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Trial registered on ANZCTR
Registration number
ACTRN12618001859279
Ethics application status
Approved
Date submitted
12/11/2018
Date registered
15/11/2018
Date last updated
15/11/2018
Date data sharing statement initially provided
15/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Self-reported daytime sleepiness and sleep-disordered breathing in patients with Atrial Fibrillation
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Scientific title
Self-reported daytime sleepiness and sleep-disordered breathing in patients with Atrial Fibrillation
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Secondary ID [1]
296053
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
Snooze AF
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Atrial Fibrillation
310376
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Sleep-Disordered Breathing
310377
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Condition category
Condition code
Cardiovascular
309097
309097
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0
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Other cardiovascular diseases
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Respiratory
309098
309098
0
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
Patients with a atrial fibrillation, a common heart rhythm abnormality, are often referred for formal sleep studies (polysomnography) to assess for the presence and severity of sleep-disordered breathing. Sleep-disordered breathing, of which sleep apnoea is an important subtype, is a known risk factor for developing atrial fibrillation and its treatment can improve the likelihood of maintaining normal sinus rhythm following atrial fibrillation treatment. One of the main clinical consequences of sleep-disordered breathing is excessive daytime sleepiness which can be assessed using questionnaires. The polysomnography tests are usually performed overnight in a specialised sleep centre and are reported by a qualified sleep technician and a respiratory physician. The duration of observation spans over the recruitment period which is from January 2012 to March 2017.
The electronic health records of the study patients will be examined and the following parameters (already present health records) retrieved for analysis: medical background (clinical history), antrhopometric data (weight, height and BMI), medication history, echocardiographic data, clinical questionnaires (AF severity questionnaires and sleepiness questionnaires) as well as the formal polysomnography reports. These data are already present in electronic format in medical records and will be accessed to retrieve the relevant information for the study once approved.
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Intervention code [1]
312888
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Diagnosis / Prognosis
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Comparator / control treatment
Formal polysomnography tests are assessed by a respiratory physician and a diagnosis of the presence and severity of sleep-disordered breathing is made. Patients with sleep-disordered breathing will function as the main study group, and those without will be the controls.
The clinical data will be retrieved from the Centre for Heart Rhythm Disorders and Royal Adelaide Hospital over the period of the study, January 2012 to March 2017.
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Control group
Historical
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Outcomes
Primary outcome [1]
308070
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Diagnosis of sleep-disordered breathing as quantified by polosymnography
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Assessment method [1]
308070
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Timepoint [1]
308070
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At time of polysomnography
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Secondary outcome [1]
353871
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Excessive Daytime Sleepiness (quantified using the Epworth Sleepiness Scale)
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Assessment method [1]
353871
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Timepoint [1]
353871
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At time of undergoing polysomnography
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Eligibility
Key inclusion criteria
• Age equal to or greater than 18 years
• Diagnosed with paroxysmal or persistent atrial fibrillation (according to the 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.
• Referred to, and completed, a formal overnight polysomnography (PSG)
• Completed a contemporaneous Epworth Sleepiness Scale questionnaire
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Minimum age
18
Years
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Maximum age
No limit
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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
• Insufficient polysomnography data (less than 4 hours of sleep study or absence of measured apnoea-hypopnoea index reporting).
