Improving Outcomes in Cognitive Impairment Using Home Sleep Apnea Testing Compared to In-Lab Polysomnography A Randomized Trial

What this Trial Is About

Researchers are investigating obstructive sleep apnea OSA, a condition causing abnormal pauses in breathing during sleep that is common in patients with vascular cognitive impairment VCI and Alzheimers disease AD. OSA worsens cognitive problems in these conditions, and although continuous positive airway pressure CPAP treatment has shown promise in improving cognition and slowing decline, many patients do not get tested due to the inconvenience of standard in-laboratory polysomnography iPSG. This trial aims to find out if home sleep apnea testing HSAT, a more convenient and less expensive option, leads to a higher rate of completed sleep tests within 6 months compared to iPSG. The study also examines cost-effectiveness, patient satisfaction, CPAP treatment rates, and changes in cognition, mood, sleep quality, and function between the two testing methods. Participants are randomly assigned to either the standard iPSG testing or the HSAT device, which records breathing and oxygen levels during sleep at home. Both groups receive usual care for diagnosing OSA. The study follows patients for 6 months after randomization to compare outcomes. HSAT measures respiratory effort, pulse, oxygen saturation, nasal flow, and reports apneas, hypopneas, snoring, and blood oxygen levels to detect OSA. The trial is a single-masked randomized controlled study. During the study, participants undergo sleep testing using their assigned method. Researchers assess how many complete the testing by 6 months as the primary outcome. They also evaluate cognitive function using the Montreal Cognitive Assessment and Psychomotor Vigilance Task, mood with the Geriatric Depression Scale, sleep quality with the Functional Outcomes of Sleep Questionnaire, daytime sleepiness using the Epworth Sleepiness Scale, and overall quality of life via the EQ-5D-5L. Patient satisfaction and cost of each testing strategy are also recorded. The total participation period is 6 months, during which caregivers may assist with completing the tests if needed.

ENhancing Outcomes in Cognitive Impairment Through Use of Home Sleep ApNea Testing