Nasal High Flow Therapy for the Treatment of Respiratory Insufficiencies During Sleep

Study Overview
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Brief Summary
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Respiratory insufficiencies during sleep can lead to reductions in the level of oxygen in the blood during the night, which has been shown to contribute to a range of morbidities. The purpose of this study is to assess the possibility that a nasal high flow therapy device may be able to treat respiratory insufficiencies, by stabilizing breathing and preventing reduction in blood oxygen. Heart failure patients will be screened at a heart failure clinic, and will be asked to undergo an overnight sleep study to determine is they exhibit respiratory insufficiencies during sleep. This sleep study may be completed in the sleep laboratory (attended polysomnography, PSG) or in-home (in-home polygraphy, PG). If they are diagnosed with respiratory insufficiencies, they will be asked to attend further overnight studies to see if treatment with nasal high flow therapy can be used to stabilize breathing.

Official Title
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Study of the Effects of Nasal High Flow Therapy as a Treatment Option for Patients With Respiratory Insufficiencies During Sleep.

Conditions
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Sleep Disordered Breathing, Congestive Heart Failure

Intervention / Treatment
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* Device: Nasal High flow therapy device


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and Women aged ≥ 18 years Heart Failure from ischemic or non-ischemic dilated cardiomyopathy for ≥ 6 months Left ventricular systolic dysfunction (LVEF ≤45% by echocardiography performed within 3 months of the screening visit, or if not within 3 months, a justification provided by the cardiologist for why a repeat echocardiography is not required, for example, because the subject's condition has remained stable since their echocardiography). All echocardiography must be within a maximum of 1 year of the screening visit. New York Heart Association Class II or III after optimization of medical therapy Stable Clinical Status on stable optimal medical therapy for ≥ 1 month before entry Exclusion Criteria: Unstable angina Myocardial infarction within the last 12 months Cardiac surgery within the previous 6 months Pregnancy Unwilling or unable to provide informed consent Uncontrolled arrhythmias Severe valvular heart disease Current/prior use of mechanical ventilation (including CPAP). At the investigator's discretion.

Ages Eligible for Study
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Minimum Age: 18 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: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Diagnostic PSG/PG, PSG w. nasal high flow therapy<br>All patients recruited will undergo a diagnostic sleep study, either a full in laboratory attended polysomnography (PSG), or an in-home polygraphy (PG). If respiratory insufficiencies with Cheyne-Stokes respiration (CSR) are detected, these patients will undergo an overnight in laboratory attended PSG on a nasal high flow therapy device to test the primary endpoint of this study. Patients without respiratory insufficiencies after the first PSG/PG will take no further part in the trial. | Device: Nasal High flow therapy device<br>* Nasal high flow therapy via nasal cannula.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Treatment Efficacy | The primary endpoint of the trial is to the efficacy of using nasal high flow therapy to stabilize breathing, as measured by the breath flow signal from PSG. | During 1 night of Sleep on PSG |