Obstructive Sleep Apnea Treatment in Serious Mental Illness

University of California San Diego

Status

Not yet enrolling

Conditions

Obstructive Sleep Apnea of Adult

Schizophrenia

Bipolar Disorder

Schizoaffective Disorder

Treatments

Device: Automatic Positive Airway Pressure (APAP)

Study type

Interventional

Funder types

Other

Identifiers

NCT05457127

800600

Details and patient eligibility

About

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.

Full description

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.

Enrollment

300 estimated patients

Sex

All

Ages

40 to 70 years old

Volunteers

Accepts Healthy Volunteers

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.