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Trial registered on ANZCTR
Registration number
ACTRN12615000993594
Ethics application status
Not yet submitted
Date submitted
27/08/2015
Date registered
22/09/2015
Date last updated
22/09/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Prevalence and nature of sleep disturbances in subjects with chronic obstructive pulmonary disease (COPD).
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Scientific title
Impact of sleep disturbances, circadian rhythm, comorbidities and medication in subjects with chronic obstructive pulmonary disease (COPD).
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Secondary ID [1]
287361
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nil
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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:
Chronic obstructive pulmonary disease (COPD)
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Sleep disorders
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Condition category
Condition code
Respiratory
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0
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Chronic obstructive pulmonary disease
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Respiratory
296307
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0
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Sleep apnoea
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Intervention/exposure
Study type
Observational
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Patient registry
False
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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
This is an observational study of evening and nocturnal respiratory symptoms and their relationship with changes in lung function in moderate to severe COPD. Patients with COPD will be recruited and studied in a single afternoon and overnight session at the Woolcock Institute of Medical research. Subjects will arrive at 4:00 pm and will provide written informed consent and complete a standard Woolcock clinical questionnaire on symptoms, medication use, medical history and smoking history in the afternoon. They will then undergo lung function tests (FEV1, FVC, DLCO and measures of respiratory resistance and reactance). Following this blood will be drawn for measuring inflammatory markers (neutrophils and eosinophills) and clock genes (genes associated with circadian variation). This will be followed by a standard-in lab diagnostic sleep study to determine the prevalence of obstructive sleep apnea (OSA) in COPD. The following morning, subjects will have lung function measures repeated and complete a Nighttime Symptoms of COPD Instrument (NiSCI) and Early Morning Symptoms of COPD Instrument (EMSCI) questionnaire. Subjects will then be issued an Actigraphy device and portable electronic spirometer for home monitoring for 2 weeks. Subjects will be taught how to use the spirometer and will record measurements each morning. Subjects will also complete a daily symptoms diary detailing the frequency and severity of symptoms for that day and will leave the Woolcock clinic by 9:00 am. The actigraph will record the levels of activity for 2 weeks continuously for later data download. These will be collected from them at the Woolcock Laboratory, after 2 weeks.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
No comparator/ control treatment
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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One of the primary outcome is the associations between the nature and prevalence of obstructive sleep apnea and sleep disturbances measured using polysomnography in COPD patients
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Assessment method [1]
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Timepoint [1]
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This data will be collected during a single afternoon session (where FEV1, FVC, DLCO, respiratory resistance and reactance will be measured) and an over night sleep study in COPD patients. 18 months will be required to recruit and collect data in the entire study population.
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Primary outcome [2]
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The second primary outcome is the association between sleep disturbances diagnosed using polysomnography during the sleep study and changes in FEV1 and respiratory system resistance and reactance between when they sleep and when they wake up (overnight changes).
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Assessment method [2]
296006
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Timepoint [2]
296006
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This data will be collected during a single afternoon session (where FEV1, FVC, DLCO, respiratory resistance and reactance will be measured) and an over night sleep study in COPD patients. 18 months will be required to recruit and collect data in the entire study population.
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Secondary outcome [1]
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One of the secondary outcomes will be associations of respiratory symptoms (cough, chest tightness, shortness of breath) determined from the questionnaire and overnight changes in spirometry (FEV1) with medication usage in COPD patients.
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Assessment method [1]
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Timepoint [1]
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This data will be collected from first session the patients visit the Woolcock clinic and over the period of 2 weeks when they will be issued a portable spirometer and a symptom diary.
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Secondary outcome [2]
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The other secondary outcome include association between sleep disturbances (diagnosed will polysomnography) and variations in ‘clock genes’ (which will me measured from the blood drawn from the patients).
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Assessment method [2]
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Timepoint [2]
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This data will be collected during a single afternoon session where the blood will drawn and an over night sleep study in COPD patients. 18 months will be required to recruit and collect data in the entire study population.
