Bright Light Therapy for Residual Daytime Symptoms Associated With Obstructive Sleep Apnea
Condition: Obstructive Sleep Apnea
MeSH terms: Apnea; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
Study type: Interventional

Summary: 
      Sleep apnea is one of the most common chronic condition among US military Veterans, causing
      sleepiness, reduced psychomotor vigilance and depression, which undermine daytime functioning
      and quality of life. Persistent daytime symptoms of sleepiness in individuals with
      Obstructive Sleep Apnea (OSA) who are using Continuous Positive Airway Pressure (CPAP) are
      associated with adverse long term medical and functional outcomes. Residual daytime
      sleepiness (RDS) is associated with reduced occupational and family functioning and overall
      lower quality of life. Napping is a common behavior among individuals with OSA and RDS and
      has been linked to both benefits to and decline in health and functioning. Longer nap times
      may maintain, as opposed to decrease, sleepiness by promoting sleep inertia and can
      contribute to maintaining subclinical circadian alterations that result in higher
      night-tonight variability in sleep patterns. Preliminary studies in humans and animal models
      have shown persisting alterations of circadian rhythms in OSA patients, that fail to
      normalize with CPAP treatment. CPAP treatment, while effective at correcting respiratory
      events and night time blood oxygen saturation levels, does not necessarily re-align the
      circadian system. Current treatment options are limited to stimulants and modafinil, whose
      long-term safety profile, effectiveness and impact on functional recovery is largely unknown.
      Supplementary exposure to bright light has beneficial effects on sleep quality and daytime
      vigilance in healthy individuals and it has been increasingly applied in a variety of sleep
      and neuropsychiatric conditions. However, no study to date has tested the application of BLT
      to treat daytime symptoms associated with sleep apnea. The investigators' study will be the
      first to explore the role of Bright Light Therapy (BLT), a well-established
      non-pharmacological intervention for circadian disturbances, for the treatment of residual
      daytime symptoms of OSA which do not respond to CPAP.
    

Detailed description: 
      Due to Covid 19 pandemic emergency measures, recruitment for clinical trials is currently on
      hold

      Background: Sleep apnea is one of the most common chronic condition among US military
      Veterans , it causes sleepiness, reduced psychomotor vigilance and depression, which
      undermine daytime functioning and quality of life . Persistent daytime symptoms of sleepiness
      and depression in individuals with OSA who are using Continuous Positive Airway Pressure
      (CPAP) are associated with adverse long term medical and functional outcomes . Current
      treatment options are limited to stimulants and modafinil, whose long-term safety profile,
      effectiveness and impact on functional recovery is largely unknown. The mechanisms for
      residual daytime symptoms in CPAP-treated sleep apnea are poorly understood and very little
      attention has been placed on interplay between sleep apnea and the circadian system. Notably,
      sleepiness, fatigue and depression, cardinal symptoms of OSA syndrome, are common
      manifestations of circadian misalignment. Circadian rhythms are synchronized to the
      environmental light or dark and to social activity cycles by zeitgebers (time givers)
      .Preliminary studies in humans and animal models have shown persisting alterations of
      circadian rhythms in OSA patients, that fail to normalize with CPAP treatment. CPAP
      treatment, while effective at correcting respiratory events and night time blood oxygen
      saturation levels, does not necessarily re-align the circadian system. Supplementary exposure
      to bright light has beneficial effects on sleep quality and daytime vigilance in healthy
      individuals and it has been increasingly applied in a variety of sleep and neuropsychiatric
      conditions. However, no study to date has tested the application of BLT to treat daytime
      symptoms associated with sleep apnea. The investigators' study will be the first to explore
      the role of Bright Light Therapy (BLT), a well-established non-pharmacological intervention
      for circadian disturbances, for the treatment of residual daytime symptoms of OSA which do
      not respond to CPAP.
    

Intervention name(s): Bright light therapy glasses
Intervention type(s): Device
Intervention description(s): Bright light therapy delivered through glasses
Other intervention name(s): BLT
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: sleep apnea; CPAP; daytime sleepiness; bright light therapy