Evaluation of Sleep Apnea and Cardiac Rhythm Abnormalities After Surgery Under General Anesthesia

NCT02833662 | Unknown

• 1 other identifier: 38RC15.080
• Study Type: interventional
• Target: 120
• Locations: 0 countries
• Sites: N/A

Brief Summary

Higher risk of cardiac and respiratory post-operative events is observed in patients with unrecognised Obstructive Sleep Apnea (OSA). The efficiency of a simple method of OSA screening by analysing ventilation with measurement of nose pressure and nocturnal hypoxemia (oxygen desaturation index) will be assessed. These sleep respiratory analyses will be compared with the research of arrhythmia, in order to show if they are linked to the hypoxemia events. Aggravation of nocturnal respiratory disorder and higher incidence of cardiac and respiratory postoperative complications will be assessed in OSA patients.

Conditions

Obstructive Sleep Apnea; Arrhythmia

Keywords

Hypoxia; Perioperative outcomes

Outcome Measures

Primary Outcomes (1)

• Change from baseline in heart rhythm troubles linked to hypoxemia events

  Heart rhythm troubles will be assessed 3 times: * First time = baseline assessment, during one night before surgery * second assessment will occur during the first night after surgery * last assessment will take place during the third night after surgery

  Before surgery and at first and third night after surgery

Secondary Outcomes (3)

• Change from baseline in severity of OSA defined by the oxygen saturation index

  Before surgery and at first and third night after surgery

• Aggravation of cardiac events linked to hypoxemia

  After surgery from night 1 to night 15 maximum

• Change from baseline OSA prevalence and cardiorespiratory complications after surgery

  Before surgery and at first and third night after surgery

Study Arms (1)

Patients suspected to present a Sleep Apnea Syndrom

OTHER

Record nocturnal respiratory and cardiac parameters before and after surgery : Severity of sleep respiratory disorders and relationship with cardiac rhythm abnormalities will be assessed in patients suspected to present Sleep Apnea, before and after surgery under general anesthesia.

Other: Measure of ODI and heart rhythm

Interventions

Measure of ODI and heart rhythm OTHER

Record nocturnal respiratory and cardiac parameters before and after surgery.

Patients suspected to present a Sleep Apnea Syndrom

Eligibility Criteria

• Age: 45 Years - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• orthopaedic, urologic, vascular, digestive surgery
• under general anaesthesia or sedation
• age \> 45 years old
• STOP-BANG score\>3

You may not qualify if:

• Head and neck surgery, planned prolonged mechanical ventilation after surgery (\>24h)
• Severe COPD
• Post-operative ICU planned
• Diagnosed OSA or other sleep disorder breathing

Sponsors & Collaborators

• University Hospital, Grenoble: lead
• AGIR à Dom: collaborator

Related Publications (28)

• Chung F, Liao P, Yegneswaran B, Shapiro CM, Kang W. Postoperative changes in sleep-disordered breathing and sleep architecture in patients with obstructive sleep apnea. Anesthesiology. 2014 Feb;120(2):287-98. doi: 10.1097/ALN.0000000000000040.

  PMID: 24158049 BACKGROUND

• Kaw R, Chung F, Pasupuleti V, Mehta J, Gay PC, Hernandez AV. Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome. Br J Anaesth. 2012 Dec;109(6):897-906. doi: 10.1093/bja/aes308. Epub 2012 Sep 6.

  PMID: 22956642 BACKGROUND

• Vizzardi E, Sciatti E, Bonadei I, D'Aloia A, Curnis A, Metra M. Obstructive sleep apnoea-hypopnoea and arrhythmias: new updates. J Cardiovasc Med (Hagerstown). 2017 Jul;18(7):490-500. doi: 10.2459/JCM.0000000000000043.

  PMID: 25000252 BACKGROUND

• Kilicaslan F, Tokatli A, Ozdag F, Uzun M, Uz O, Isilak Z, Yiginer O, Yalcin M, Guney MS, Cebeci BS. Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are prolonged in patients with moderate and severe obstructive sleep apnea. Pacing Clin Electrophysiol. 2012 Aug;35(8):966-72. doi: 10.1111/j.1540-8159.2012.03439.x. Epub 2012 Jun 5.

  PMID: 22671991 BACKGROUND

• Chung F, Liao P, Elsaid H, Shapiro CM, Kang W. Factors associated with postoperative exacerbation of sleep-disordered breathing. Anesthesiology. 2014 Feb;120(2):299-311. doi: 10.1097/ALN.0000000000000041.

  PMID: 24158050 BACKGROUND

• Singh M, Liao P, Kobah S, Wijeysundera DN, Shapiro C, Chung F. Proportion of surgical patients with undiagnosed obstructive sleep apnoea. Br J Anaesth. 2013 Apr;110(4):629-36. doi: 10.1093/bja/aes465. Epub 2012 Dec 19.

