Obstructive Sleep Apnea
Conditions
Keywords
Obstructive sleep apnea, CPAP, Residual daytime sleepiness, Depressive symptoms
Brief summary
Persistent daytime symptoms of sleepiness in individuals with obstructive sleep apnea (OSA) who are using Continuous Positive Airway Pressure (CPAP) are associated with adverse long term medical and functional outcomes. Supplementary exposure to bright light has beneficial effects on sleep quality and daytime vigilance in healthy individuals and it has been increasingly applied in a variety of sleep and neuropsychiatric conditions. This study will explore the role of Bright Light Therapy (BLT), a well-established non-pharmacological intervention for circadian disturbances, for the treatment of residual daytime symptoms of OSA which do not respond to CPAP. BLT will be delivered via therapy glasses in a cross-over design, where each participant will be exposed to active treatment and sham treatment (4 weeks in each arm) in a randomized order. The hypothesis is that participants will demonstrate improvements in the variables of interest during the four-week active treatment portion of the eight-week crossover study, compared to the four-week sham treatment portion.
Detailed description
Persistent daytime symptoms of sleepiness in individuals with obstructive sleep apnea (OSA) who are using Continuous Positive Airway Pressure (CPAP) are associated with adverse long term medical and functional outcomes. Supplementary exposure to bright light has beneficial effects on sleep quality and daytime vigilance in healthy individuals and it has been increasingly applied in a variety of sleep and neuropsychiatric conditions. This study will explore the role of Bright Light Therapy (BLT), a well-established non-pharmacological intervention for circadian disturbances, for the treatment of residual daytime symptoms of OSA which do not respond to CPAP. BLT will be delivered via therapy glasses in a cross-over design, where each participant will be exposed to active treatment and sham treatment (4 weeks in each arm) in a randomized order. The hypothesis is that participants will demonstrate improvements in the variables of interest during the four-week active treatment portion of the eight-week crossover study, compared to the four-week sham treatment portion.
Interventions
OTHERBLT
Bright light therapy delivered via glasses
OTHERs-BLT
sham delivered with bright light therapy glasses to which a neutral density filter has been applied
Sponsors
VA Office of Research and Development
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Participants are not told which arm is active versus sham
Intervention model description
single blind crossover design with randomized condition order
Eligibility
Sex/Gender
ALL
Age
40 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Documented diagnosis of OSA * Currently on CPAP or BiPAP for at least 3 months * with documented adherence (defined as wearing CPAP/BiPAP for \>6h/night on at least 75% of nights), and adequate control of sleep apnea, as indicated by an AHI of 10 or less when on CPAP * Excessive residual daytime sleepiness (Epworth score \> 10) * If taking alertness promoting medication, the investigators will require that they are on a stable dose for at least one month prior to entering the study and that they refrain from dose changes while participating in the study * If already prescribed BLT, subjects must not have used it for at least one month prior to participating
Exclusion criteria
* Shift work * Travel across time zones in the past month * Narcolepsy * Regular hypnotics use * Decompensated congestive heart failure (CHF) * Primary central sleep apnea, needing O2 therapy via nasal cannula * Poorly controlled diabetes (HgA1c\>8%) * Active substance use disorder * Dementia * Untreated bipolar disorder * the investigators will consider individuals with a diagnosis of bipolar disorder who are currently in treatment and stable * Macular degeneration, recent lasik surgery (within 3 months) * Legally blind * Taking medication that will cause photosensitivity to blue-green light spectrum wavelength * Already using bright light therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Epworth sleepiness scale | baseline, week 4 (end of treatment 1), week 8 (end of wash out), week 12 (end of treatment 2) | self report questionnaire assessing daytime drowsiness and tendency to fall asleep if inactive |
| Change in QIDS score | baseline, week 4 (end of treatment 1), week 8 (end of wash out), week 12 (end of treatment 2) | self report assessment of depressive symptoms severity |
Countries
United States
Contacts
Primary ContactIsabella Soreca, MD
Backup ContactL. A Pisarov
Outcome results
None listed