None listed
Conditions
Brief summary
Sleep-related breathing disorder has been commonly reported in elderly individuals with mild cognitive impairment. This project is interested in examining the prevalence of Obstructive Sleep Apnoea (OSA) in patients attending the Cognitive, Dementia, and Memory Service (CDAMS) at Northern Health and Austin Health. Also, this project aims to determine if 3 months of CPAP therapy for OSA in patients with memory impairments improves mood and memory. Firstly, patients attending CDAMS with memory impairment will be screened for OSA and patients who have a high risk of OSA will be invited to take part in Phase 1. Interested participants will be invited to attend the RMIT Sleep Laboratory for a 90-minute neuropsychological testing session and an overnight diagnostic polysomnography (PSG). Healthy age-matched controls will also undergo the same neuropsychological testing and overnight PSG to investigate differences in cognition and memory of individuals with memory impairment and healthy individuals. Patients who are diagnosed with OSA and recommended Continuous Positive Airway Pressure (CPAP) by the study physician will be invited to participate in Phase 2 the project. Participants will be randomised to either an immediate CPAP group or a 3-month wait-list group. Participants in the immediate CPAP condition will be given an auto-titrating PAP machine and asked to use their CPAP at home. After 3 months of CPAP therapy, participants will attend a second appointment at the Sleep Laboratory to complete follow-up tests and questionnaires. Patients in the wait-list condition will commence CPAP after 3 months and the same follow-up procedures will be followed as per the immediate CPAP group.
Interventions
Phase 1.
The STOP-bang questionnaire will be used in memory clinics to screening for patients who are at risk of having obstructive sleep apnoea (OSA). Patients with memory impairment and have a moderate-high risk of having OSA based on the questionnaire (STOP-bang score of 3 or more) will be invited to take part in Phase 1 which includes an overnight sleep study and a neuropsychological testing session. The overnight diagnostic sleep study will be conducted in-lab at the RMIT Sleep Laboratory,
Phase 1. The STOP-bang questionnaire will be used in memory clinics to screening for patients who are at risk of having obstructive sleep apnoea (OSA). Patients with memory impairment and have a moderate-high risk of having OSA based on the questionnaire (STOP-bang score of 3 or more) will be invited to take part in Phase 1 which includes an overnight sleep study and a neuropsychological testing session. The overnight diagnostic sleep study will be conducted in-lab at the RMIT Sleep Laboratory, Bundoora or at-home with a portable sleep recording device by a trained sleep lab staff. On the following morning, a baseline 90-minute neuropsychological testing session will be conducted. The sleep study will be reviewed by the study's sleep physician. Participants with moderate to severe obstructive sleep apnoea and recommended CPAP by the study's sleep physician will proceed into Phase 2. Phase 2. Auto Positive Airway Pressure (AutoPAP) therapy will be used as the intervention. Positive airway pressure therapy involves a AutoPAP machine with three basic parts: (i) an air pump; (ii) a mask that fits over the nose or/and mouth and; (iii) a tube that connects the machine and mask. The AutoPAP machine will be used daily during sleep for 3 months. An introductory Auto CPAP session along with a mask fitting session will be conducted by trained sleep lab staff. Participants will be required to use the machine at home daily following the initial 30-minute introductory session. The AutoPAP machine adjusts and varies the pressure breath to breath throughout the night automatically, with a minimum pressure of 4 and maximum pressure of 20. Participants will be followed-up via phone calls throughout the 3-month intervention to troubleshoot issues and encourage optimal usage. Phone calls will be conducted on the day after first AutoPAP usage followed by, weekly phone calls for the first month and monthly phone calls for the next two months.
Sponsors
RMIT University
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
The key inclusion criteria includes untreated Obstructive Sleep Apnoea with an Apnoea-Hypopnoea Index (AHI) of 15 or more, clinically significant memory impairment and English fluency.
Exclusion criteria
Participants will be excluded if memory impairment is due to stroke, epilepsy or traumatic brain injury. Other exclusion criteria includes sleep disorders other than OSA, learning disability and alcohol or drug dependence .
Outcome results
None listed