• Incomplete Epworth Sleepiness Scale score
• Pregnancy
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
Clinical characteristics and relevant data from polysomnography, including apnoea-hypopnoea index (AHI), in addition to Epworth Sleepiness Scale (ESS) will be retrieved from Electronic Medical Reports (EMRs). Statistical analysis will be performed using SPSS statistical software for Windows (Version 24; IBM corp.). Following the reporting of descriptive statistics, the correlation between ESS and AHI will be tested using the Pearson correlation coefficient testing. The utility of ESS to predict SDB will be tested using the receiver-operating-characteristic (ROC) analysis and presented as area-under-the-curve (AUC). A binary logistic regression model that would utilise the available clinical features will be constructed to try and identify patients with significant sleep-disordered breathing.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/12/2018
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Actual
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Date of last participant enrolment
Anticipated
10/12/2018
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Actual
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Date of last data collection
Anticipated
1/01/2019
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
12388
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
24653
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
300641
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University
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Name [1]
300641
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University of Adelaide
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Address [1]
300641
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Centre for Heart Rhythm Disorders - part of the University of Adelaide and the Royal Adelaide Hospital
Cardiology 4G751-769
Royal Adelaide Hospital
Port Rd, SA 5000
AUSTRALIA
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Country [1]
300641
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Australia
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Primary sponsor type
Individual
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Name
Professor Prashanthan Sanders
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Address
Director, Centre for Heart Rhythm Disorders
NHMRC Practitioner Fellow,
Knapman-NHF Chair of Cardiology Research,
University of Adelaide | SAHMRI
Director, Cardiac Electrophysiology & Pacing,
Royal Adelaide Hospital
Port Road
SA 5000
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Country
Australia
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Secondary sponsor category [1]
300777
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None
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Name [1]
300777
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Address [1]
300777
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Country [1]
300777
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301430
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Central Adelaide Local Health Network (CALHN) Research Ethics Committee
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Ethics committee address [1]
301430
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L3, Roma Mitchell House, North Terrace, Adelaide – Postal Details: RAH Clinical Trial Centre, Wayfinder 3D460.02, Level 3, Royal Adelaide Hospital, Port Road, ADELAIDE SA 5000
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Ethics committee country [1]
301430
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Australia
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Date submitted for ethics approval [1]
301430
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27/08/2018
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Approval date [1]
301430
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12/11/2018
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Ethics approval number [1]
301430
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R20180831
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Summary
Brief summary
Sleep-disordered breathing (SDB) is common in patients with atrial fibrillation (AF) and is associated with poor clinical outcomes. International AF management guidelines advocate for the interrogation for clinical signs of SDB when addressing AF risk factors given the important interplay between SDB and AF. Excessive daytime sleepiness is an important clinical consequence of SDB and its presence can be a key consideration in patient selection for SDB investigation and management. However, patients with cardiovascular disease report low levels of daytime sleepiness. Therefore, relying on self-reported daytime sleepiness in patient selection for diagnosis and management can potentially result in a significant proportion of patients not being identified with SDB or provided appropriate management opportunities. We hypothesise that in patients with atrial fibrillation, excessive daytime sleepiness is low and that self-reported sleepiness correlates poorly with the presence or degree of SDB. We aim to test this hypothesis by studying patients with AF who have undergone overnight sleep studies. We will assess the self-reported sleepiness and its correlation to the presence and degree of SDB. We will test the utility of the Epworth Sleepiness Scale, a widely used tool to quantify daytime sleepiness, to predict the presence of SDB. Further, we aim to characterise clinical features that can help identify patients with significant SDB, and assess the potential impact this would have on AF management.
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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
86966
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Prof Prashanthan Sanders
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Address
86966
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Royal Adelaide Hospital
Cardiology 4G751-769
The University of Adelaide
Port Rd, SA 5000
AUSTRALIA
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Country
86966
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Australia
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Phone
86966
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+61 8 8313 9000
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Fax
86966
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Email
86966
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[email protected]
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Contact person for public queries
Name
86967
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Kadhim Kadhim
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Address
86967
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Royal Adelaide Hospital
Cardiology 4G751-769
The University of Adelaide
Port Rd, SA 5000
AUSTRALIA
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Country
86967
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Australia
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Phone
86967
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+61 8 8313 9000
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Fax
86967
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Email
86967
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[email protected]
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Contact person for scientific queries
Name
86968
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Kadhim Kadhim
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Address
86968
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Royal Adelaide Hospital
Cardiology 4G751-769
The University of Adelaide
Port Rd, SA 5000
AUSTRALIA
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Country
86968
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Australia
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Phone
86968
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+61 8 8313 9000
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Fax
86968
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Email
86968
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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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