Multi-Ethnic Study of Atherosclerosis (MESA), is an NHLBI-sponsored 6-center collaborative longitudinal investigation of factors associated with the development of subclinical cardiovascular disease and the progression of subclinical to clinical cardiovascular disease in 6,814 black, white, Hispanic, and Chinese-American men and women initially ages 45-84 at baseline in 2000-2002. There have been four follow-up exams to date, in the years 2003-2004, 2004-2005, 2005-2007, and 2010-2011. Between 2010-2012, 2,237 participants also were enrolled in a Sleep Exam (MESA Sleep) which included full overnight unattended polysomnography, 7-day wrist-worn actigraphy, and a sleep questionnaire. The objectives of the sleep study are to understand how variations in sleep and sleep disorders vary across gender and ethnic groups and relate to measures of subclinical atherosclerosis.
The Home Positive Airway Pressure (HomePAP) study was a multisite, nonblinded, randomized controlled trial that enrolled 373 patients at seven American Academy of Sleep Medicine (AASM)-accredited academic sleep centers with a high pretest probability of moderate to severe OSA (based on a clinical algorithm). Eligible subjects were evaluated in clinic and randomized to one of two management pathways: 1) laboratory-based and 2) home-based. All subjects with an AHI ≥ 15 who underwent a successful CPAP titration study were offered CPAP therapy. Subjects were re-evaluated in clinic after 1- and 3-month follow-up periods.
The Best Apnea Interventions for Research (BestAIR) study aimed to randomize approximately 180 patients with sleep apnea who had either established CVD or at least three CVD risk factors into a 12-mo, four-arm intervention study. All arms included nightly use of nasal dilator strips and conservative medical therapy (CMT) defined as education on healthy sleep and lifestyle. The two active arms were: (1) active CPAP delivered using standard support from a trained sleep technician; and (2) active CPAP enhanced by a behavioral promotion intervention delivered by a behavioral therapist. The two control arms were: (1) sham-CPAP; and (2) CMT alone. The primary physiological outcome was change in mean 24-h systolic blood pressure. Process measures were recruitment yields, retention rates, and CPAP adherence levels.
The Apnea, Bariatric surgery, and CPAP (ABC) study is a randomized trial of CPAP versus laparoscopic gastric banding (LGB) for patients with severe obstructive sleep apnea (OSA), hypothesizing that residual disease (effective apnea-hypopnea index [AHI]) and Epworth Sleepiness Scale (ESS) would be significantly lower with LGB compared to CPAP at 9- and 18-months.
The subject wore an actigraph on his wrist for 365 consecutive days. The main purpose of the project is to search for predictive algorithms from wrist actigraphy recordings of one subject using a MotionWatch8 (CamNtech Ltd) system on the non predominant wrist, for unrestricted lifestyle.