Sleep Apnea Syndrome and Vitamin D

Study Overview
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Brief Summary
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Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a highly prevalent disorder with multiple comorbidities. OSAHS is characterized by repetitive episodes of airflow reduction (hypopnoea) or cessation (apnoea) due to upper airway collapse during sleep. Its major risk factor is obesity. However, its pathogenesis is complex and multifactorial. Reduced upper airway muscle tonus and/or unstable neuromuscular output seem to be involved in this collapsus. A normal vitamin D status is necessary for normal muscle function and neuromuscular output. As obesity is associated with a high rate of hypovitaminosis D, it appears of interest to evaluate the effect of vitamin D supplementation on OSAHS patients with vitamin D deficiency.

Detailed Description
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Prospective, longitudinal, double bind, randomized study of the effect of vitamin D supplementation in OSAHS patients with hypovitaminosis D. After written informed consent, patients will be randomized to receive a single dose of oral vitamin D (400 000 UI) or placebo. Subjects will undergo medical screening before randomisation into placebo or active group. Follow-up measurements will be performed at the beginning (day 0) and after 32 days of vitamin D supplementation: clinical examination, biological check up and sleep parameter evaluation. Patients will be instructed to stop using continuous positive airway pressure device for two nights before nocturnal sleep studies.

Official Title
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Effect of the Correction of Vitamin D Deficiency in Patients With Obstructive Sleep Apnea-hypopopnea Syndrome (OSAHS)

Conditions
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Obstructive Sleep Apnea-hypopnea Syndrome

Intervention / Treatment
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* Drug: 25 OH vitamin D


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Moderate to severe obstructive sleep apnoea (AHI > 15) With or without continuous positive airway pressure for a minimum of six months aged 30-75 years Vitamin D2D3 level < 30 ng/ml Exclusion Criteria: Diseases or therapy known to interfere with phospho-calcium or vitamin D metabolism Patients with mixed sleep apnoea (central and obstructive) Patients with CPAP use < 4 hours per night Patients with maxillofacial or oro-pharyngeal diseases) Patients with chronic respiratory failure, hypercapnic patients Muscle diseases Alcohol intake > 2 glasses per day Body mass index > 40 kg/m2

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: 25 OH vitamin D|After written informed consent, patients will be randomized to receive a single dose of oral vitamin D (400 000 UI) or placebo. Subjects will undergo medical screening before randomisation into placebo or active group. Follow-up measurements will be performed at the beginning (day 0) and after 32 days of vitamin D supplementation: clinical examination, biological check up and sleep parameter evaluation. Patients will be instructed to stop using continuous positive airway pressure device for two nights before nocturnal sleep studies|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Apnea-hypopnea index (AHI), defined as the average rate of apneas and hypopneas per hour of sleep |  | at the beginning (day 0) and after 32 days of vitamin D supplementation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Epworth sleepiness scale |  | at the beginning (day 0) and after 32 days of vitamin D supplementation | 
| mean arterial oxygen saturation (SaO2) during sleep, time of SaO2<90%, and Nadir of arterial oxygen saturation (Nadir SaO2) |  | at the beginning (day 0) and after 32 days of vitamin D supplementation | 
| Continuous positive airway pressure measured with a CPAP equipment |  | at the beginning (day 0) and after 32 days of vitamin D supplementation | 
| Muscular strength measured with handgrip test |  | at the beginning (day 0) and after 32 days of vitamin D supplementation | 
| Mini Mental Sate Examination, trail making test, Hamilton Anxiety Depression scale, SF36 questionnaire |  | at the beginning (day 0) and after 32 days of vitamin D supplementation | 
| Inflammatory status : IL6 and high sensitivity C-reactive proteine (hs CRP) |  | at the beginning (day 0) and after 32 days of vitamin D supplementation | 
| Analysis of genes implicated in vitamin D metabolism |  | at inclusion. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obstructive sleep apnea-hypopnea syndrome, OSAHS, Vitamin D