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Completed

NCT Number: NCT01175031

Comparison of Breathing Event Detection by a Continuous Positive Airway Pressure Device to Clinical Polysomnography

The purpose of this study is to demonstrate diagnostic agreement and determine the accuracy of the continuous positive airway pressure (CPAP) device compared to simultaneous, attended clinical polysomnography (PSG) in identifying breathing events in participants previously diagnosed with complex sleep apnea (CompSAS), complex sleep apnea with Cheyne-Stokes respiration (CSR), or obstructive sleep apnea (OSA).

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Key information

Conditions

Sleep Apnea Central Apnea Cheyne-Stokes Respiration Dyssomnias Nervous System Diseases Obstructive Sleep Apnea Pathological Conditions, Signs and Symptoms Respiration Disorders Respiratory Tract Diseases Signs and Symptoms Signs and Symptoms, Respiratory Sleep Apnea Syndromes Sleep Apnea, Central Sleep Apnea, Obstructive Sleep Disorders, Intrinsic Sleep Wake Disorders

Age range

21 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

National Jewish Health, Denver, Colorado, United States

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About this study

Study Objectives: To compare a positive airway pressure (PAP) device's detection of respiratory events and airway status during device detected apneas with events scored on simultaneous polysomnography (PSG).

Design: Prospective PSGs of patients with sleep apnea using a new-generation PAP device.

Settings: Four clinical and academic sleep centers.

Patients: Forty-five patients with obstructive sleep apnea (OSA) and complex sleep apnea (Comp SA) performed a PSG on PAP levels adjusted to induce respiratory events.

Interventions: None.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Males and females, ages 21-80.
  • Able and willing to provide written informed consent.
  • Diagnosis of complex sleep apnea (CompSAS) or Obstructive Sleep Apnea (OSA) within one year of study participation.
  • For participants with CompSAS: (a) Diagnostic PSG with an Apnea-Hyopnea Index (AHI) greater than or equal to 10 events/hour and central apnea index (CAI) greater than or equal to 5 events/hour of sleep or (b) PAP titration with a CAI greater than or equal to 5 events/hour of sleep.
  • For participants with OSA, a diagnostic PSG with an AHI greater than or equal to 15 events/hour of sleep.
  • Must have had a CPAP titration such that the necessary PAP level to treat the sleep disordered breathing is known.
  • Agreement to undergo a full-night, in-laboratory PSG on CPAP device.

Exclusion criteria

  • Participation in an interventional research study within 30 days of study participation.
  • Pre-menopausal females known to be pregnant or who are sexually active and not using a reliable method of birth control.
  • Surgery of the upper airway, nose, sinus, or middle ear within the last 90 days.
  • Surgery at any time for the treatment of OSA such as uvulopalatopharyngoplasty (UPPP).
  • Major medical or psychiatric condition that would interfere with the demands of the study, adherence to positive airway pressure, or the ability to complete the study.
  • Chronic respiratory failure or insufficiency with suspected or known neuromuscular disease, moderate or severe Chronic Obstructive Pulmonary Disease (COPD) or other pulmonary disorders, or any condition with an elevation of arterial carbon dioxide levels (> 45 mmHg) while awake.
  • Currently prescribed oxygen therapy.
  • Ventilatory induced barotrauma within 6 months of study participation.
  • Untreated insomnia.
  • Other major medical condition that, in the judgment of the investigator, precludes participation in this study.

Treatment and study plan

Manipulation of Positive Airway Pressure (PAP)

Other

Positive airway pressure (PAP) will be manipulated throughout the night to induce breathing events. PAP will be set to the participant's prescribed pressure, increased until breathing events are induced , and then returned to the prescribed pressure. This cyclic pattern will continue throughout the night.

Primary outcomes

  1. Number of Breathing Events Identified by the Continuous Positive Airway Pressure (CPAP) Device Compared to a Simultaneous Polysomnography

    Time frame: During a single night of polysomnography lasting an average of 8 hours

    The following breathing events: RERAs, central apneas, periodic breathing, obstructive apneas, and hypopneas in patients previously diagnosed with CompSAS or OSA detected by simultaneous Polysomnography and REMstar Auto with A-Flex were compared.

Secondary outcomes

  1. Device Detected Apneas as Detected by Philips Respironics (PR) System One

    Time frame: During a single night of polysomnography lasting an average of 8 hours

    All device-detected apneas were tabulated. Then they were broken down into obstructed airway apneas and clear airway apneas. The results are recorded below as apneas with obstructed airway and apneas with clear airway.

  2. Device-Detected Obstructed Airway Apnea Agreement

    Time frame: During a single night of polysomnography lasting an average of 8 hours

    Device-Detected Apneas were broken down and then reviewed with the manually scored apneas. Of the Obstructed Airway apneas they were broken down into a few different categories: Manually Scored Obstructive Apneas, Manually Scored Central Apneas, Manually Scored Hypopneas and Manually Scored RERAs.

  3. Device-Detected Clear Airway Apnea Agreement

    Time frame: During a single night of polysomnography lasting an average of 8 hours

    Device Detected Clear Airways events were counted by the device. These events were then compared to manual PSG scoring. The manual PSG scoring determined that these were apnea events. However, the manual scoring allows for more channels to be reviewed and manual scoring was able to classify them into 4 different categories: Manually Scored Obstructive Apneas, Manually Scored Central Apneas, Manually scored hypopneas and manually scored RERAs.

Sponsors and collaborators

Lead sponsor

Philips Respironics

Industry

Registry information

Official study title

Validation of Breathing Event Detection of the Philips Respironics Sleep Therapy System REMstar Auto A-Flex Compared to Clinical Polysomnography

Important dates

Study start
2010
Primary completion
2013
Study completion
2013
First posted
Aug 4, 2010
Registry last updated
Oct 31, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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