Central Apnea in Heart Failure: Physiological Mechanisms to Inform Treatment (NCT07210606) | Clinical Trial Compass
Not Yet RecruitingPhase 4
Central Apnea in Heart Failure: Physiological Mechanisms to Inform Treatment
United States200 participantsStarted 2026-10-01
Plain-language summary
Central sleep apnea (CSA) is common in patients with heart failure and those using opioid analgesics. Unfortunately, effective treatment of central apnea remains elusive, pressure therapy given the modest efficiency of positive airway pressure therapy. The focus of this proposal is to identify mechanistic pathways to guide future therapeutic interventions for central sleep apnea based on the strong premise that multi-modality therapy will normalize respiration and hence mitigate adverse long-term consequences of CSA. The investigators' proposed studies will test combination therapies, including positive airway pressure (PAP) plus a pharmacological agent who have heart failure or are using opioid analgesics. The investigators anticipate that findings will inform future clinical trials to improve care and quality of life among Veterans suffering from central sleep apnea, which remains difficult to treat using existing approaches.
Who can participate
Age range
18 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Men and Women Veterans with central sleep apnea, defined as Apnea Hypopnea Index (AHI)\>15/hour with CAHI\>5/hour, will be included with the experiments.
* Those with chronic, stable heart failure with reduced ejection fraction, receiving stable optimized guideline-based therapy and no hospitalizations or change in the medical regimen for the past 90 days before enrollment.
Exclusion Criteria:
* less than 18 years old
* pregnant or breastfeeding females
* moderate or severe obstructive or restrictive lung disease, including supplemental o2 use
* current treatment for CSA, including any form of PAP in the past three months, or phrenic nerve situation.
* too ill to engage in the study procedures, inability to provide consent for participation.
* a history of cardiac arrhythmia
* Alcohol or substance abuse (less than 90 days sobriety) or current participation in a treatment program
* depression or a history of suicidality
* severe insomnia (ISI\>21) or reported short sleep duration (\<6 hours)
* PAP-emergent central sleep apnea
* Lack of PAP acceptance/adherence after a one-week home PAP trial after enrollment.
Additional Trazodone Exclusions:
* Prolonged QT on baseline ECG, using medications that inhibit CYP3A4
* Patients with severe renal impairment (GFR \< 20ml/min/1.73m2) or end-stage renal disease
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.