  PMID: 23257990 BACKGROUND

• Rennotte MT, Baele P, Aubert G, Rodenstein DO. Nasal continuous positive airway pressure in the perioperative management of patients with obstructive sleep apnea submitted to surgery. Chest. 1995 Feb;107(2):367-74. doi: 10.1378/chest.107.2.367.

  PMID: 7842763 BACKGROUND

• Latina JM, Estes NA 3rd, Garlitski AC. The Relationship between Obstructive Sleep Apnea and Atrial Fibrillation: A Complex Interplay. Pulm Med. 2013;2013:621736. doi: 10.1155/2013/621736. Epub 2013 Feb 26.

  PMID: 23533751 BACKGROUND

• Gupta S, Cepeda-Valery B, Romero-Corral A, Shamsuzzaman A, Somers VK, Pressman GS. Association between QRS duration and obstructive sleep apnea. J Clin Sleep Med. 2012 Dec 15;8(6):649-54. doi: 10.5664/jcsm.2256.

  PMID: 23243398 BACKGROUND

• Filgueiras-Rama D, Arias MA, Iniesta A, Armada E, Merino JL, Peinado R, Lopez-Sendon JL. Atrial arrhythmias in obstructive sleep apnea: underlying mechanisms and implications in the clinical setting. Pulm Med. 2013;2013:426758. doi: 10.1155/2013/426758. Epub 2013 Apr 3.

  PMID: 23691306 BACKGROUND

• Rossi VA, Stradling JR, Kohler M. Effects of obstructive sleep apnoea on heart rhythm. Eur Respir J. 2013 Jun;41(6):1439-51. doi: 10.1183/09031936.00128412. Epub 2012 Dec 20.

  PMID: 23258782 BACKGROUND

• Gami AS, Olson EJ, Shen WK, Wright RS, Ballman KV, Hodge DO, Herges RM, Howard DE, Somers VK. Obstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10,701 adults. J Am Coll Cardiol. 2013 Aug 13;62(7):610-6. doi: 10.1016/j.jacc.2013.04.080. Epub 2013 Jun 13.

  PMID: 23770166 BACKGROUND

• Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, Khajehdehi A, Shapiro CM. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008 May;108(5):812-21. doi: 10.1097/ALN.0b013e31816d83e4.

  PMID: 18431116 BACKGROUND

• Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaesth. 2012 May;108(5):768-75. doi: 10.1093/bja/aes022. Epub 2012 Mar 8.

  PMID: 22401881 BACKGROUND

• Chouchou F, Poupard L, Philippe C, Court-Fortune I, Barthelemy JC, Roche F. Thoracic impedance, in association with oximetry, in a multi-modal ECG Holter system is useful for screening sleep disordered breathing. Int J Cardiol. 2013 Feb 10;163(1):100-2. doi: 10.1016/j.ijcard.2012.06.082. Epub 2012 Jul 16. No abstract available.

  PMID: 22805548 BACKGROUND

• Poupard L, Mathieu M, Goldman M, Chouchou F, Roche F. Multi-modal ECG Holter system for sleep-disordered breathing screening: a validation study. Sleep Breath. 2012 Sep;16(3):685-93. doi: 10.1007/s11325-011-0558-1. Epub 2011 Jul 26.

  PMID: 21789729 BACKGROUND

• Baguet JP, Levy P, Barone-Rochette G, Tamisier R, Pierre H, Peeters M, Mallion JM, Pepin JL. Masked hypertension in obstructive sleep apnea syndrome. J Hypertens. 2008 May;26(5):885-92. doi: 10.1097/HJH.0b013e3282f55049.

  PMID: 18398330 BACKGROUND

• Pepin JL, Defaye P, Vincent E, Christophle-Boulard S, Tamisier R, Levy P. Sleep apnea diagnosis using an ECG Holter device including a nasal pressure (NP) recording: validation of visual and automatic analysis of nasal pressure versus full polysomnography. Sleep Med. 2009 Jun;10(6):651-6. doi: 10.1016/j.sleep.2008.07.002. Epub 2008 Nov 22.

  PMID: 19028140 BACKGROUND

• Tamisier R, Gilmartin GS, Launois SH, Pepin JL, Nespoulet H, Thomas R, Levy P, Weiss JW. A new model of chronic intermittent hypoxia in humans: effect on ventilation, sleep, and blood pressure. J Appl Physiol (1985). 2009 Jul;107(1):17-24. doi: 10.1152/japplphysiol.91165.2008. Epub 2009 Feb 19.

