The Outcome of CPAP Titration Under Sleep Endoscopy

Study Overview
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Brief Summary
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The outcome of CPAP titration under sleep endoscopy: A randomized controlled crossover trial

Detailed Description
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This is the study entitled The outcome of CPAP titration under sleep endoscopy: A randomized controlled crossover trial. CPAP is first line golden standard treatment for Obstructive sleep apnea (OSA). However, the overall CPAP compliance is about 50%. One of the reasons responsible for the poor compliance is the inadequate pressure setting initially. Therefore, it is crucial for us to find out the adequate pressure as soon as possible. Sleep endoscopy is the way to evaluate upper airway obstruction of OSA patients. Meanwhile, the investigators used CPAP to titrate the adequate pressure to keep upper airway open under sleep endoscopy guidance. While the investigators find out this adequate pressure, the investigators set this pressure into CPAP program, which OSA patient will use for 1 month. To compare the different effect of CPAP under either auto-CPAP titration pressure or sleep endoscopy guidance pressure, those OSA patients will use auto-titration CPAP for 1 month as well. Another highlight of this study is the sedative agent-dexmedetomidine. Dexmedetomidine is a α2 antogonist, which cause patients sedative but less respiratory drive suppression. The mechanism of dexmedetomidine is more physiological for nature sleep.

Official Title
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The Outcome of CPAP Titration Under Sleep Endoscopy: A Randomized Controlled Crossover Trial

Conditions
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Obstructive Sleep Apnea, CPAP, DISE

Intervention / Treatment
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* Device: CPAP


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: moderate to severe OSA ESS >10 Exclusion Criteria: ASA > 3 allergy to Dexmedetomidine second or third degree AVB severe heart failure Fc class IV asthma acute attack

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Diagnostic
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CPAP pressure (determied by DISE)<br> | Device: CPAP<br>* CPAP treatment with different pressure for OSA patients<br>|
| Active Comparator: CPAP pressure (determined by physician)<br> | Device: CPAP<br>* CPAP treatment with different pressure for OSA patients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| complaince of CPAP use | CPAP complaince was defined as the use of CPAP is more than 4 hours per day and 5 days per week | the change of complaince between baseline, 1 month and 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sleepiness score | ESS | the change of ESS between baseline, 1 month and 2 months |