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Trial registered on ANZCTR
Registration number
ACTRN12606000486527
Ethics application status
Approved
Date submitted
16/10/2006
Date registered
24/11/2006
Date last updated
7/07/2022
Date data sharing statement initially provided
7/07/2022
Date results provided
7/07/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Measurement location for the indices of obstructive apnea / hypopnea frequency during Continuous Positive Airway Pressure (CPAP) therapy
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Scientific title
The effect of location of airflow measurement on the ability to assess Apnea Hypopnea Index (AHI) during Continuous Positive Airway Pressure (CPAP) therapy in patients with Obstructive Sleep Apnea (OSA) undergoing subtherapeutic CPAP and AutoCPAP therapy.
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Secondary ID [1]
288426
0
Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obstructive Sleep Apnea
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Condition category
Condition code
Respiratory
1559
1559
0
0
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Sleep apnoea
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Subjects will receive an identical two-night titration protocol in random order up to 3 weeks apart. On one night, an auto-adjusting CPAP device will automatically titrate pressure throughout the night within the range of 4cmH2O – 20cmH2O (cmH2O is a centimeter (centimetre) of water used to determine pressures during mechanical ventilation). On the other night, sub-therapeutic pressure will be delivered with the same device set in fixed pressure mode (2/3 of the subject’s currently prescribed CPAP level (either home fixed CPAP level or the 95th percentile of pressure on current AutoCPAP device)). Subjects will undergo full polysomnography with additional flow measurements from four sites: mask, nares, CPAP machine airflow outlet and the analogue output of the CPAP device.There is no control group in this study. Auto-titrating CPAP therapy is increasingly used to treat sleep disordered breathing, however, the standard care remains fixed pressure CPAP therapy. This is an observational study as both conditions under which data is collected in this study represent actual clinical presentations of clinical patients receiving CPAP therapy.
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Intervention code [1]
1402
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None
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Assessment of differences in Apnea Hypopnea Index (AHI) measured at four sites during overnight polysomnography (PSG) of subjects established on CPAP therapy. AHI will be measured during a two-night titration protocol (random order) using polysomnography in the sleep laboratory. Subjects will be connected to the CPAP device for the entirety of the PSG recording on both nights.
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Assessment method [1]
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Timepoint [1]
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Polysomnography data will be recorded from Lights Out to Lights On (approximately 8 hour recording) during overnight PSG.
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Secondary outcome [1]
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Sleep architecture
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Assessment method [1]
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Timepoint [1]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Secondary outcome [2]
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Sleep efficiency
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Assessment method [2]
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Timepoint [2]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Secondary outcome [3]
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Total sleep time
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Assessment method [3]
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Timepoint [3]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Secondary outcome [4]
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Arousal index – cortical (EEG) and autonomic (Pulse Transit Time)
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Assessment method [4]
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Timepoint [4]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Secondary outcome [5]
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Flow limitation events (frequency of oxygen desaturation of >3% per hour during sleep)Minimum oxygen saturation during sleep
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Assessment method [5]
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Timepoint [5]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Secondary outcome [6]
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Autoset T data
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Assessment method [6]
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Timepoint [6]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Secondary outcome [7]
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Optimum CPAP Pressure
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Assessment method [7]
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Timepoint [7]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Secondary outcome [8]
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Near infra red spectroscopy data (cerebral blood volume/cerebral oxygen saturation).
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Assessment method [8]
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Timepoint [8]
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Secondary outcomes will be measured throughout the entire 8 hour PSG recording on both nights during a two-night protocol (random order) in the sleep laboratory.
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Eligibility
Key inclusion criteria
Subjects must satisfy the following inclusion criteria:Previously diagnosed with moderate-severe obstructive sleep apnea (RDI>15)Compliant CPAP use for at least 3 months durationCompliance: CPAP use > 4 hours per night for at least 5 nights per week No significant problems with CPAP therapy such as mask/mouth leak or severe nasal congestion. English speaking.
