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

睡眠呼吸暂停是美国退伍军人中最常见的慢性疾病之一， 严重损害功能和生活质量。持续的白天嗜睡症状 阻塞性睡眠呼吸暂停综合征患者中持续阳性 气道压力（CPAP）与不良的长期医疗和功能结局相关。 CPAP治疗，虽然有效纠正呼吸事件和夜间血氧 饱和水平，并不一定改善白天的症状，这是负责损失 的功能。我们假设，在昼夜节律系统脆弱的个体中，昼夜节律 节律紊乱可能由睡眠呼吸暂停引起。我们的研究将是第一个探索 明亮的光疗法（BLT）的作用，一种成熟的非药物干预， 昼夜节律紊乱，用于治疗OSA的残留日间症状， 回复CPAP 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，他们目前 坚持使用CPAP治疗，并且仍然经历白天的显著症状 嗜睡和抑郁。我们将他们随机接受两种可能的治疗之一 亮光疗法（BLT）和假亮光疗法（s-BLT）的序列：BLT-sBLT; sBLT-BLT。我们希望患者能够体验到睡眠相关功能和质量的改善 在治疗序列的主动治疗部分期间，结果将提供一个 为一项有效的随机对照试验奠定了基础，以测试早晨的光线（明亮与安慰剂）是否作为非 药理学治疗，可以增强现有的睡眠呼吸暂停治疗， 改善症状管理和功能结果。

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.