Ezopiclone Improves the Quality of Overnight Polysomnography - Full Text View

Sponsor:	Walter Reed Army Medical Center
Collaborator:	Sepracor, Inc.
Information provided by:	Walter Reed Army Medical Center
ClinicalTrials.gov Identifier:	NCT00507117

Purpose

Patients often have difficulty sleeping during overnight sleep testing in a lab environment. The purpose of this study is to determine if taking a sleep aid will improve sleep and therefore the quality of the sleep study.

Condition	Intervention	Phase
Obstructive Sleep Apnea	Drug: Lunesta Drug: Placebo control	Phase IV

Study Type:	Interventional
Study Design:	Diagnostic, Randomized, Double-Blind, Placebo Control, Parallel Assignment, Efficacy Study
Official Title:	Prospective, Randomized, Placebo Controlled Trial Assessing the Effects of Ezopiclone on the Quality of Overnight Polysomnography and CPAP Titration

Resource links provided by NLM:

MedlinePlus related topics: Sleep Apnea

Drug Information available for: Eszopiclone

U.S. FDA Resources

Further study details as provided by Walter Reed Army Medical Center:

Primary Outcome Measures:

diagnostic yield of PSG [ Time Frame: during overnight study ]
total sleep time [ Time Frame: during overnight study ]
wake after sleep onset [ Time Frame: during overnight study ]
sleep latency [ Time Frame: during overnight study ]
sleep efficiency [ Time Frame: during overnight study ]
total arousal index [ Time Frame: during overnight study ]
respiratory disturbance index at highest CPAP level [ Time Frame: during overnight study ]

Secondary Outcome Measures:

Respiratory Disturbance Index [ Time Frame: during overnight study ]

Estimated Enrollment:	300
Study Start Date:	March 2007
Study Completion Date:	October 2007

Arms	Assigned Interventions
PSG: Active Comparator	Drug: Lunesta Lunesta 3mg prior to PSG Drug: Placebo control matching placebo

Detailed Description:

The increasing awareness of sleep-disordered breathing (i.e obstructive sleep apnea) has created a growing demand for polysomnography (sleep study), resulting in excessive waiting times in many laboratories. Sleep centers have therefore needed to develop methods to improve their efficiency. Unfortunately many patients find it difficult to fall asleep in the unfamiliar environment of a laboratory setting (the "first-night effect"), circumstances that may prolong falling alseep and staying sleep. Likewise, intolerance of continuous positive airway pressure (CPAP) may also reduce the quality of the sleep study. Poor quality studies may lead to an inability to make a diagnosis or adequately titrate CPAP therapy. Unsatisfactory studies may need to be repeated.

Sleep aids (hypnotics) are commonly used to treat both acute and chronic insomnia. These agents have minimal side-effects and do not disrupt normal sleep architecture or alter respiratory events. These attributes make such agents ideal for use to improve the quality of sleep studies and enhance the efficiency of sleep centers.

In a recent retrospective review, we found that the use of a hypnotic prior to the sleep study resulted improved patient satisfaction and improved quality of the sleep study with significantly less studies needing to be repeated. Although promising, these results must be validated with a prospective, randomized, placebo-controlled trial.

Eszopiclone (Lunesta) is a new non-narcotic, non-benzodiazepine hypnotic agent which received FDA approval on December 15, 2004 for the treatment of acute and chronic insomnia. Multiple clinical trials have found that eszopiclone decreases sleep latency, improves sleep efficiency/maintenance and reduces wake time after sleep onset (WASO). Given its efficacy in promoting sleep onset and sleep maintenance and its excellent safety profile, this agent should be ideal as a pre-study sedative. The purpose of this study is to validate the use of Lunesta in improving the quality of overnight sleep studies.

Eligibility

Ages Eligible for Study:	18 Years to 64 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

All adult patients aged 18-65, evaluated by a sleep medicine provider in the Walter Reed Army Medical Center Sleep Disorders Clinic, who are referred for PSG for suspected Obstructive Sleep Apnea Syndrome

Exclusion Criteria:

Pregnancy
Liver dysfunction or history of EtOH abuse
Concomitant use of benzodiazepines, narcotics or ketozonazole
Decompensated CHF
CVA within 3 months
Uncontrolled psychiatric disorders
Patients < 18 years old
Patients over 65

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00507117

Locations

United States, District of Columbia
Walter Reed Army Medical Center
Washington DC, District of Columbia, United States, 20307

Sponsors and Collaborators

Walter Reed Army Medical Center

Sepracor, Inc.

Investigators

Principal Investigator:

Christopher J Lettieri, MD

Walter Reed Army Medical Center

More Information

Publications:

Lettieri CJ, Eliasson AH, Andrada T, Khramtsov A, Kristo DA. Does zolpidem enhance the yield of polysomnography? J Clin Sleep Med. 2005 Apr 15;1(2):129-31.

Additional publications automatically indexed to this study by National Clinical Trials Identifier (NCT ID):

Lettieri CJ, Collen JF, Eliasson AH, Quast TM. Sedative use during continuous positive airway pressure titration improves subsequent compliance: a randomized, double-blind, placebo-controlled trial. Chest. 2009 Nov;136(5):1263-8. Epub 2009 Jun 30.

Lettieri CJ, Quast TN, Eliasson AH, Andrada T. Eszopiclone improves overnight polysomnography and continuous positive airway pressure titration: a prospective, randomized, placebo-controlled trial. Sleep. 2008 Sep 1;31(9):1310-6.

Study ID Numbers:	WRAMC05-17017
Study First Received:	July 23, 2007
Last Updated:	November 29, 2007
ClinicalTrials.gov Identifier:	NCT00507117 History of Changes
Health Authority:	United States: Federal Government

Keywords provided by Walter Reed Army Medical Center:

Obstructive Sleep Apnea
Polysomnography
Non-benzodiazepine hypnotics

Additional relevant MeSH terms:

Sleep Apnea Syndromes
Respiratory Tract Diseases
Apnea
Nervous System Diseases
Respiration Disorders

Sleep Apnea, Obstructive
Sleep Disorders
Dyssomnias
Sleep Disorders, Intrinsic

ClinicalTrials.gov processed this record on February 08, 2010