The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT05606991




Registration number
NCT05606991
Ethics application status
Date submitted
12/07/2022
Date registered
7/11/2022

Titles & IDs
Public title
The Effect of OSA on Brain Waste Clearance
Scientific title
The Impact of 2 Weeks CPAP Withdrawal on Brain Waste Clearance in Adults With Severe Obstructive Sleep Apnoea - A Randomised Controlled Crossover Trial
Secondary ID [1] 0 0
BrainOSA-0522
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Obstructive Sleep Apnea 0 0
Dementia 0 0
Cognitive Impairment 0 0
Condition category
Condition code
Respiratory 0 0 0 0
Sleep apnoea
Neurological 0 0 0 0
Dementias
Neurological 0 0 0 0
Alzheimer's disease
Mental Health 0 0 0 0
Other mental health disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Other interventions - CPAP Withdrawal

No intervention: CPAP on - Participants will continue with their usual continuous positive airway pressure (CPAP) therapy as advised by their treating physician.

Experimental: CPAP off - Participants will be weaned off their usual continuous positive airway pressure (CPAP) therapy and enter a 2-week period of non-treatment.


Other interventions: CPAP Withdrawal
Complete withdrawal of continuous positive airway pressure (CPAP) therapy for a 2-week period.

Intervention code [1] 0 0
Other interventions
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Changes in sleep-wake amplitudes (peak-trough) of blood levels of Aß
Timepoint [1] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [1] 0 0
Changes in NREM slow wave parietal cortex activity
Timepoint [1] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [2] 0 0
Changes in brain tissue oxygenation during sleep
Timepoint [2] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [3] 0 0
Changes in brain blood volume during sleep
Timepoint [3] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [4] 0 0
Changes in arterial stiffness indices during sleep
Timepoint [4] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [5] 0 0
Changes in central aortic blood pressure during sleep
Timepoint [5] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [6] 0 0
Changes in pulse wave velocity (PWV)
Timepoint [6] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [7] 0 0
Changes in sympathetic and parasympathetic activity during wake and sleep periods
Timepoint [7] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [8] 0 0
Changes in sleep-wake amplitudes (peak-trough) of blood levels of p-tau-180
Timepoint [8] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [9] 0 0
Changes in sleep-wake amplitudes (peak-trough) of blood levels of p-tau-217
Timepoint [9] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [10] 0 0
Changes in sleep-wake amplitudes (peak-trough) of blood levels of glial fibrillary acidic protein (GFAP)
Timepoint [10] 0 0
Pre- and 2 weeks post-intervention
Secondary outcome [11] 0 0
Changes in sleep-wake amplitudes (peak-trough) of blood levels of neurofilament light chain (NfL)
Timepoint [11] 0 0
Pre- and 2 weeks post-intervention

Eligibility
Key inclusion criteria
* Community dwelling adults aged 35-65 years.
* Polysomnography-confirmed severe OSA with apnea hypopnea index (AHI) = 30/hour, with Non-Rapid Eye Movement (NREM) AHI = 15/hour.
* Established CPAP use for treatment of OSA with compliance of > 3 months, with = 5 hours use per night for > 5 nights per week.
* Willing to withdraw from CPAP use for 14 nights.
* Able to give informed verbal and written consent.
* Fluent in spoken, and comprehension of English.
Minimum age
35 Years
Maximum age
65 Years
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
* Commercial drivers (e.g.: drivers of heavy vehicles, public passenger vehicles, or vehicles requiring dangerous goods driver license).
* History of severe cardiovascular disease (e.g.: stroke, myocardial infarction, atrial fibrillation).
* Presence of cognitive impairment and/or established diagnosis of dementia.
* Regular use of medications which affect sleep (e.g.: benzodiazepines, opioids, stimulants, sedating antihistamines).
* Regular 24-hour shift workers, presence of jetlag, or history of trans-meridian travel (crossing 2 or more time zones) in the past 2 weeks.
* Advice against withdrawal of CPAP treatment, as determined by the participant's treating physician or study physician.
* Vulnerable to driving impairment without CPAP therapy/upon withdrawal of CPAP therapy, as assessed by: (a) positive response(s) to screening questions in the modified ASTN-Motor Vehicle Accident Questionnaire, reporting driving accidents and/or impairments prior to established CPAP therapy; AND/OR (b) the participant's treating physician.
* Prior history of severe COVID-19 infection involving significant neurological symptoms (e.g.: reduced level of consciousness, delirium, encephalopathy) - warranting hospitalization.
* Current COVID-19 infection and/or experience of ongoing symptoms/sequelae following a recent COVID-19 infection.
* Not up to date with the COVID-19 vaccination schedule - as per the current Australian Technical Advisory Group on Immunization (ATAGI) definition for individuals aged 16 years and over - at the time of writing this Protocol, defined as having:

1. Received 2 primary doses of any Therapeutic Goods Administration (TGA)-approved or TGA-recognized COVID-19 vaccine at least 14 days apart (except for the Janssen COVID-19 vaccine, where only 1 primary dose is required); PLUS
2. A booster dose of a TGA-approved COVID-19 vaccine (Pfizer, Moderna or AstraZeneca) at a recommended interval of 3-6 months after the receipt of 2nd primary dose; OR
3. For severely immunocompromised individuals: received 3 primary doses of any TGA-approved or TGA-recognized COVID-19 vaccine, with dose 3 administered within 6 months of receiving dose 2.
* Other medical conditions deemed by study physicians to warrant exclusion.

Study design
Purpose of the study
Other
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Crossover
Other design features
Phase
NA
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW
Recruitment hospital [1] 0 0
Woolcock Institute of Medical Research - Glebe
Recruitment postcode(s) [1] 0 0
2095 - Glebe

Funding & Sponsors
Primary sponsor type
Other
Name
Woolcock Institute of Medical Research
Address
Country
Other collaborator category [1] 0 0
Other
Name [1] 0 0
National Health and Medical Research Council, Australia
Address [1] 0 0
Country [1] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Keith Wong, MBBS FRACP
Address 0 0
Woolcock Institute of Medical Research
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment


What supporting documents are/will be available?

No Supporting Document Provided



Results publications and other study-related documents

No documents have been uploaded by study researchers.