The purpose of this study is to determine if ramelteon has respiratory depressant effects in subjects with moderate to severe chronic obstructive pulmonary disease.
About 30% of the adult population report sleep disturbance and 10% meet diagnostic criteria for chronic insomnia. While 20 -25% of these individuals have primary insomnia the vast majority have an additional condition such as chronic obstructive pulmonary disease. Several studies have looked at this and have estimated that 30% to 48% of the general population is affected at some time in their life with a form of insomnia that goes on for several months, and about one third of those are described as severely affected. Daytime symptoms of insomnia include tiredness, lack of energy, difficulty concentrating and irritability. Recent epidemiologic research focusing on the quality of life has identified significant insomnia related conditions or diseases that relate to work productivity, health care utilization, and risk of depression. Insomnia is associated with diminished work output, absenteeism and greater rates of accidents. Ramelteon, is being developed as a sleep promoting agent based on agonism of melatonin receptor subtype 1 and 2. Ramelteon is marketed in the United States as Rozerem™ for the treatment of insomnia characterized by difficulty with sleep initiation. Sleep problems are common in patients with chronic obstructive pulmonary disease. There is evidence that traditional hypnotics can cause adverse respiratory effects in insomniac populations with respiratory disorders, and so the safety and efficacy of new hypnotic agents must be ascertained in this group of patients. This study will examine if ramelteon has respiratory depressant effects in subjects with moderate to severe chronic obstructive pulmonary disease. Study participation is anticipated to be about 6 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
25
Ramelteon 8 mg, tablets, orally, one night only and Ramelteon placebo-matching tablets, orally, one night only.
Unnamed facility
Birmingham, Alabama, United States
Unnamed facility
Los Angeles, California, United States
Unnamed facility
Santa Monica, California, United States
Unnamed facility
Naples, Florida, United States
Mean oxygen saturation during sleep for the entire night measured by pulse oximetry.
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Mean oxygen saturation calculated for each hour of the night, as measured by pulse oximetry.
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Mean oxygen saturation for rapid eye movement sleep stages, as measured by pulse oximetry.
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Mean oxygen saturation for non- rapid eye movement sleep stages, as measured by pulse oximetry.
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Minutes for which oxygen saturation was less than 80% as measured by pulse oximetry.
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Minutes for which oxygen saturation was less than 90% as measured by pulse oximetry.
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Apnea-hypopnea index as determined by polysomnography.
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Latency to persistent sleep as determined by polysomnography.
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Total sleep time as determined by polysomnography.
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Unnamed facility
St. Petersburg, Florida, United States
Unnamed facility
Louisville, Kentucky, United States
Unnamed facility
Lincoln, Nebraska, United States
Unnamed facility
New York, New York, United States
Sleep efficiency as determined by polysomnography.
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Wake time after persistent sleep onset as determined by polysomnography.
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Number of awakenings after persistent sleep as determined by polysomnography.
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Percentage of time in rapid eye movement sleep as determined by polysomnography.
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Percentage of time in stage 1 sleep as determined by polysomnography.
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Percentage of time in stage 2 sleep as determined by polysomnography.
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Percentage of time in stage 3/4 sleep as determined by polysomnography.
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Latency to rapid eye movement sleep as determined by polysomnography.
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Subjective sleep latency as determined by postsleep questionnaire.
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Subjective total sleep time as determined by postsleep questionnaire.
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Subjective Sleep Quality as determined by postsleep questionnaire.
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Subjective number of awakenings as determined by postsleep questionnaire.
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