Endotype-Targeted Therapy to Rescue OSA Patients Struggling With CPAP Adherence (TOP-CPAP)
Status:
Recruiting
Trial end date:
2024-12-31
Target enrollment:
Participant gender:
Summary
More than 10% of the US population have obstructive sleep apnea (OSA). Standard of care is
therapy with CPAP (continuous positive airway pressure) which virtually eliminates OSA.
However, most patients use CPAP only for part of the night (4-5hours) and about 50% patients
discontinue CPAP long-term. Alternative therapies are limited, thus many OSA patients remain
at risk of OSA sequelae (e.g. sleepiness, memory issues, high blood pressure, etc.).
Importantly, different patients get OSA for different reasons, and recent data show that some
of the underlying causes of OSA ("endotypes") such as having a low arousal threshold (i.e.
waking up easily) are associated with lower CPAP adherence. Using a randomized controlled
trial design, this will be the first study using a targeted intervention to manipulate the
underlying OSA causes (i.e., giving a safe hypnotic to patients with OSA to increase the
arousal threshold) to test the hypothesis that endotype-targeted therapy increases
CPAP-adherence in patients who have low but continued CPAP usage. Ultimately, this strategy
may improve the care and outcomes of millions of undertreated OSA patients.