Diagnosis and Treatment of Sleep Apnea in Cerebrovascular Disease (Go To Sleep)

VA Office of Research and Development

Status and phase: Completed; Phase 3; Phase 2

Conditions: Hypertension; Stroke; Transient Ischemic Attack; Obstructive Sleep Apnea

Treatments: Procedure: CPAP Therapy for Newly Diagnosed Obstructive Sleep Apnea (OSA)

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00984308

IIR 06-233

Details and patient eligibility

About

Sleep apnea is common among Veterans with cerebrovascular disease (stroke or transient ischemic attack [TIA]), leads to hypertension, and is associated with recurrent stroke and death. Although continuous positive airway pressure (CPAP) safely treats sleep apnea, few Veterans with cerebrovascular disease are diagnosed with sleep apnea or offered treatment.

Full description

The project sought to evaluate whether a diagnostic and therapeutic intervention strategy among Veterans with cerebrovascular disease and hypertension using unattended polysomnography and auto-titrating CPAP with a targeted adherence evaluation and educational protocol resulted in: an improved rate of diagnosed sleep apnea, an improved rate of treated sleep apnea, and improved blood pressure control.

Enrollment: 225 patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Stroke or Transient Ischemic Attack Hypertension

Exclusion criteria

• Prior diagnosis of sleep apnea or other sleep disorder
• Life expectancy < 6 months or Hospice
• Non-English speaker
• Unable/unwilling to use mask
• Inability to give informed consent
• Oxygen dependent COPD
• Chronic renal failure with dialysis
• Active Suicidal Ideation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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225 participants in 2 patient groups

Intervention

Experimental group

Description:

The intervention group received unattended polysomnography and auto-titrating CPAP if sleep apnea was diagnosed

Treatment:

Procedure: CPAP Therapy for Newly Diagnosed Obstructive Sleep Apnea (OSA)

Control

Other group

Description:

The control group received usual clinical care which may include receipt of sleep diagnostic and therapeutic services

Treatment:

Procedure: CPAP Therapy for Newly Diagnosed Obstructive Sleep Apnea (OSA)