Bright Light Therapy for residual daytime symptoms associated with obstructive sleep apnea

亮光疗法治疗与阻塞性睡眠呼吸暂停相关的残留日间症状

• 批准号: 10016755
• 负责人: Isabella Soreca
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10016755
• 关键词: Adherence; Animal Model; Behavior; Behavior Therapy; Blood; Chronic; Circadian Dysregulation; Circadian Rhythms; Continuous Positive Airway Pressure; Cross-Over Studies; Crossover Design; Data; Diagnosis; Drowsiness; Event; Exposure to; Family; Foundations; Future; Health; Individual; Intervention; Light; Link; Mediating; Medical; Mental Depression; Military Personnel; Napping; Obstructive Sleep Apnea; Occupational; Oxygen; Participant; Patients; Phototherapy; Placebos; Quality of life; Randomized; Residual state; Resistance; Role; Sleep; Sleep Apnea Syndromes; Symptoms; System; Testing; Time; Veterans; actigraphy; active method; associated symptom; circadian; design; effective intervention; experience; functional disability; functional outcomes; human model; improved; loss of function; neuropsychiatry; recruit; reduce symptoms; respiratory; sleep pattern; sleep quality; symptom management; symptom treatment; symptomatic improvement; vigilance

Sleep apnea is one of the most common chronic condition among US military veterans, causing significant detriment to function and quality of life. Persistent daytime symptoms of sleepiness and depression in individuals with obstructive sleep apnea who are using Continuous Positive Airway Pressure (CPAP) are associated with adverse long term medical and functional outcomes. CPAP treatment, while effective at correcting respiratory events and night time blood oxygen saturation levels, does not necessarily improve daytime symptoms, which are responsible for loss of function. We hypothesize that, in individuals with vulnerable circadian system, circadian rhythms disturbances may be triggered by sleep apnea. Our study will be the first to explore the role of Bright Light Therapy (BLT), a well-established non-pharmacological intervention for circadian disturbances, for the treatment of residual daytime symptoms of OSA which do not respond to CPAP. We will recruit 25 Veterans who have been diagnosed with Obstructive Sleep Apnea, are currently adherent to treatment with CPAP and are still experiencing significant symptoms of daytime sleepiness and depression. We will randomize them to receive one of the two possible treatment sequences of Bright Light Therapy (BLT) and sham Bright Light Therapy (s-BLT): BLT-sBLT; sBLT-BLT. We expect patients to experience improvement in sleep related functioning and quality of life during the active treatment portion of the treatment sequence. The results will provide a foundation for a well-powered RCT to test if morning light (bright vs. placebo), as a non- pharmacological adjunctive treatment, can enhance existing treatments for sleep apnea to improve symptom management and functional outcomes.

睡眠呼吸暂停是美国退伍军人中最常见的慢性病之一，导致 严重损害功能和生活质量。白天持续出现嗜睡症状 患有阻塞性睡眠呼吸暂停的患者使用持续积极治疗后会出现抑郁症 气道压力 (CPAP) 与不良的长期医疗和功能结果相关。 CPAP 治疗，同时可有效纠正呼吸事件和夜间血氧 饱和水平，不一定会改善白天症状，这是造成损失的原因 的功能。我们假设，在昼夜节律系统脆弱的个体中，昼夜节律 睡眠呼吸暂停可能会引发节律紊乱。我们的研究将首先探索 亮光疗法（BLT）的作用，这是一种行之有效的非药物干预措施 昼夜节律紊乱，用于治疗 OSA 的残余日间症状 对 CPAP 做出反应。 我们将招募 25 名被诊断患有阻塞性睡眠呼吸暂停的退伍军人，目前正在接受治疗 坚持使用 CPAP 治疗，但白天仍出现明显症状 嗜睡和抑郁。我们将随机分配他们接受两种可能的治疗方法之一 亮光疗法（BLT）和假亮光疗法（s-BLT）的序列：BLT-sBLT； sBLT-BLT。我们期望患者的睡眠相关功能和质量得到改善 治疗序列的积极治疗部分期间的生命。结果将提供一个 为一项强有力的随机对照试验奠定了基础，以测试晨光（明亮与安慰剂）是否作为非 药物辅助治疗，可以增强现有的睡眠呼吸暂停治疗方法 改善症状管理和功能结果。