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Obstructive Sleep ApneaDINISASNCT03449550

Validity of a Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children (DINISAS)

A study testing Home Respiratory Polygraphy (HRP) and Standard Polysomnography (PSG) in people with Obstructive Sleep Apnea, run by Hospital Universitario Araba at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

To assess the diagnostic validity and cost-effectiveness of a home respiratory polygraphy (HRP) performed at home compared with the standard polysomnography (PSG) in children with clinically suspected Obstructive Sleep Apnea (OSA). Read more about this study

Who is it for?
Ages 2 to 14 years
Conditions the study is for
Obstructive Sleep Apnea
What is being tested?
Home Respiratory Polygraphy (HRP) and Standard Polysomnography (PSG)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
320 participants
Where
1 siteSpain
Study dates
7 May 2015to 30 Mar 2020
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 2 to 14 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Children between 2 and 14 years of age of both sexes consecutively assessed for clinical suspicion of OSA, defined as: snoring children with observed respiratory and / or apnea pauses and / or ventilatory effort during observed sleep, and who were asked for a sleep test
  • Written informed consent signed.

Who cannot join

  • Place of residence more than 100 km from the hospital
  • Psychophysical incapacity to perform the study at home
  • Severe, unstable or exacerbated cardio-vascular, cerebro-vascular or respiratory disease, that makes it impossible to carry out adequate studies
  • Children with chronic insomnia and / or depressive syndrome
  • Children with malformative syndromes, Down Syndrome and neuromuscular diseases
  • Complete or near complete nasal obstruction that prevents obtaining a quality signal with the HRP
  • History of surgery and / or previous Positive continuous pressure (CPAP) for OSA

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Hospital Universitario Alava

    Vitoria-Gasteiz, Alava, 01009

Other trials in Spain

About this study

Official title: Validity and Cost-effectiveness Analysis of a Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children (DINISAS)

To assess the diagnostic validity and cost-effectiveness of a home respiratory polygraphy (HRP) performed at home compared with the standard polysomnography (PSG) in children with clinically suspected Obstructive Sleep Apnea (OSA).

Read the detailed description

AIMS: To assess the diagnostic validity and cost-effectiveness of a home respiratory polygraphy (HRP) performed at home compared with the standard polysomnography (PSG) in children with clinically suspected Obstructive Sleep Apnea (OSA).

METHODOLOGY: DESIGN: Randomized, prospective, multicenter, double blind and crossover trial. The study will include 320 children, both sexes, with clinical suspicion of obstructive sleep apnea (OSA). MEASUREMENTS: To all patients with clinical suspected OSA and referred to the sleep units, the following questionnaires and measurements will be performed: a) clinic history; b) Anthropometric variables: weight, height, body mass index, neck circumference and percentile; c) Chervin questionnaire, quality of life and clinical questionnaires and comorbidity; d) PSG in the sleep laboratory; e) HRP at home; f) Quantitative unbiased proteinic urine analysis and g) Cost-effectiveness variables.

ANALYSIS: Data from HRP and from full PSG will be compared as follows: 1) Agreement of results according to the different apnea-hypopnea index by using the ROC curves; 2) The concordance of the diagnosis and treatment decisions when using clinical findings and data from PSG or HRP at home, 3) All data will be analyzed independently by participating hospitals according the Cohen Kappa method, 4) A diagnosis paradigm based on proteinic defined variables and 5) A cost-effectiveness analysis of the different diagnostic and therapeutic procedures will be performed.

Being tested
Home Respiratory Polygraphy (HRP), Standard Polysomnography (PSG)
Keywords
Child obstructive sleep apnea, Home Respiratory Polygraphy, Diagnosis, Validity, Polysomnography
Medical subject headings
Sleep Apnea, Obstructive, Disease

What participants receive

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

  • Home Respiratory Polygraphy (HRP)Other

    Also called Validity

    Randomizing to start with home respiratory polygraphy

  • Standard Polysomnography (PSG)Other

    Also called Validity

    Randomizing to start with Standard Polysomnography (PSG)

  • Home Respiratory Polygraphy (HRP)Other

    Also called Effectiveness

    Randomizing for therapeutic decision taken with home respiratory polygraphy (HRP)

  • Standard Polysomnography (PSG)Other

    Also called Effectiveness

    Randomizing for therapeutic decision taken with Standard Polysomnography (PSG)

Study groups in NCT03449550
Study groupRoleWhat they receive
Diagnostic RandomizingActive comparatorRandomizing to start with home respiratory polygraphy (HRP) or Standard Polysomnography (PSG)
Receives: Other: Home Respiratory Polygraphy (HRP); Other: Standard Polysomnography (PSG)
Therapeutic RandomizingActive comparatorRandomizing for therapeutic decision taken with home respiratory polygraphy (HRP) or Standard Polysomnography (PSG)
Receives: Other: Home Respiratory Polygraphy (HRP); Other: Standard Polysomnography (PSG)

What is being measured

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

  1. Diagnostic validity of a Home Respiratory Polygraphy (HRP)

    To establish the diagnostic validity of home respiratory polygraphy (HRP) compared with the findings obtained with polysomnography (PSG) in the sleep laboratory in children with suspected Obstructive Sleep Apnea (OSA), based on the results of Apnea-hypopnea Index (AHI)

    Measured: baseline

Secondary outcomes (9)
  1. Cost effectiveness analysis

    Cost-efficacy evaluation: the analysis will be made in both arms based on intention to treat. Only direct costs will be analyzed: the cost of the use of polysomnography and home respiratory polygraphy (Staff and consumable material).

