RecruitingPhase 3NCT07332442

Continuous Positive Airway Pressure, Arousability and Links to Mechanisms in Obstructive Sleep Apnea


Sponsor

Yale University

Enrollment

250 participants

Start Date

May 1, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The study design is a randomized, controlled clinical trial to test the hypothesis that arousal threshold (ArTH) will affect how individuals with obstructive sleep apnea (OSA, Apnea-Hypopnea Index (AHI) of 10/hour of higher) respond to CPAP therapy regarding adherence and cognitive function (executive function). Investigators hypothesize that raising ArTH with eszopiclone will improve adherence to CPAP and neurocognitive function with CPAP therapy. Investigators also hypothesize that a lower baseline ArTH is associated with worse CPAP adherence, while a higher baseline ArTH is associated with improved neurocognitive outcomes with CPAP therapy.


Eligibility

Min Age: 18 Years

Inclusion Criteria4

  • Able to provide informed consent.
  • Clinically confirmed new diagnosis of OSA:
  • Polysomnography AHI ≥ 10 per hour of sleep and/or
  • Home sleep apnea testing, respiratory even index, REI ≥ 10 per hour of recording

Exclusion Criteria13

  • Known non-OSA related conditions associated with sleep-disordered breathing (e.g., a central disorder of hypersomnolence, neurological, neuromuscular, or pulmonary disorder)
  • Use of sleep-inducing medications (e.g., other non-benzodiazepine sedative hypnotic-drugs \[e.g., zoldpidem\], benzodiazepines, non-selective antihistamines, trazodone, opiates, barbituates)
  • Known hypersensitivity reaction to eszopiclone
  • Contraindications to its use based on medical history or function (e.g., dizziness at baseline or established mobility problems or imbalance)
  • History of complex sleep behaviors (e.g., NREM or REM parasomnias)
  • Concomitant use of ≥ 2 servings of alcohol per night or other CNS depressant for 2 weeks prior or throughout the study
  • Sleep opportunity of less than 7 hours
  • Severe active depression or other mental health disorders (e.g., schizophrenia, bipolar disorder, personality disorder).
  • History of sleep-walking, sleep-driving, and engaging in other activities while not fully awake
  • History of motor vehicle accidents related to sleepiness and/or motor vehicle "near misses" (e.g. sleepiness during driving or lane changes)
  • Severe hepatic impairment (liver function tests 2 X the upper limit of normal)
  • Unstable medical condition (e.g., decompensated heart failure, end-stage chronic obstructive pulmonary disease, end-stage renal disease)
  • Females of childbearing potential who are pregnant, breastfeeding, or intend to become pregnant, and women who are in the process of egg donation .

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Interventions

DRUGEszopiclone

3mg for \< 65 and 2mg for ≥ 65 years

DRUGPlacebo

Matched placebo


Locations(1)

Yale Centers for Sleep Medicine

North Haven, Connecticut, United States

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NCT07332442


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