A Pilot Study of Biomarkers in Obstructive Sleep Apnea (Cytokine OSA)
Obstructive Sleep Apnea
About this trial
This is an interventional diagnostic trial for Obstructive Sleep Apnea focused on measuring Obstructive Sleep Apnea, Arthroplasty, Replacement, Knee, Cerebrospinal Fluid, Inflammation, TNF-alpha, Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), Cytokines, Neurotrophins, BDNF, Beta-NGF, Proteomic Analysis
Eligibility Criteria
Inclusion Criteria:
- Patients between the ages of 50 and 84
- Treated and Untreated OSA Patients: Known OSA, diagnosed by polysomnography
- Treated OSA Patients: Known CPAP prescription, dose used nightly, and compliance status
- Controls: No suspicion for OSA, based on STOP-BANG screening score (<3)
- Any patient presenting for knee replacement surgery with prior consent for spinal or combined spinal-epidural anesthesia
Exclusion Criteria:
- Presence of dementia
- Presence of cognitive disease
- Presence of depression, anxiety, or other mood disorder(s)
- Recent oral steroid therapy (within prior 6 months)
- Requirement of stress-dose steroids pre-operatively
- Autoimmune disease
- Neurologic disease
- Controls: Suspected OSA, either disclosed by patient, or by clinical suspicion based on STOP-BANG questionnaire (score ≥ 3)
- Chronic renal disease
- Chronic liver disease
- Traumatic spinal or spinal-epidural placement (i.e., blood-contaminated CSF)
- Alcohol abuse - defined as being diagnosed with alcohol abuse or consuming more than 2 drinks per night, on average
- Use of NSAIDs within 7 days prior to surgery
- Chronic benzodiazepine use (for more than one month)
Sites / Locations
- Hospital for Special Surgery
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Treated OSA (CPAP-compliant)
Untreated OSA (non-CPAP-compliant)
Control (No suspicion of OSA)
Treated OSA patients will have previously been diagnosed with OSA, and are currently CPAP-compliant. CPAP compliance is defined by daily use of a CPAP machine for at least 4 hours. We will determine if patients are CPAP-compliant by looking at their medical records and pre-operative assessments, as well as directly verifying compliance with the patient. Intervention: Lumbar Puncture (Standard-of-Care)
Patients in the untreated OSA group will have previously been diagnosed with OSA, but for some reason do not use a CPAP machine every night. We will determine if patients are CPAP-compliant by looking at their medical records and pre-operative assessments, as well as directly verifying compliance with the patient. Intervention: Lumbar Puncture (Standard-of-Care)
Patients in the control group will not have previously been diagnosed with OSA, and are currently not at high risk. We will determine overall risk for OSA using the STOP-BANG questionnaire. Patients with a STOP-BANG score <3 are considered to have minimal risk for OSA and will be included in the control group. Intervention: Lumbar Puncture (Standard-of-Care)