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CompletedNCT03381508SAS-leak-1Updated Jul 2, 2020

Air Leakage Under Continuous Positive Airway Pressure

An observational study in Obstructive Sleep Apnea Syndrome, sponsored by University Hospital, Montpellier. Completed at 3 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-07-02.

Sponsored by University Hospital, Montpellier · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
79
Ages
18 Years and older
Sex
All
01

Study summary

The software embedded in recent continuous positive pressure devices enables the analysis of the level of leakage that occurs during treatment around the mask or from the mouth. However, there is no clear threshold defining when it would be appropriate to implement means for correcting these leaks. In addition, the calculation methods used to detect/measure leaks and the terminology used vary according to the manufacturers of continuous pressure devices, which also complicates the clinical interpretation of the leakage reports provided by the various devices.

In daily practice, when a patient complains of unintentional leakage, technicians adjust the mask, replace the nasal-mask by an oro-nasal mask or install a chinstrap. Nevertheless, those strategies are not always effective in reducing leakage or patient's complaints. A better understanding of the mechanisms beyond leak appearance for a given patient could lead to individualised leak-treatment solutions. Pressure level, mandibular behaviour, respiratory effort, sleep position or sleep stages may contribute to leak emergence.

A recent exploratory study has proposed a genuine analysis method of determining factors of unintentional-leaks using polysomnographic recordings in OSA patients treated with automatic Continuous Positive Airway Pressure (auto-CPAP). Based on the same methodology, the NOMICS company (Liège, Belgium) has developed a polygraphic device (Brizzy®) recording unintentional leakage during auto-CPAP treatment and providing an etiological analysis of unintentional-leaks via a software named APIOS.

Due to the innovative nature of the analysis, it appears necessary to validate it onto a population of OSA patients treated with auto-CPAP. Also, to our knowledge, there is no descriptive data of the distribution of the determinants of unintentional leaks in such a population. From this perspective, the investigators aim to retrospectively analyse some polygraphic recordings that have been performed with the Brizzy® on OSA patients treated with auto-CPAP.

The primary objective of this study is to identify and describe the determinants of unintentional leaks for a population of patients with OSA and treated with an auto-CPAP device

Read the detailed description

The secondary objectives are:

  1. to evaluate the concordance of the determinants of leaks according to different leak thresholds (0 l/min ; 5l/min ; 10l/min : 20l/min).
  2. to describe any technical problems that arise in relation to the analysis of leaks in the study population.
02

Conditions studied

  • Obstructive Sleep Apnea Syndrome

Keywords

  • CPAP
  • masks
  • unintentional leak
  • leakage
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

The study population corresponds to patients (all meeting eligibility criteria) with obstructive sleep apnea syndrome treated via continuous positive pressure and monitored according to usual practice with the latest Brizzy device.

Inclusion criteria

  • Sleep recordings from patients with OSA treated via auto-CPAP and monitored with Brizzy® device (including measures of non-intentional leaks) between June 1st and December 31th, 2017.

Exclusion criteria

Exclusion Criteria:

  • The patient opposes the usage of his/her data
  • Minors or adults under any kind of guardianship
  • Fixed pressure
  • Bilevel positive airway pressure devices
  • Adaptive servo-ventilation
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
79 participants (actual)
Patient registry
No

Groups and cohorts

  • The study population

    The study population corresponds to patients with obstructive sleep apnea syndrome treated via continuous positive pressure and monitored according to usual practice with the latest Brizzy device. Intervention: Brizzy continuous positive pressure device

    Device: Brizzy continuous positive pressure device

Interventions

  • DeviceBrizzy continuous positive pressure device

    Patients are treated with the Brizzy continuous positive pressure device, including pneumotachograph.

05

What researchers measure

Primary outcomes

  1. Mouth-opening odds ratio

    For each patient presenting with an unintentional leak, determination of odds ratios for mouth-opening.

    Time frame: day 0 (transversal study)

  2. Auto-CPAP pressure level odds ratio

    For each patient presenting with an unintentional leak, determination of odds ratios for Auto-CPAP pressure level

    Time frame: day 0 (transversal study)

  3. Sleep position odds ratio

    For each patient presenting with an unintentional leak, determination of odds ratios for sleep position

    Time frame: day 0 (transversal study)

  4. Respiratory effort (increase in the Jawac signal > 0.3 mm) odds ratio

    For each patient presenting with an unintentional leak, determination of odds ratios respiratory effort

    Time frame: day 0 (transversal study)

Secondary outcomes

  1. Epworth scale score

    Time frame: day 0 (transversal study)

  2. Pichot scale

    Time frame: day 0 (transversal study)

  3. Occurrence of nasal obstruction

    Time frame: day 0 (transversal study)

  4. Occurrence of mouth dryness

    Time frame: day 0 (transversal study)

  5. Occurrence of nasal dryness

    Time frame: day 0 (transversal study)

Other outcomes

  1. Type/brand of mask and device used

    Time frame: day 0 (transversal study)

  2. Presence of heated humidifier

    Time frame: day 0 (transversal study)

  3. Presence of chinstraps.

    Time frame: day 0 (transversal study)

  4. The Brizzy output

    Time frame: day 0 (transversal study)

  5. Mask pressure as measured by Brizzy

    Time frame: day 0 (transversal study)

  6. Presence/absence of technical problems that arise in relation to the analysis of leaks

    Time frame: day 0 (transversal study)

  7. Presence/absence of a comorbidity

    Time frame: day 0 (transversal study)

  8. Presence of a psychotropic treatment

    Time frame: day 0 (transversal study)

  9. Presence of a treatment of nasal problem

    Time frame: day 0 (transversal study)

  10. Anterior ORL surgery

    Time frame: day 0 (transversal study)

06

Study locations

3 sites
  • Polyclinic Saint-Privat
    Boujan sur Libron, 34760, France
  • University Hospital of Grenoble
    Grenoble, France
  • Hôpital Arnaud de Villeneuve
    Montpellier, France
07

References and documents

Publications

  • Lebret M, Arnol N, Martinot JB, Lambert L, Tamisier R, Pepin JL, Borel JC. Determinants of Unintentional Leaks During CPAP Treatment in OSA. Chest. 2018 Apr;153(4):834-842. doi: 10.1016/j.chest.2017.08.017. Epub 2017 Aug 26. PubMed 28847549 ↗
  • Lebret M, Jaffuel D, Suehs CM, Mallet JP, Lambert L, Rotty MC, Pepin JL, Matzner-Lober E, Molinari N, Borel JC. Feasibility of Type 3 Polygraphy for Evaluating Leak Determinants in CPAP-Treated OSA Patients: A Step Toward Personalized Leak Management. Chest. 2020 Nov;158(5):2165-2171. doi: 10.1016/j.chest.2020.05.593. Epub 2020 Jun 13. PubMed 32544491 ↗
08

Registry details

Key details

Study ID
NCT03381508
Lead sponsor
University Hospital, Montpellier
Responsible party
Sponsor
First posted
Dec 22, 2017
Start date
Jan 10, 2018
Primary completion
Apr 20, 2018
Completion
Apr 20, 2018
Last update
Jul 2, 2020

Study contacts

Jean-Christian Borel, PhD
principal investigator · University Hospital, Grenoble
Nicolas Molinari, PhD
study director · University Hospital, Montpellier

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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