Skip to main content
OpenTrials
Not Yet Recruiting

NCT Number: NCT05457127

Obstructive Sleep Apnea Treatment in Serious Mental Illness

Serious mental illnesses (SMI) like schizophrenia and bipolar disorder are two of the most disabling and costly chronic illnesses worldwide. A high proportion of adults with schizophrenia and bipolar disorder have sleep disorders, like obstructive sleep apnea (OSA), but tend to be underdiagnosed and undertreated compared to the general population. This study aims to examine feasibility, acceptance, and impact of OSA treatment and how it affects cognitive function in people with SMI.

Not Yet Recruiting

Trial opening soon.

Get Notified

Key information

Conditions

Schizoaffective Disorder Bipolar Disorder Bipolar and Related Disorders Mental Disorders Mood Disorders Obstructive Sleep Apnea of Adult Psychotic Disorders Schizophrenia Schizophrenia Spectrum and Other Psychotic Disorders

Age range

40 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Sleep disturbances are central to many psychiatric disorders, including schizophrenia and bipolar disorder, with clear implications for cognition, brain health, physical health and aging. Obstructive sleep apnea (OSA) is typically underdiagnosed and undertreated due to impairment from psychiatric symptoms, limited resources, and stigma. In turn, consequences of untreated OSA in SMI are dire: in particular, worsening cardiometabolic health, cognitive decline, and death. Few studies have examined the impact of treatments for obstructive sleep apnea on cognitive problems in a high-risk group, such as older adults with SMI. The goals of the proposed study are to assess the acceptance and effectiveness of positive airway pressure (PAP) treatment for OSA, and its impact on cognitive and cardiometabolic outcomes as well as biological processes over a 3-month period. In order to determine eligibility, participants will be asked to complete a diagnostic test either at home or overnight in-lab. If diagnosed with sleep apnea, the participant will be offered a 3-month treatment with an automatic PAP. In addition, eligible participants will complete weekly check-ins with study staff and a series of detailed interviews, physical and neuropsychological tests, instrumental and clinical assessments, and blood draws every month for a total of 3 months.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

Control participants:

  • lifetime absence of major psychiatric illness
  • 40 to 70 years old
  • be at risk for or have a diagnosis of obstructive sleep apnea

For participants with serious mental illness:

  • diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder
  • must not be conservatized
  • 40 - 70 years old
  • be at risk or have a diagnosis of obstructive sleep apnea.

Exclusion criteria

  • DSM-IV-TR diagnosis of active alcohol or other substance abuse or dependence in the 3 months preceding enrollment. This will be self-report.
  • Diagnosis of dementia, mental retardation, or other neurological or medical conditions known to affect neurophysiologic or neurocognitive functioning, or autoimmune disease
  • Other major DSM-IV-TR Axis I Disorder
  • Medical problems that interfere with a participant's ability to complete the assessments
  • Plans to move out of the San Diego county area within the following 6 months
  • Diagnosis of OSA and currently receiving APAP, CPAP, or any treatment from a physician.

Treatment and study plan

Automatic Positive Airway Pressure (APAP)

Device

If eligible, participants will be given a clinical Automatic Positive Airway Pressure (APAP) device for up to 3 months, while they are waiting for their clinical evaluation from a sleep physician. The APAP device will we will be using is the ResMed Airsense 11 Autoset. APAP is a smart positive airway pressure (PAP) device, where the pressure changes as needed to provide optimal pressure to splint the upper airway. Dr. Lee and Dr. Schmickl will oversee management of the device.

During the first month of APAP use, individuals will participate in weekly phone calls or in-person visits to ensure optimal adherence and troubleshoot any issues (improper mask fitting, discomfort, etc) that may arise.

Primary outcomes

  1. Acceptance of PAP trial

    Time frame: 3 months

    Acceptance of PAP trial (based on post-adherence program survey taken after the completion of the 4 sessions.) Acceptability will be rated by % individuals who rate high level of satisfaction with the intervention.

  2. OSA self-efficacy using the SEMSA

    Time frame: 3 months

    OSA self-efficacy will be assessed using the Self-Efficacy Measure for Sleep Apnea (SEMSA). The SEMSA is a 26-item, self-administered questionnaire. The SEMSA has 3 categories: perceived risk, outcome expectancies, and treatment self-efficacy. In the perceived risk category, individuals answer questions about their perceived vulnerability to health risks. In the outcome expectancies, individuals answer questions regarding the potential behavior to reduce those risks, and in the treatment self-efficacy, the participant rates the level of validity of the statements on a 4-point scale regarding their perceived ability to perform behavior. Each of the 3 categories has a 4-point ordinal scale (1= irrelevant, 4 = extremely relevant) ranging from very low to very high. The mean of the 3 subscales are calculated. Higher scores indicate greater perceived self-efficacy, perceived response efficacy, and higher perceived susceptibility.

  3. PAP usage

    Time frame: 3 months

    PAP usage will be assessed using mean hours/night - which will be obtained from the PAP machine data.

  4. Cognitive Functioning

    Time frame: 3 months

    Cognitive functioning will be measured with the MATRICS Cognitive Consensus Battery (MCCB).159 The MCCB assesses six cognitive domains (attention/vigilance**, verbal learning/memory**, processing speed, working memory, auditory learning/memory, and reasoning), and has excellent test-retest reliability (ICC = 0.88) with minimal practice effects.159, 160 Executive functioning is the one cognitive domain that is less ideally covered within the MCCB. The closest MCCB domain, reasoning, is measured by a single timed-mazes task that can be readily affected by non-executive functions. We use subtests from the Delis-Kaplan Executive Functioning System (D-KEFS) battery161 [Color Word Interference, Letter Number Sequencing, and phonemic (FAS) and semantic (Animals) fluency] to assess Executive Functioning*. We have successfully employed these measures as a supplement to the MCCB in multiple prior studies in PwS.

  5. Monitoring Slow Wave Sleep and Sleep Spindle Density

    Time frame: 3 months

    Slow wave sleep -based on proportion/duration of Slow wave activity on overnight sleep EEG recordings. Sleep Spindle density - based on sleep spindle density measured during non-REM sleep on overnight sleep EEG recordings

Study contacts

Contact information is provided by the study sponsor or research team.

Ellen Lee, M.D.

CONTACT

[email protected]

858-314-8126

Stephanie Ibrahim

CONTACT

[email protected]

(858) 255-0721

Sponsors and collaborators

Lead sponsor

University of California, San Diego

Other

Registry information

Official study title

Obstructive Sleep Apnea Treatment in People Aging With Serious Mental Illness

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jul 13, 2022
Registry last updated
Jul 10, 2024

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.

Related clinical trials

Published trials that share one or more normalized conditions with this study.