    Measured: baseline

  2. Validation of the therapeutic decision

    Analyze the concordance in the therapeutic decision using clinical findings and the results of Apnea-Hypopnea Index (AHI) from standard polysomnography (PSG) compared with data from home respiratory polygraphy (HRP)

    Measured: 6 month

  3. Validity of the determination of a protein sequence in urine in OSA

    To analyze the validity of the determination of a protein sequence in urine, alone or in combination, to establish the diagnosis of OSA and to evaluate its modification over time after the treatment of OSA

    Measured: baseline

  4. Pediatric Sleep Questionnaire.

    Pediatric Sleep Questionnaire designed to screen for sleep problems in children.The scale consists of 22 parent-reported items examining snoring and breathing problems, daytime sleepiness, inattention, hyperactivity, and other signs and symptoms of apnea including obesity and nocturnal enuresis.

    The result is a number, a proportion that ranges from 0.0 to 1.0. Scores >0.33 are considered positive and suggestive of high risk for a pediatric sleep-related breathing disorder

    Measured: baseline and at six month

  5. BEARS Sleep screening

    BEARS Sleep screening is divided into five major sleep domains (B=Bedtime Issues, E=Excessive Daytime Sleepiness, A=Night Awakenings, R=Regularity and Duration of Sleep, S=Snoring), providing a comprehensive screen for the major sleep disorders affecting children in the 2- to 18-year old range

    Measured: baseline and at six month

  6. Quality of life (KINDLR)

    The KINDLR is a generic instrument for assessing Health-Related Quality of Life in children and adolescents aged 3 years and older. Consists of 24 Likert-scaled items associated with six dimensions: physical well-being, emotional well-being, self-esteem, family, friends and everyday functioning (school). The response categories cover 3 levels (1=never, 2=sometimes, 3=very often)

    Measured: baseline and at six month

  7. Children's sleep habits questionnaire (CSHQ)

    Parent-report sleep screening instrument designed for school-aged children.The instrument evaluates the child's sleep based on behavior within eight different subscales: bedtime resistance, sleep-onset delay, sleep duration, sleep anxiety, night wakings, parasomnias, sleep-disordered breathing, and daytime sleepiness.

    Measured: baseline and at six month

  8. Anthropometric variables

    Body mass index

    Measured: baseline and at six month

  9. Blood pressure

    Blood pressure measurements: systolic blood pressure and diastolic blood pressure

    Measured: baseline and at six month

Timeline

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

  1. First posted28 Feb 2018
  2. Study start7 May 2015
  3. Primary completion30 Apr 2019
  4. Study completion30 Mar 2020

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
Diagnosis
Allocation
Randomised
Intervention model
Crossover
Masking
Single blind
Who is masked
Investigator
Enrolment
320 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03449550
Sponsor's protocol ID
PI14/01187
Acronym
DINISAS
Status last verified
Sep 2021
First submitted
6 Oct 2017
Last updated
9 Sep 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Luz Alonso-Alvarez M, Canet T, Cubell-Alarco M, Estivill E, Fernandez-Julian E, Gozal D, Jurado-Luque MJ, Lluch-Rosello MA, Martinez-Perez F, Merino-Andreu M, Pin-Arboledas G, Roure N, Sanmarti FX, Sans-Capdevila O, Segarra-Isern F, Tomas-Vila M, Teran-Santos J; Sociedad Espanola de Sueno; Area de Sueno de la Sociedad Espanola de Neumologia y Cirugia Toracica(SEPAR)]. [Consensus document on sleep apnea-hypopnea syndrome in children (full version). Sociedad Espanola de Sueno. El Area de Sueno de la Sociedad Espanola de Neumologia y Cirugia Toracica(SEPAR)]. Arch Bronconeumol. 2011 May;47 Suppl 5:0, 2-18. doi: 10.1016/S0300-2896(11)70026-6. Epub 2011 Jun 22. No abstract available. Spanish.

    PubMed 22682520
  • Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J et al. American Academy of Pediatrics Statement. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics109:704-23, 2002.

  • Alonso-Alvarez ML, Cordero-Guevara JA, Teran-Santos J, Gonzalez-Martinez M, Jurado-Luque MJ, Corral-Penafiel J, Duran-Cantolla J, Kheirandish-Gozal L, Gozal D. Obstructive sleep apnea in obese community-dwelling children: the NANOS study. Sleep. 2014 May 1;37(5):943-9. doi: 10.5665/sleep.3666.