  PMID: 19228987 BACKGROUND

• Pepin JL, Tamisier R, Barone-Rochette G, Launois SH, Levy P, Baguet JP. Comparison of continuous positive airway pressure and valsartan in hypertensive patients with sleep apnea. Am J Respir Crit Care Med. 2010 Oct 1;182(7):954-60. doi: 10.1164/rccm.200912-1803OC. Epub 2010 Jun 3.

  PMID: 20522795 BACKGROUND

• Tamisier R, Pepin JL, Remy J, Baguet JP, Taylor JA, Weiss JW, Levy P. 14 nights of intermittent hypoxia elevate daytime blood pressure and sympathetic activity in healthy humans. Eur Respir J. 2011 Jan;37(1):119-28. doi: 10.1183/09031936.00204209. Epub 2010 Jun 4.

  PMID: 20525723 BACKGROUND

• Roche F, Pepin JL, Achour-Crawford E, Tamisier R, Pichot V, Celle S, Maudoux D, Chouchou F, Ntougou-Assoumou HG, Levy P, Barthelemy JC; PROOF Study Group. At 68 years, unrecognised sleep apnoea is associated with elevated ambulatory blood pressure. Eur Respir J. 2012 Sep;40(3):649-56. doi: 10.1183/09031936.00162710. Epub 2012 Apr 20.

  PMID: 22523363 BACKGROUND

• Cereda CW, Tamisier R, Manconi M, Andreotti J, Frangi J, Pifferini V, Bassetti CL. Endothelial dysfunction and arterial stiffness in ischemic stroke: the role of sleep-disordered breathing. Stroke. 2013 Apr;44(4):1175-8. doi: 10.1161/STROKEAHA.111.000112. Epub 2013 Mar 7.

  PMID: 23471270 BACKGROUND

• Gasa M, Tamisier R, Launois SH, Sapene M, Martin F, Stach B, Grillet Y, Levy P, Pepin JL; Scientific Council of the Sleep Registry of the French Federation of Pneumology-FFP. Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure. J Sleep Res. 2013 Aug;22(4):389-97. doi: 10.1111/jsr.12039. Epub 2013 Feb 15.

  PMID: 23409736 BACKGROUND

• Maziere S, Pepin JL, Siyanko N, Bioteau C, Launois S, Tamisier R, Arnol N, Levy P, Couturier P, Bosson JL, Gavazzi G. Usefulness of oximetry for sleep apnea screening in frail hospitalized elderly. J Am Med Dir Assoc. 2014 Jun;15(6):447.e9-14. doi: 10.1016/j.jamda.2014.03.011. Epub 2014 Apr 24.

  PMID: 24768555 BACKGROUND

• Minville C, Hilleret MN, Tamisier R, Aron-Wisnewsky J, Clement K, Trocme C, Borel JC, Levy P, Zarski JP, Pepin JL. Nonalcoholic fatty liver disease, nocturnal hypoxia, and endothelial function in patients with sleep apnea. Chest. 2014 Mar 1;145(3):525-533. doi: 10.1378/chest.13-0938.

  PMID: 24264333 BACKGROUND

• Seguin L, Mendelson M, Doutreleau S, Clin R, Destors M, Albaladejo P, Pepin JL, Payen JF, Tamisier R. Temporal link between cardiac arrhythmias and postoperative episodes of hypoxemia during nocturnal sleep in patients with obstructive sleep apnea syndrome. Sleep Med. 2024 Dec;124:260-267. doi: 10.1016/j.sleep.2024.09.014. Epub 2024 Sep 12.

  PMID: 39332270 DERIVED

• Seguin L, Tamisier R, Deletombe B, Lopez M, Pepin JL, Payen JF. Preoperative Screening for Obstructive Sleep Apnea Using Alternative Scoring Models of the Sleep Tiredness Observed Pressure-Body Mass Index Age Neck Circumference Gender Questionnaire: An External Validation. Anesth Analg. 2020 Oct;131(4):1025-1031. doi: 10.1213/ANE.0000000000004909.

  PMID: 32925319 DERIVED

MeSH Terms

Conditions

Sleep Apnea, Obstructive; Arrhythmias, Cardiac; Hypoxia

Condition Hierarchy (Ancestors)

Sleep Apnea Syndromes; Apnea; Respiration Disorders; Respiratory Tract Diseases; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders; Nervous System Diseases; Heart Diseases; Cardiovascular Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms, Respiratory; Signs and Symptoms

Study Officials

• Renaud TAMISIER, Md,PhD

  University Hospital, Grenoble

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: SCREENING
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 3, 2015
• First Posted: July 14, 2016
• Study Start: June 1, 2015
• Primary Completion: December 1, 2016
• Study Completion: July 1, 2017
• Last Updated: July 14, 2016

Record last verified: 2016-05