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Secondary outcome [3]
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To determine the relationship between sleep disturbances (diagnosed with polysomnography) and systemic and pulmonary inflammation (inflammatory markers will be measured from the blood drawn from each patient) .
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Assessment method [3]
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Timepoint [3]
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This data will be collected during a single afternoon session where the blood will drawn and an over night sleep study in COPD patients. 18 months will be required to recruit and collect data in the entire study population.
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Secondary outcome [4]
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The other secondary outcome include association between sleep disturbances (diagnosed will polysomnography) and activity levels (measured using actigraph watches issued to each subject) will be determined.
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Assessment method [4]
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Timepoint [4]
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This data will be collected from over night sleep study and the period of 2 weeks when they will be issued a portable spirometer and a symptom diary.
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Eligibility
Key inclusion criteria
1. A cigarette smoking history of >10 pack years.
2. Subjects will have a post-bronchodilator FEV1/FVC ratio of <0.70
3. A post-bronchodilator FEV1 of <60% of predicted (COPD-X moderate and severe disease)
4. Report symptoms of COPD (exertional breathlessness, cough, wheeze or sputum production) at least 4 days/week.
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Minimum age
18
Years
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Maximum age
80
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
1. A past Dr diagnosis of asthma
2. Any other cardiac or pulmonary disease that is likely to significantly influence lung function and symptoms, e.g. heart failure, cancer, pleural disease, dementia.
3. An inability to provide written informed consent.
4. COPD exacerbation within the last 8 weeks
5. The presence of cor pulmonale
6. Use of home oxygen
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
5/10/2015
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Menarini
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Address [1]
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Level 8, 67 Albert Avenue,
Chatswood NSW 2067
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Gregory King
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Address
Department of Respiratory Medicine
Royal North Shore Hospital
Pacific Highway
St Leonards 2065, NSW
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Country
Australia
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Secondary sponsor category [1]
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Other
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Name [1]
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Woolcock Institute of Medical Research
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Address [1]
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431 Glebe point road, Glebe
NSW, 2037
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Country [1]
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Belberry Limited
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Ethics committee address [1]
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129 Glen Osmond Road Eastwood South Australia 5063
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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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18/09/2015
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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction that is incompletely reversible by short acting bronchodilators, which causes typical symptoms of breathelessness on exertion, cough, sputum production and sometimes wheeze. Nocturnal symptoms can also occur, which may be related directly to the severity of airflow obstruction but there may be other factors that affect sleep quality such as upper airway obstruction, obesity, medications, genetic variability and systemic inflammation. There has been little published work on sleep abnormalities in COPD, but sleep related symptoms in COPD appear to be common. Research questions and hypotheses In this project, we address the questions of how prevalent and what is the nature of sleep disturbance in COPD? We also propose the answer the question of how the sleep disturbances relate to changes in lung function, systemic and airway inflammation, genetic variations, activity levels and day-to-day variations in spirometry. Hypotheses Sleep disturbance in COPD is due to overnight changes in lung function, and associated with subjective overnight and early morning symptoms and worse quality of life. Our secondary hypotheses are that overnight changes in lung function are related to airway and systemic inflammation, and variations in genes that influence circadian variation. The significance of the findings will be increased understanding of the prevalence and mechanisms of sleep disturbance and symptoms in COPD. This may influence management of COPD in terms of physical and pharmacological treatment.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Greg King
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Address
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Department of Respiratory Medicine
Royal North Shore Hospital
Pacific Highway
St Leonards, NSW, 2065
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Country
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Australia
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Phone
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+61 2 9463 2935
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Fax
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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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Kanika Jetmalani
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Address
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The Woolcock Institute of Medical Research
431 Glebe point road, Glebe, NSW, 2037
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Country
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Australia
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Phone
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+61 2 91140147
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Greg King
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Address
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Department of Respiratory Medicine
Royal North Shore Hospital
Pacific Highway
St Leonards, NSW, 2065
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Country
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Australia
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Phone
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+61 2 9463 2935
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
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
No additional documents have been identified.
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