Sleep Apnea in Elderly

  • STATUS
    Recruiting
  • days left to enroll
    22
  • participants needed
    100
  • sponsor
    VA Office of Research and Development
Updated on 15 December 2021
sleep-disordered breathing
acetazolamide
Accepts healthy volunteers

Summary

Sleep-disordered breathing (SDB or sleep apnea) is very common among elderly Veterans and leads to increased morbidity and mortality in this population. The proposal aims to identity whether oxygen, finasteride and acetazolamide can be effective in reducing unstable breathing and eliminating sleep apnea in the elderly via different mechanisms. This proposal will enhance the investigators' understanding of the pathways that contribute to the development of sleep apnea in the elderly. The investigators expect that the results obtained from this study will positively impact the health of Veterans by identifying new treatment modalities for sleep apnea. A cumulative effect of the investigators' research will fulfill the long-term goal of improving the quality of life of elderly Veterans suffering from sleep apnea and its potential life-threatening complications.

Description

Sleep apnea-hypopnea syndrome (SAHS) has a high prevalence and is associated with adverse cardiovascular consequences in elderly Veterans. Positive airway pressure therapy is deemed cumbersome and often associated with non-adherence to therapy. This proposal will investigate whether alternative therapies can be developed by modulating specific physiologic mechanisms of ventilatory control. Specifically, the investigators will study whether interventions with sustained hyperoxia (Aim 1), finasteride (Aim 2) and acetazolamide (Aim 3) will reduce breathing instability during sleep by reducing chemoresponsiveness and/or increasing cerebrovascular reactivity (CVR) in order to alleviate sleep disordered breathing in the elderly with sleep apnea. The proposed aims will also allow us to delineate key mechanisms of breathing instability in the elderly. The investigators envision that the results obtained from this project will ultimately allow us to develop novel alternative therapies for sleep apnea in the elderly. We will also compare CVR in young vs older adults

Details
Condition Sleep Apnea, Elderly Adults
Treatment acetazolamide, Finasteride, Hyperoxia/oxygen
Clinical Study IdentifierNCT02703220
SponsorVA Office of Research and Development
Last Modified on15 December 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Adults who are 60 years old and older, with mild to moderate sleep apnea with AHI >/=5 to 20/hr with central, obstructive, mixed apneas and hypopneas
For the finasteride protocol elderly men with above criteria will be enrolled

Exclusion Criteria

Patients with severe sleep apnea (AHI>20/hr)
Patients with history of prostate cancer
Males with hypogonadism
History of cardiac disease, including myocardial infarction
Bypass surgery
Atrial and ventricular tachy-bradycardias
Systolic congestive heart failure and Cheyne-Stokes respiration
Current unstable angina
Stroke
Schizophrenia
Untreated hypothyroidism
Seizure disorder
Preexisting renal failure and liver disorders
Failure to give informed consent
Patients with significant pulmonary diseases by history and abnormal pulmonary function testing, including moderate obstructive/restrictive lung/chest wall disorders with resting oxygen saturation of <96% or on supplemental oxygen
Patients on certain medications including
study drugs
sympathomimetics/parasympathomimetics or their respective blockers
narcotics
antidepressants
anti-psychotic agents
other central nervous system (CNS) altering medications
current alcohol, tobacco or recreational drug use
Patients with BMI>34kg/m2 will be excluded to avoid the effects of morbid obesity on
Elderly with unstable gait or mobility issues that may preclude safe participation
pulmonary mechanics and ventilatory control
Individuals with allergy to finasteride or acetazolamide will be excluded from the specific protocol
Pregnant women
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