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Other sleep disorders including:PLMD Untreated RLS >10 Central apnoeas/hr on diagnostic sleep studyNeurological disordersPsychiatric disordersSignificant medical complaint including:Severe cardiovascular disease Congestive heart failure Significant lung disease (e.g., chronic obstructive pulmonary disease) Daytime hypoxemia and respiratory failure from any cause Prominent nocturnal desaturation other than from OSA (e.g., obesity hypoventilation syndrome).
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
8/11/2005
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Actual
8/11/2005
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Date of last participant enrolment
Anticipated
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Actual
11/04/2006
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Date of last data collection
Anticipated
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Actual
28/04/2006
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Sample size
Target
34
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Accrual to date
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Final
34
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
1700
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Commercial sector/Industry
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Name [1]
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DiagnoseIT Pty Ltd
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Address [1]
1700
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PO Box 36 Tintenbar
NSW 2478
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Country [1]
1700
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
DiagnoseIT Pty Ltd, Sydney, NSW, Australia
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Address
PO Box 36 Tintenbar
NSW 2478
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Country
Australia
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Secondary sponsor category [1]
1500
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None
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Name [1]
1500
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NIL
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Address [1]
1500
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Country [1]
1500
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sydney South West Area Health Service
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Ethics committee address [1]
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Level 11, KGV Building Missenden Road CAMPERDOWN NSW 2050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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03/08/2005
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Ethics approval number [1]
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X05-0176
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Summary
Brief summary
Subjects who have been using chronic CPAP therapy will be invited to participate in the study. The study will take place after the subjects have been instructed on the details of the trial and have provided informed consent. Subjects are randomised to one of two nights in the sleep laboratory. Under polysomnography and using an auto-titrating CPAP (AutoCPAP) systems, the subjects will be studied either under a sub-therapeutic pressure level for one night of recording (simulating a sub-standard therapy night – encountered by clinical patients), or on the AutoCPAP device in the therapeutic auto-titrating mode (which is also a commonly applied therapeutic device). The study is observational in that the purpose and endpoints are collected as described below, under conditions in the laboratory simulating ‘normal’ clinical occurrences. Sleep and breathing parameters will be collected using standard laboratory methodologies, with the addition of flow measurement from four different sites: nares via a cannula; the CPAP machine flow outlet; the electronic output from the CPAP machine and the standard nasal mask via an oxygen port. Integrity of the flow signal as well as the presence of ‘break-through’ apnea / hypopnea phenomena are evaluated.
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Trial website
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Trial related presentations / publications
Denotti, A. L., Wong, K. K., Dungan, G. C., 2nd, Gilholme, J. W., Marshall, N. S. and Grunstein, R. R. Residual sleep-disordered breathing during autotitrating continuous positive airway pressure therapy. Eur Respir J, 2012, 39: 1391-7.
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Public notes
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Contacts
Principal investigator
Name
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Prof Ronald R Grunstein
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Address
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Woolcock Institute
PO Box M77 Missenden Road
Sydney
2050
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Country
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Australia
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Phone
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0291140438
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Fax
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0291140014
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Email
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[email protected]
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Contact person for public queries
Name
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Angela D'Rozario
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Address
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PO Box M77
Missenden Road
Camperdown NSW 2050
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Country
10591
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Australia
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Phone
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0291140435
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Fax
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0291140014
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Email
10591
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[email protected]
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Contact person for scientific queries
Name
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Angela D'Rozario
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Address
1519
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PO Box M77
Missenden Road
Camperdown NSW 2050
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Country
1519
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Australia
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Phone
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0291140435
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Fax
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0291140010
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Individual participant underlying published results only.
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When will data be available (start and end dates)?
Data will be made available upon request, after publication, with no end date determined.
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Available to whom?
Data will be made available upon request, after publication and will be determined upon negotiation with researchers who provided a methodologically sound proposal.
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Available for what types of analyses?
Any purpose.
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How or where can data be obtained?
Secure data transfer and signed data access agreement. Contact:
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Residual sleep-disordered breathing during autotitrating continuous positive airway pressure therapy
2011
https://doi.org/10.1183/09031936.00093811
N.B. These documents automatically identified may not have been verified by the study sponsor.
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