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Obstructive Sleep Apnea SyndromeTHERMA-SASNCT02559427

SPA Therapy in the Treatment of Sleep Apnea Syndrome

A study testing 3-week immediate SPA treatment and 3-week late SPA treatment in people with Obstructive Sleep Apnea Syndrome and Chronic Venous Insufficiency, run by Association Francaise pour la Recherche Thermale at 9 sites in France.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The purpose of this study is to determine whether 3-week of SPA therapy improves sleep apnea in patients with chronic venous insufficiency and concomitant Obstructive Sleep Apnea Syndrome (OSAS). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
3-week immediate SPA treatment and 3-week late SPA treatment
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
0 participants
Where
9 sitesFrance
Study dates
Oct 2016to Mar 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient with Chronic Venous Insufficiency with oedema (CEAP clinical classes C3 to C5) and concomitant Sleep Apnea Syndrome (AHI > 15 events/hour)
  • Patient in stable state (no change in medical treatment and no hospitalization for respiratory, cardiac or metabolic event in the 2 months preceding inclusion)
  • Patient available for a program of 3-week SPA Therapy

Who cannot join

  • Patient with no social insurance
  • Pregnant and nursing woman
  • Patient detained by judicial order
  • Patient with contra-indication to SPA therapy
  • Patient with chronic venous insufficiency < CEAP C3 or CEAP C6
  • Patient already treated by class IV compression stockings for severe veinolymphatic insufficiency
Show all 10Show fewer
  • Patient already treated for sleep apnea
  • Patient who have already benefited of SPA therapy (any type) within 9 months before the enrollment
  • Patient with severe comorbidities
  • Patient who could not respect the constraints related to the study

Trial locations and contacts

9 sites in 1 country.

9 sites in 1 country

France9 sites
  • Medical pratice (angiology)

    Annecy

  • Medical practice (angiology)

    Bourgoin

  • Medical practice (angiology)

    Castelnau-le-Lez

  • University Hospital Grenoble

    Grenoble, 38000

  • Medical pratice (angiology)

    Grenoble

  • University Hospital Grenoble

    Grenoble

  • Clinic Beau Soleil

    Montpellier

  • Medical pratice (angiology)

    Tarbes

  • Medical practice (angiology)

    Valence

Other trials in France

About this study

Official title: Impact of 3-week SPA Therapy on Sleep Apnea in Patients With Obstructive Sleep Apnea Syndrome and Chronic Venous Insufficiency: A Randomized, Controlled Study

The purpose of this study is to determine whether 3-week of SPA therapy improves sleep apnea in patients with chronic venous insufficiency and concomitant Obstructive Sleep Apnea Syndrome (OSAS).

Read the detailed description

Obstructive Sleep Apnea Syndrome (OSAS), characterized by repetitive episodes of partial or complete upper airway (UA) obstruction, is highly prevalent in the general population (2% in women, 4% in men). OSAS is associated with hypersomnolence and it increases the risk of cardiovascular morbidity and mortality. Its pathogenesis is largely multifactorial. In patients with chronic venous insufficiency, fluid retention contributes to this pathogenesis: during the day, fluid accumulates in the legs due to gravity ; during sleep in recumbent position, this accumulated fluid redistributes rostrally in the neck and causes upper airway narrowing and predisposes to OSAS.

The hypothesis is that a comprehensive treatment program for chronic venous insufficiency (SPA therapy) would reduce sleep apnea in patients with chronic venous insufficiency and concomitant sleep apnea Syndrome.

The objective is to assess the efficacy of a 3-week SPA therapy on attenuation of sleep apnea in this population of patients.

Being tested
3-week immediate SPA treatment, 3-week late SPA treatment
Keywords
sleep apnea, Venous Insufficiency, SPA treatment
Medical subject headings
Sleep Apnea, Obstructive, Sleep Apnea Syndromes, Venous Insufficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 3-week immediate SPA treatmentOther

    Also called Immediate SPA treatment

    a comprehensive program soon after randomization including sessions of balneotherapy, diet information, exercise training. The most adapted to the concerned pathology and common to all SPA resorts (walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massages shower...)

  • 3-week late SPA treatmentOther

    Also called Late SPA treatment

    a comprehensive program after 4.5 months, including sessions of balneotherapy, diet information, exercise training. The most adapted to the concerned pathology and common to all SPA resorts (walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massages shower...)

