Trial Search Results
Comparative Outcomes Management With Electronic Data Technology (COMET) Study
STAGE I of the COMET study was to develop an Electronic Network Informatics Infrastructure that prospectively enabled access to and the sharing of clinical and research data.
STAGE II: This was a Comparative Effectiveness Trial (CET) evaluating positive airway pressure (PAP) vs. oral appliance (OA) therapy in improving hypertension and abnormalities in cardiovascular function in overweight/obese patients with obstructive sleep apnea (OSA). Data collected during the STAGE II study was incorporated in Part 3 of the STAGE I study.
STAGE III of the COMET study was completion of data analysis and preparation of the electronic network informatics infrastructure for use beyond the four Clinical Centers to interested CTSA institutions. We also explored expanding ontologies, and the use of federated database methodology.
Stanford is currently not accepting patients for this trial.
- Device: Positive Airway Pressure (PAP)
- Device: Oral Appliance (OA)
- Age > 18 years.
- BMI > = 25.0 kg/m^2.
- A diagnosis of obstructive sleep apnea based upon medical history and apnea- hypopnea
index > = 10.0 or oxygen desaturation index (ODI; ≥4%) ≥ 10.0 on Diagnostic
- Report a history of hypertension (or need for treatment for hypertension) which is
currently untreated OR taking medication for the treatment of hypertension.
- Stable medication regimen for 2 months prior to the Baseline Testing Visit. As-needed
medications such as those used for allergy, cold, or minor pain symptoms may be used
at the discretion of the Clinical Center physician.
- Cardiovascular disease which, in the judgment of the investigator, if observed during
standard clinical practice would lead the treating physician to make every effort to
treat the patient's sleep apnea with positive airway pressure, rather than alternative
- Clinically significant acute or chronic disease that is not well controlled or could
affect ability to complete or comply with study procedures, in the opinion of the
Clinical Center physician.
- Respiratory disease requiring supplemental oxygen or medication. Individuals with
asthma may be included at the discretion of the Clinical Center physician if disease
is well controlled and medications are stable for 2 months.
- History of (within 12 months prior to enrollment), or current diagnosis of, Axis I or
Axis II psychiatric disorder (other than obstructive sleep apnea) that in the opinion
of the Clinical Center physician would affect ability to complete or comply with study
procedures (e.g., schizophrenia and other psychotic disorders).
- History of (within 3 months prior to enrollment), or current diagnosis of narcolepsy,
idiopathic hypersomnia, restless legs syndrome, rapid eye movement (REM) behavior
disorder, persistent situational insomnia, or sleep-related breathing disorders other
than obstructive sleep apnea.
- Periodic limb movement arousal index > 10.0 on the Diagnostic Polysomnogram.
- Significant daytime sleepiness at study entry as indicated by:
- an Epworth Sleepiness Scale total score > 16, or a score of 3 (high chance) on
the question about risk of dozing "In a car, while stopped for a few minutes in
- a report of falling asleep at the wheel, a motor vehicle accident, or near-miss
accident due to sleepiness in the past 24 months, which in the judgment of the
study physician was not attributable to acute sleep loss.
- Oxygen saturation < 80% for > 10% of sleep time during the Diagnostic Polysomnogram,
or intervention with positive airway pressure or oxygen for safety purposes during the
- Any prior treatment for obstructive sleep apnea with positive airway pressure or oral
appliance, or surgical treatment for obstructive sleep apnea in the past year.
- Contraindication for treatment with either positive airway pressure or oral appliance,
in the opinion of the Clinical Center physician or dentist, including significant
nasal obstruction, insufficient or loose teeth, dentures, advanced periodontal
disease, or significant temporomandibular joint pain.
- Difficulty understanding or speaking English, or inability to read and understand
informed consent and study procedures.
- Significant vision, hearing, or motor problems that, in the opinion of the Clinical
Center physician, would affect ability to complete study procedures.
- A work schedule that does not allow for nighttime sleep on the 3 nights before each
- Current or planned participation in another research study.
- Metal objects, devices, or implants that are in or on the body (Stanford Clinical
- Creatinine clearance <30 and creatinine >1.6 (Stanford Clinical Center only).
- Upper arm circumference > 20 inches
Ages Eligible for Study
18 Years - N/A
Genders Eligible for Study