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Treatment Resistant Depression and Obstructive Sleep Apnea, Effect of Continuous Positive Airway Pressure (CPAP)

This study is currently recruiting participants.
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Verified November 2015 by Dr. Ruzica Jokic, Queen's University
Information provided by (Responsible Party):
Dr. Ruzica Jokic, Queen's University Identifier:
First received: February 27, 2007
Last updated: November 13, 2015
Last verified: November 2015
The purpose of the study is to determine the effect on mood and anxiety symptoms of adding CPAP to the psychiatric treatment of patients with TRD (treatment resistant depression) and associated OSA (obstructive sleep apnea).

Condition Intervention
Depression Sleep Apnea, Obstructive Device: continuous positive airway pressure (CPAP)

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Treatment Resistant Depression and Obstructive Sleep Apnea: Effect of Treatment With CPAP on Mood, Anxiety and Quality of Life

Resource links provided by NLM:

Further study details as provided by Dr. Ruzica Jokic, Queen's University:

Primary Outcome Measures:
  • Montgomery Asberg Depression Rating Scale (MADRS) [ Time Frame: baseline and 6 weeks ]

Secondary Outcome Measures:
  • Symbol digit modalities [ Time Frame: baseline and 6 weeks ]
  • Stroop Test [ Time Frame: baseline and 6 weeks ]
  • Trail-Making test [ Time Frame: baseline and 6 weeks ]
  • Pittsburgh Sleep Quality Index (PSQI) [ Time Frame: baseline and 6 weeks ]
  • Epworth Sleepiness Score (ESS) [ Time Frame: baseline and 6 weeks ]
  • Beck Anxiety Inventory (BAI) [ Time Frame: baseline and 6 weeks ]
  • SF-36 questionnaire [ Time Frame: baseline and 6 weeks ]
  • Profile of mood state (POMS) [ Time Frame: baseline and 6 weeks ]
  • HAM-D21 [ Time Frame: baseline and 6 weeks ]
    Hamilton depression inventory

Estimated Enrollment: 120
Study Start Date: March 2007
Estimated Study Completion Date: December 2016
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: CPAP treatment
Continuous Positive Airway Pressure (CPAP)for 4 weeks
Device: continuous positive airway pressure (CPAP)
CPAP (Respironics: RemStar plus M-series) machines for treatment of obstructive sleep apnea training for participant required by registered sleep technologist
Other Name: CPAP - Respironics: RemStar plus M-series
No Intervention: No CPAP
routine psychiatric care for 4 weeks followed by CPAP titration and initiation after followup measures.
No Intervention: Control group
No obstructive sleep apnea detected.

Detailed Description:

Primary objective:

What is the effect on mood and anxiety symptoms of adding CPAP to the psychiatric treatment of patients with TRD and associated OSA?

Secondary objectives:

  1. How common is co-morbid OSA in patients with treatment resistant unipolar depression referred to a tertiary Mood Disorders Clinic?
  2. Is there a difference in daytime functioning (severity of depressive and anxiety symptoms, cognitive function, daytime sleepiness) and sleep quality between patients with TRD diagnosed with OSA compared with patients with TRD who have no OSA?
  3. What is the association between sleep fragmentation and hypoxemia and the severity of depression in patients with TRD?

Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Patients with TRD.
  • Males and females between the ages of 18 and 65 years who agree to take part and sign the Informed Consent will be invited to participate in the study.
  • Patients with co-morbid Dysthymic Disorder, Generalized Anxiety Disorder or Social Anxiety Disorder may be included in the study.

Exclusion Criteria:

  • Patients with uncontrolled medical illnesses will not be permitted to participate.
  • Patients with a history of current or Bipolar Disorder, Schizophrenia, Panic Disorder, Obsessive-Compulsive Disorder or Anorexia Nervosa.
  • Head injury patients resulting in loss of consciousness for more than 10 minutes.
  • Patients with epilepsy or severe personality disorders who, at the judgment of the investigators, are not appropriate candidates for the study, will be excluded.
  • Patients who do not have the mental or physical capacity to apply the CPAP interface and to plug in and switch on an auto CPAP unit at home will be excluded.
  • Blind and/or deaf patients will be excluded.
  • Patients who initially decline an offer of CPAP treatment for OSA, and those who prefer conservative treatment options (weight loss, avoidance of alcohol and sedatives) will be excluded.
  • Patients with severe claustrophobia, who cannot tolerate any CPAP interface, will be excluded.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00441636

Contact: Ruzica Jokic, MD
Contact: Gisele Berube

Canada, Ontario
Providence Continuing Care Centre, Mental Health Services Recruiting
Kingston, Ontario, Canada, K7L4X3
Contact: Ruzica Jokic, MD         
Principal Investigator: Ruzica Jokic, MD         
Sponsors and Collaborators
Queen's University
Principal Investigator: Ruzica Jokic, MD Queen's University
  More Information

Responsible Party: Dr. Ruzica Jokic, Principal Investigator, Queen's University Identifier: NCT00441636     History of Changes
Other Study ID Numbers: PSIY-247-06
Study First Received: February 27, 2007
Last Updated: November 13, 2015

Keywords provided by Dr. Ruzica Jokic, Queen's University:
obstructive sleep apnea

Additional relevant MeSH terms:
Depressive Disorder
Sleep Apnea Syndromes
Sleep Apnea, Obstructive
Depressive Disorder, Treatment-Resistant
Behavioral Symptoms
Mood Disorders
Mental Disorders
Respiration Disorders
Respiratory Tract Diseases
Signs and Symptoms, Respiratory
Signs and Symptoms
Sleep Disorders, Intrinsic
Sleep Wake Disorders
Nervous System Diseases processed this record on August 22, 2017