Reversible Effect of Falling Ventilatory Drive in Drive-dependent Obstructive Sleep Apnea Using Timed Carbon Dioxide Delivery

What this Trial Is About

Obstructive sleep apnea (OSA) is a common condition that affects breathing during sleep and is linked to problems with heart health, brain function, daytime sleepiness, and quality of life. Traditional models do not fully explain OSA's complexity. Researchers are studying a newer model called drive-dependent OSA, where increased breathing drive helps prevent airway blockages. This study aims to show that preventing the loss of breathing drive can stop OSA events in people with drive-dependent OSA but not in those with classic OSA. The study involves carefully timed delivery of carbon dioxide (CO2) during sleep to keep the breathing drive from falling. Participants will undergo a series of sleep studies, including a baseline sleep study and an overnight physiological study to identify their OSA type. Then, during sleep, about 2% CO2 will be given for 3-4 breaths before about 30 respiratory events to see if it prevents OSA events. Sham treatments with air will be given as controls. The CO2 dose may be adjusted to a maximum of 6% or diluted to 1-1.5% if needed. The study compares effects between drive-dependent and classic OSA groups. Participants will join a virtual screening and consent visit followed by overnight sleep studies with advanced monitoring of ventilation, breathing drive, and muscle activity. Researchers will measure the reduction in likelihood of respiratory events, changes in ventilation, and muscle activity using detailed breath-by-breath analysis. The study lasts one night for each intervention, and results will be analyzed statistically to see if CO2 reduces OSA events specifically in drive-dependent OSA. Safety and event scoring follow current clinical guidelines.

Reversible Effect of Falling Ventilatory Drive in Drive-dependent OSA