Effect of CPAP (Continuous Positive Airway Pressure) on Lung Function in Asthmatics With Sleep Apnea

Study Overview
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Brief Summary
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This is a research study of asthma and sleep apnea. Our hypothesis is that untreated sleep apnea causes inflammation in the lung, which can worsen asthma. We believe treatment of sleep apnea will reduce this inflammation, and improve asthma control. This study will help us better understand what happens to the lung and bronchial tubes before and after treatment of sleep apnea, which could benefit all patients with sleep apnea. This study involves 2 bronchoscopies.

Official Title
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Effect of CPAP (Continuous Positive Airway Pressure) on Airway Inflammation in Asthmatics With Sleep-Disordered Breathing: A Pilot Study

Conditions
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Sleep Apnea, Asthma

Intervention / Treatment
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* Device: CPAP machine as a result of sleep study


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult (>18yrs at the time of recruitment) Body mass index (BMI) ≥ 30 Symptoms suggestive of sleep apnea Epworth Sleepiness Score (ESS) within range Positive sleep study for sleep apnea Exclusion Criteria: Tobacco use within the last 3 months. Presence of other significant comorbid heart or lung disease Presence of another chronic inflammatory disease, such as connective-tissue disease, inflammatory bowel disease, or active infection. Use of systemic steroids, as defined as any prednisone use in the preceding 3 months. Use of leukotriene antagonists or theophylline within the preceding 6 weeks. Presence of severe or uncontrolled sinusitis, such that CPAP therapy will be difficult or uncomfortable. History of significant claustrophobia, uncontrolled psychiatric disease, or anticipated intolerance of CPAP therapy. Night shift workers, or other subjects with significantly altered sleep-wake cycles. Baseline post-bronchodilator FEV1 < 70% predicted. Severe gastroesophageal reflux disease.

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: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: CPAP machine as a result of sleep study|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Systemic inflammatory markers will include IL-6, IL-8, CRP, and TNF-α. |  |  | 
| Exhaled breath condensate levels of IL-6 and 8-isporostane will be measured. |  |  | 
| BAL (bronchial lavage) fluid cell count and differential, IL-6, IL-8, and TNF- α will be measured. |  |  | 
| Endobronchial biopsies to analyze extent and type of inflammatory cell. |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Symptoms, albuterol use and daily morning and evening peak expiratory flows from diary cards. |  |  | 
| Spirometry measured at three time points: before, during, and after CPAP therapy. |  |  | 
| Post-CPAP methacholine for bronchial hyperreactivity |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Asthma, Sleep Apnea, Obesity, CPAP