CPAP Effect on the Polycythemia in Patients With Obstructive Sleep Apnea

Phase

Condition

Sleep Apnea Syndromes

Red Blood Cell Disorders

Treatment

Continuous positive airway pressure

Conventional pharmacological treatment

Sleep ,diet and life style recomendations

Clinical Study ID

NCT06089603

HURyC 207/23

Ages 18-80
All Genders

Study Summary

Objectives: To compare the response of polycythemia in terms of hematocrit decrease in patients treated with positive airway pressure (CPAP) versus patients not treated with CPAP.

Methodology: Randomized, parallel-group, nonblinded, controlled clinical trial.

Patients diagnosed with OSA in a respiratory polygraphy (RP) and who meet all the inclusion criteria and none of the exclusion criteria will undergo sleepiness and quality of life questionnaires, anthropometric measurements and blood tests and will be randomized to a CPAP treatment group or control group, maintaining this treatment for 12 months. A visit will be made at 12 weeks ,24 weeks and 52 weeks to check compliance with CPAP in the treatment group and to carry out questionnaires on physical activity and quality of life, anthropometric measurements, blood tests including hemoglobin and hematocrit as well as parameters related to coagulation and platelet function and changes in medication as well as adverse effects.

Efficacy variables: blood count, hemoglobin, haematocrit, erythropoietin, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), mean platelet volume (MPV), platelets, coagulation, erythrocyte range of distribution (ADE), glucose, creatinine, glomerular filtration rate, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyltransferase (GGT), Total bilirubin, hypoxic burden, Epworth score, EuroQol- 5D questionnaire.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Subjects from 18 to 80 years old.
Diagnosis of polycytemia defined as hematocrit > 49% in men and > 48% in women. ç
Diagnosis of moderate or severe sleep apnea, defined by an apnea-hypoapnea index >15. - Patients able to read and understand informed consent and give their signedconsent.

Exclusion

Exclusion Criteria:

Smokers or former smokers with pack-year index (IPA>30) or chronic obstructivepulmonary disease diagnosed by spirometry (FEV1/FVC post-bronchodilator below thelower limit of normal or z score < 1.645).
Patients with central sleep apnea or periodic breathing
Patients with oxygen saturation <92% or pO2< 60 mmHg at rest during wakefulness. -Evidence of severe heart failure (LVEF<50) or pulmonary hypertension.
Patients with primary polyglobulia (polycythemia vera). It will be done prior to theinclusion in the study blood levels of erythropoietin (EPO) and determination of themutation of the JAK2 V617F gene. Patients with normal or elevated EPO levels (normallimits 2.9- 25.9 mU/ml) and no JAK2 V617F gene mutation
Patients with any active neoplasm will be included in the study. - Patients withchronic kidney disease (Glomerular Filtration Rate (GFR) <60 mL/min/1.73 m2).
Patients with any active neoplasia.- Patients with chronic kidney disease (Glomerular Filtration Rate (GFR) <60 mL/min/1.73 m2).
Need for periodic bleeding according to hematology guidelines.
Treatment with diuretics.
Treatment with antiplatelets or anticoagulants.
Systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg at thebaseline visit.
Stroke, transient ischemic attack, acute coronary syndrome or hospitalization due toworsening heart failure, in the previous 30 days .
Professional drivers, high-risk profession or respiratory failure (according tocriteria of the clinical path of diagnosis and treatment of sleep-relatedrespiratory disorders).
High daytime sleepiness (Epworth sleepiness scale > 16)
Previous treatment with CPAP- Participation in another clinical trial within 30 daysprior to randomization.

Study Design