Study groups in NCT02559427
Study groupRoleWhat they receive
Immediate SPA treatmentActive comparator3-week immediate SPA treatment (soon after randomization)
Receives: Other: 3-week immediate SPA treatment
Late SPA treatmentSham comparator3-week late SPA treatment (soon after primary endpoint at 4 1/2 months visit)
Receives: Other: 3-week late SPA treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Apnea-Hypopnea Index (AHI)

    Variation in AHI according to the allocation group

    Measured: 4.5 months

Secondary outcomes (19)
  1. Specific Quality of life

    Variation in the scores of CIVIQ 20 according to the allocation group (Specific quality of life scale for venous insufficiency)

    Measured: 4.5 months

  2. Global Quality of life

    Variation in the score of EUROQUOL according to the allocation group (Global quality of life scale)

    Measured: 4.5 months

  3. severity of sleep apnea

    Variation of AHI according to the severity of sleep apnea at inclusion. Moderate sleep apnea (AHI <30) vs Severe Sleep apnea (AHI >30) at inclusion

    Measured: 4.5 months

  4. Nocturnal hypoxemia

    Nocturnal hypoxemia is assessed by mean SpO2 and time spent with SpO2<90%

    Measured: 4.5 months

  5. Clinically significant improvement of OSAS

    Clinically significant improvement is defined with a reduction in AHI by 50% or more and a reduction in oxygen desaturation index by 50% or more

    Measured: 4.5 months

  6. Sleep duration

    Mean sleep duration is assessed by actigraphy over a period of 7 days.

    Measured: 4.5 months

  7. Quality of Sleep

    Quality of sleep is assessed by Quebec Quality of life Questionnaire

    Measured: 4.5 months

  8. Daytime sleepiness

    Sleepiness is assessed by Epworth sleepiness scale

    Measured: 4.5 months

  9. Variation of interstitial fluid

    bioimpedance is used to measure interstitial fluid

    Measured: 4.5 months

  10. Long term efficacy

    Long term efficacy is measured by nocturnal respiratory polygraphy only in patients who are not treated by CPAP

    Measured: 1 year

  11. Venous insufficiency classification

    Variation of venous insufficiency is assessed by CEAP classification

    Measured: 1 year

  12. Venous insufficiency variation

    Variation of venous insufficiency is assessed by Villalta score

    Measured: 1 year

  13. Venous insufficiency examination

    Variation of venous insufficiency is assessed by leg circumferences

    Measured: 1 year

  14. long term effect of the SPA treatment on primary outcome

    confirmation of the long term effect of the SPA treatment at 1 year for the control group. Primary outcome evolution between 4.5 months and 12 months (evolution of AHI)

    Measured: 1 year

  15. long term effect of the SPA treatment on specific quality of life

    confirmation of the long term effect of the SPA treatment at 1 year for the control group. Evolution between 4.5 months and 12 months of specific quality of life with CIVIQ 20 scale

    Measured: 1 year

  16. long term effect of the SPA treatment on global quality of life

    confirmation of the long term effect of the SPA treatment at 1 year for the control group. Evolution between 4.5 months and 12 months of global quality of life with EUROQUOL Scale

    Measured: 1 year

  17. long term effect of the SPA treatment on venous insufficiency

    confirmation of the long term effect of the SPA treatment at 1 year for the control group. Evolution between 4.5 months and 12 months of venous insufficiency

    Measured: 1 year

  18. long term effect of the SPA treatment on specific treatment of OSAS

    confirmation of the long term effect of the SPA treatment at 1 year for the control group. Evolution between 4.5 months and 12 months. The long term effect will be confirmed if patients did not require a specific treatment of OSAS (for example CPAP (Continuous Positive Airway Pressure).

    Measured: 1 year

  19. benefit for patients with first SPA treatment

    stratification at randomization (first SPA treatment or not) to evaluate a higher benefit (variation of Apnea-Hypopnea Index (AHI)) for patients with first SPA treatment. Comparison of patients with first SPA treatment or not on primary outcome according to the allocation group.

