar pill in the form of one capsule, taken before bedtime. Dosage is taken on one instance for one night only.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

A placebo sugar pill that looks like the quetiapine tablet taken at bedtime for one night.

Interventions

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Quetiapine 50 MG

A single dose of 50mg of quetiapine taken at bedtime for one night.

Intervention Type DRUG

Placebo

A placebo sugar pill that looks like the quetiapine tablet taken at bedtime for one night.

Intervention Type DRUG

Other Intervention Names

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Seroquel Sugar pill

Eligibility Criteria

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Inclusion Criteria

* Ages: 18+ (Adult, Older Adult)
* Gender: All
* Moderate or more "difficulty staying asleep" score on the Insomnia Severity Index questionnaire
* Obstructive Sleep Apnoea (OSA), Apnoea Hypopnea Index ≥ 5 events/hour
* BMI between 18.5 and 40 kg/m2

Exclusion Criteria

* Concomitant medications that interact or are contraindicated with quetiapine
* Concomitant medications known to influence breathing, sleep, arousal, or muscle physiology
* Current pregnancy or breast-feeding
* Current or recent other medical conditions likely to affect results or safety
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Flinders University

OTHER

Sponsor Role lead

Responsible Party

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Professor Danny Eckert

Director, Adelaide Institute for Sleep Health

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Danny Eckert, PhD

Role: PRINCIPAL_INVESTIGATOR

Flinders University

Locations

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Adelaide Institute for Sleep Health

Adelaide, South Australia, Australia

Site Status

Countries

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Australia

References

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Debernard KAB, Frost J, Roland PH. Quetiapine is not a sleeping pill. Tidsskr Nor Laegeforen. 2019 Sep 16;139(13). doi: 10.4045/tidsskr.19.0205. Print 2019 Sep 24. English, Norwegian.

Reference Type BACKGROUND
PMID: 31556541 (View on PubMed)

McKean A, Monasterio E, Elliott T. How common is off-label prescription of quetiapine? N Z Med J. 2018 Oct 26;131(1484):77-78. No abstract available.

Reference Type BACKGROUND
PMID: 30359361 (View on PubMed)

Pringsheim T, Gardner DM. Dispensed prescriptions for quetiapine and other second-generation antipsychotics in Canada from 2005 to 2012: a descriptive study. CMAJ Open. 2014 Oct 1;2(4):E225-32. doi: 10.9778/cmajo.20140009. eCollection 2014 Oct.

Reference Type BACKGROUND
PMID: 25485247 (View on PubMed)

Cohrs S, Rodenbeck A, Guan Z, Pohlmann K, Jordan W, Meier A, Ruther E. Sleep-promoting properties of quetiapine in healthy subjects. Psychopharmacology (Berl). 2004 Jul;174(3):421-9. doi: 10.1007/s00213-003-1759-5. Epub 2004 Mar 17.

Reference Type BACKGROUND
PMID: 15029469 (View on PubMed)

Karsten J, Hagenauw LA, Kamphuis J, Lancel M. Low doses of mirtazapine or quetiapine for transient insomnia: A randomised, double-blind, cross-over, placebo-controlled trial. J Psychopharmacol. 2017 Mar;31(3):327-337. doi: 10.1177/0269881116681399. Epub 2017 Jan 16.

Reference Type BACKGROUND
PMID: 28093029 (View on PubMed)

Meira E Cruz M, Kryger MH, Morin CM, Palombini L, Salles C, Gozal D. Comorbid Insomnia and Sleep Apnea: mechanisms and implications of an underrecognized and misinterpreted sleep disorder. Sleep Med. 2021 Aug;84:283-288. doi: 10.1016/j.sleep.2021.05.043. Epub 2021 Jun 8.

Reference Type BACKGROUND
PMID: 34214960 (View on PubMed)

Sweetman A, Lack L, McEvoy RD, Smith S, Eckert DJ, Osman A, Carberry JC, Wallace D, Nguyen PD, Catcheside P. Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA). Sleep Med Rev. 2021 Dec;60:101519. doi: 10.1016/j.smrv.2021.101519. Epub 2021 Jun 23.

Reference Type BACKGROUND
PMID: 34229295 (View on PubMed)

Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, Nunez CM, Patel SR, Penzel T, Pepin JL, Peppard PE, Sinha S, Tufik S, Valentine K, Malhotra A. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019 Aug;7(8):687-698. doi: 10.1016/S2213-2600(19)30198-5. Epub 2019 Jul 9.

Reference Type BACKGROUND
PMID: 31300334 (View on PubMed)

Eckert DJ. Phenotypic approaches to obstructive sleep apnoea - New pathways for targeted therapy. Sleep Med Rev. 2018 Feb;37:45-59. doi: 10.1016/j.smrv.2016.12.003. Epub 2016 Dec 18.

Reference Type BACKGROUND
PMID: 28110857 (View on PubMed)

Eckert DJ, White DP, Jordan AS, Malhotra A, Wellman A. Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. Am J Respir Crit Care Med. 2013 Oct 15;188(8):996-1004. doi: 10.1164/rccm.201303-0448OC.

Reference Type BACKGROUND
PMID: 23721582 (View on PubMed)

Carter SG, Eckert DJ. Effects of hypnotics on obstructive sleep apnea endotypes and severity: Novel insights into pathophysiology and treatment. Sleep Med Rev. 2021 Aug;58:101492. doi: 10.1016/j.smrv.2021.101492. Epub 2021 Apr 22.

Reference Type BACKGROUND
PMID: 33965721 (View on PubMed)

Eckert DJ, Owens RL, Kehlmann GB, Wellman A, Rahangdale S, Yim-Yeh S, White DP, Malhotra A. Eszopiclone increases the respiratory arousal threshold and lowers the apnoea/hypopnoea index in obstructive sleep apnoea patients with a low arousal threshold. Clin Sci (Lond). 2011 Jun;120(12):505-14. doi: 10.1042/CS20100588.

Reference Type BACKGROUND
PMID: 21269278 (View on PubMed)

Khazaie H, Sharafkhaneh A, Khazaie S, Ghadami MR. A weight-independent association between atypical antipsychotic medications and obstructive sleep apnea. Sleep Breath. 2018 Mar;22(1):109-114. doi: 10.1007/s11325-017-1537-y. Epub 2017 Jul 13.

Reference Type BACKGROUND
PMID: 28707161 (View on PubMed)

Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999 Aug 1;22(5):667-89. No abstract available.

Reference Type BACKGROUND
PMID: 10450601 (View on PubMed)

Related Links

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http://www.medicines.org.uk/emc/product/5495/smpc

Compendium EM. SEROQUEL 25 mg film-coated tablets. 2021 \[cited 2021 22/10/2021\].

Other Identifiers

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4965

Identifier Type: -

Identifier Source: org_study_id

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