Acute Coronary Syndrome, Obstructive Sleep Apnea
Conditions
Keywords
obstructive sleep apnea, acute coronary event, cognitive functions, Continuous positive airway pressure night
Brief summary
The presence of Obstructive Sleep Apnea Syndrome (OSAS) has a high frequency in patients victims of a coronary artery disease (CAD) (myocardial infarction, revascularization). Unlike patients seen in a sleep Laboratory with an impact on daytime functioning, CAD apneic patients do not complain in their daytime functioning. The objective of this study is to explore whether the objective cognitive assessment measures may be a good marker of the efficacy of CPAP treatment given to non-sleepy apneic CAD patients. Coronary patients with an AHI between 15 and 40 / h will be treated (or not) after randomization with CPAP treatment. The expected results are: CPAP apneic coronary patients should have a positive impact on cognitive performance, particularly on attention span and working memory measured by improvement in the Paced Auditory Serial Addition Test score (PASAT score).
Interventions
DEVICECPAP treatment
Patients treated wear a face mask during sleep which is connected to a pump (CPAP machine) that forces air into the nasal passages at pressures high enough to overcome obstructions in the airway and stimulate normal breathing.
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
30 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patient admitted to the Clinical Physiology Department of Exercise of the Saint Etienne University Hospital (myocardial infarction, coronary stenting or coronary artery bypass) and referred for care in cardiac rehabilitation * A native French speaker * No daytime sleepiness (ESS \<or = 10) * Signature of informed consent by the patient
Exclusion criteria
* Patients with a previous diagnosis of sleep apnea syndrome * Patients with severe heart failure (stage III and IV of the NYHA) * Patients with a neurodegenerative disease or other known cognitive disorders * Presence of progressive disease other than coronary artery disease (cancer for example) * Patients participating in other research that can change their cognitive function or drowsiness
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PASAT-4sec test score | Day 120 | The PASAT is a measure of cognitive function that assesses auditory information processing speed and flexibility, as well as calculation ability. Single digits are presented every 4 seconds and the patient must add each new digit to the one immediately prior to it. The score for the PASAT is the total number correct out of 60 possible answers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean time (ms) obtained in a Continus Performance Test | Day 120 | It is an other score obtained in psychometric tests. It measures a person's sustained and selective attention (associated with impulsivity and distractibility). |
| Percentage (%) obtained in a test measurement of the reaction time | Day 120 | It is an other score obtained in psychometric tests. It is a psychometer vigilance test. |
| Mean time (ms) obtained in a test measurement of the reaction time | Day 120 | It is an other score obtained in psychometric tests. It is a psychometer vigilance test. |
| Percentage (%) for a N-back working memory task | Day 120 | It is an other score obtained in psychometric tests. The subject is presented with a sequence of stimuli, and the task consists of indicating when the current stimulus matches the one from n steps earlier in the sequence. |
| Average time (ms) for a N-back working memory task | Day 120 | It is an other score obtained in psychometric tests. The subject is presented with a sequence of stimuli, and the task consists of indicating when the current stimulus matches the one from n steps earlier in the sequence. |
| Score Mini Mental State (MMS) | Day 120 | It is a score obtained in psychometric tests. This is a series of 30 questions that assesses cognitive and mnemonic ability of a person. |
| Mean nocturnal oxygen saturation (%) | Day 120 | It is a percentage index of hypoxemia measured by a polysomnography. |
| Minimal nocturnal oxygen saturation (%) | Day 120 | It is an other percentage index of hypoxemia measured by a polysomnography. |
| The oxyhemoglobin desaturation index | Day 120 | It is an other index of hypoxemia measured by a polysomnography. It is expressed in desaturations / hour |
| The time (min) spent with a SaO2 below 90% | Day 120 | The arterial oxygen saturation (SaO2)is an other index of hypoxemia measured by a polysomnography. |
| Sleep fragmentation | Day 120 | It is determined by a polysomnography. |
| AHI | Day 120 | It is the number of apnea and hypopnea per hour. It determined by polysomnography. |
Countries
France
Outcome results
None listed