    Measured: 4.5 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Sep 2015 (estimated)
  2. Study startOct 2016
  3. Primary completionJun 2018 (estimated)
  4. Study completionMar 2019 (estimated)

Why it stopped: no patients randomized after more than one year sponsor decided to withdrawn the study.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02559427
Sponsor's protocol ID
THERMA SAS
Acronym
THERMA-SAS
Status last verified
Jun 2018
First submitted
29 Jul 2015
Last updated
29 Jun 2018
Results posted
No
Data monitoring committee
No

Publications

  • Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008 Feb 15;5(2):136-43. doi: 10.1513/pats.200709-155MG.

    PubMed 18250205
  • Caffo B, Diener-West M, Punjabi NM, Samet J. A novel approach to prediction of mild obstructive sleep disordered breathing in a population-based sample: the Sleep Heart Health Study. Sleep. 2010 Dec;33(12):1641-8. doi: 10.1093/sleep/33.12.1641.

    PubMed 21120126
  • Young T, Palta M, Dempsey J, Peppard PE, Nieto FJ, Hla KM. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study. WMJ. 2009 Aug;108(5):246-9.

    PubMed 19743755
  • Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005 Mar 19-25;365(9464):1046-53. doi: 10.1016/S0140-6736(05)71141-7.

    PubMed 15781100
  • Monahan K, Storfer-Isser A, Mehra R, Shahar E, Mittleman M, Rottman J, Punjabi N, Sanders M, Quan SF, Resnick H, Redline S. Triggering of nocturnal arrhythmias by sleep-disordered breathing events. J Am Coll Cardiol. 2009 Nov 3;54(19):1797-804. doi: 10.1016/j.jacc.2009.06.038.

    PubMed 19874994
  • Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000 May 11;342(19):1378-84. doi: 10.1056/NEJM200005113421901.

    PubMed 10805822
  • Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med. 1999 Mar 18;340(11):847-51. doi: 10.1056/NEJM199903183401104.

    PubMed 10080847
  • Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005 Nov 10;353(19):2034-41. doi: 10.1056/NEJMoa043104.

    PubMed 16282178
  • Flemons WW, Reimer MA. Development of a disease-specific health-related quality of life questionnaire for sleep apnea. Am J Respir Crit Care Med. 1998 Aug;158(2):494-503. doi: 10.1164/ajrccm.158.2.9712036.

    PubMed 9700127
  • Dempsey JA, Veasey SC, Morgan BJ, O'Donnell CP. Pathophysiology of sleep apnea. Physiol Rev. 2010 Jan;90(1):47-112. doi: 10.1152/physrev.00043.2008.

    PubMed 20086074
  • Levy P, Pepin JL, Dematteis M. Pharyngeal neuropathy in obstructive sleep apnea: where are we going? Am J Respir Crit Care Med. 2012 Feb 1;185(3):241-3. doi: 10.1164/rccm.201111-1992ED. No abstract available.

    PubMed 22298363
  • Javaheri S. Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report. Int J Cardiol. 2006 Jan 4;106(1):21-8. doi: 10.1016/j.ijcard.2004.12.068.

    PubMed 16321661
  • Yumino D, Wang H, Floras JS, Newton GE, Mak S, Ruttanaumpawan P, Parker JD, Bradley TD. Prevalence and physiological predictors of sleep apnea in patients with heart failure and systolic dysfunction. J Card Fail. 2009 May;15(4):279-85. doi: 10.1016/j.cardfail.2008.11.015. Epub 2009 Jan 21.

    PubMed 19398074
  • de Oliveira Rodrigues CJ, Marson O, Tufic S, Kohlmann O Jr, Guimaraes SM, Togeiro P, Ribeiro AB, Tavares A. Relationship among end-stage renal disease, hypertension, and sleep apnea in nondiabetic dialysis patients. Am J Hypertens. 2005 Feb;18(2 Pt 1):152-7. doi: 10.1016/j.amjhyper.2004.08.028.

    PubMed 15752940
  • Logan AG, Perlikowski SM, Mente A, Tisler A, Tkacova R, Niroumand M, Leung RS, Bradley TD. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens. 2001 Dec;19(12):2271-7. doi: 10.1097/00004872-200112000-00022.

    PubMed 11725173

Questions about this trial

What is this clinical trial studying?

A study testing 3-week immediate SPA treatment and 3-week late SPA treatment in people with Obstructive Sleep Apnea Syndrome and Chronic Venous Insufficiency, run by Association Francaise pour la Recherche Thermale at 9 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 29 Jun 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Apnea-Hypopnea Index (AHI) (time frame: 4.5 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02559427, which also lists 34 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2018.

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