    PubMed 24790273
  • Gileles-Hillel A, Alonso-Alvarez ML, Kheirandish-Gozal L, Peris E, Cordero-Guevara JA, Teran-Santos J, Martinez MG, Jurado-Luque MJ, Corral-Penafiel J, Duran-Cantolla J, Gozal D. Inflammatory markers and obstructive sleep apnea in obese children: the NANOS study. Mediators Inflamm. 2014;2014:605280. doi: 10.1155/2014/605280. Epub 2014 Jun 1.

    PubMed 24991089
  • Reuveni H, Simon T, Tal A, Elhayany A, Tarasiuk A. Health care services utilization in children with obstructive sleep apnea syndrome. Pediatrics. 2002 Jul;110(1 Pt 1):68-72. doi: 10.1542/peds.110.1.68.

    PubMed 12093948
  • Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med. 2000 Feb 1;1(1):21-32. doi: 10.1016/s1389-9457(99)00009-x.

    PubMed 10733617
  • Spruyt K, Gozal D. Screening of pediatric sleep-disordered breathing: a proposed unbiased discriminative set of questions using clinical severity scales. Chest. 2012 Dec;142(6):1508-1515. doi: 10.1378/chest.11-3164.

    PubMed 22677350
  • Nixon GM, Kermack AS, Davis GM, Manoukian JJ, Brown KA, Brouillette RT. Planning adenotonsillectomy in children with obstructive sleep apnea: the role of overnight oximetry. Pediatrics. 2004 Jan;113(1 Pt 1):e19-25. doi: 10.1542/peds.113.1.e19.

    PubMed 14702490
  • Marcus CL, Keens TG, Ward SL. Comparison of nap and overnight polysomnography in children. Pediatr Pulmonol. 1992 May;13(1):16-21. doi: 10.1002/ppul.1950130106.

    PubMed 1589307
  • Goodwin JL, Enright PL, Kaemingk KL, Rosen GM, Morgan WJ, Fregosi RF, Quan SF. Feasibility of using unattended polysomnography in children for research--report of the Tucson Children's Assessment of Sleep Apnea study (TuCASA). Sleep. 2001 Dec 15;24(8):937-44. doi: 10.1093/sleep/24.8.937.

    PubMed 11766164
  • Jacob SV, Morielli A, Mograss MA, Ducharme FM, Schloss MD, Brouillette RT. Home testing for pediatric obstructive sleep apnea syndrome secondary to adenotonsillar hypertrophy. Pediatr Pulmonol. 1995 Oct;20(4):241-52. doi: 10.1002/ppul.1950200407.

    PubMed 8606854
  • Moss D, Urschitz MS, von Bodman A, Eitner S, Noehren A, Urschitz-Duprat PM, Schlaud M, Poets CF. Reference values for nocturnal home polysomnography in primary schoolchildren. Pediatr Res. 2005 Nov;58(5):958-65. doi: 10.1203/01.PDR.0000181372.34213.13. Epub 2005 Sep 23.

    PubMed 16183829
  • Alonso Alvarez ML, Teran Santos J, Cordero Guevara JA, Navazo Eguia AI, Ordax Carbajo E, Masa Jimenez JF, Pelayo R. [Reliability of respiratory polygraphy for the diagnosis of sleep apnea-hypopnea syndrome in children]. Arch Bronconeumol. 2008 Jun;44(6):318-23. Spanish.

    PubMed 18559221
  • Brockmann PE, Schaefer C, Poets A, Poets CF, Urschitz MS. Diagnosis of obstructive sleep apnea in children: a systematic review. Sleep Med Rev. 2013 Oct;17(5):331-40. doi: 10.1016/j.smrv.2012.08.004. Epub 2013 Jan 30.

    PubMed 23375659
  • Marcus CL, Moore RH, Rosen CL, Giordani B, Garetz SL, Taylor HG, Mitchell RB, Amin R, Katz ES, Arens R, Paruthi S, Muzumdar H, Gozal D, Thomas NH, Ware J, Beebe D, Snyder K, Elden L, Sprecher RC, Willging P, Jones D, Bent JP, Hoban T, Chervin RD, Ellenberg SS, Redline S; Childhood Adenotonsillectomy Trial (CHAT). A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013 Jun 20;368(25):2366-76. doi: 10.1056/NEJMoa1215881. Epub 2013 May 21.

    PubMed 23692173

Questions about this trial

What is this clinical trial studying?

A study testing Home Respiratory Polygraphy (HRP) and Standard Polysomnography (PSG) in people with Obstructive Sleep Apnea, run by Hospital Universitario Araba at 1 site in Spain.

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 2 inclusion and 7 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: finished, as of the sponsor's last update on 9 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. 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. 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Diagnostic validity of a Home Respiratory Polygraphy (HRP) (time frame: baseline). 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 NCT03449550, which also lists 19 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 9 Sep 2021.

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