Cognition After OSA Treatment Among Native American People (CATNAP)

Not Applicable

Recruiting

• Conditions: Obstructive Sleep Apnea; Cognitive Change
• Interventions: Behavioral: CATNAP MI

• Registration Number: NCT06227572
• Lead Sponsor: Washington State University

Brief Summary

This research project will develop and implement a motivational interviewing and electronic messaging intervention to address obstructive sleep apnea (OSA), positive airway pressure (PAP) adherence, and risk of Alzheimer's disease and related dementias in American Indians. The project will work with American Indian Elders, aged 50 years and older, from three Northern Plains Reservations and surrounding communities. A total of 300 American Indian elders with a confirmed OSA diagnosis and prescribed PAP therapy will be randomized to receive usual care consisting of PAP therapy alone (control condition) or usual care plus the culturally informed CATNAP MI component (intervention condition).

Detailed Description

The investigators will develop a multilevel 9-month culturally informed motivational interviewing and electronic messaging intervention- "Cognition After Obstructive Sleep Apnea (OSA) Among Native American People" (CATNAP) to: 1) provide participants with Motivational Interviewing sessions to address obstructive sleep apnea (OSA), positive airway pressure (PAP) adherence, and risk of Alzheimer's disease and related dementias (ADRD) in American Indians and 2) provide participants with electronic messaging to support PAP adherence among American Indian elders, aged 50 years and older.

This study will explore the relationship between OSA and cognitive function and evaluate OSA as a mechanism for the strong association between sleep disorders and Alzheimer's disease and related dementias (ADRD). CATNAP will be implemented as a randomized controlled trial at 4 community sites serving American Indians in the Northern Plains. A total of 300 American Indian elders, aged 50 years and older, with a confirmed OSA diagnosis and prescribed PAP therapy will be randomized to receive usual care consisting of PAP therapy alone (control condition) or usual care plus the culturally informed CATNAP component (intervention condition).

The primary outcome is PAP adherence and secondary outcome cognitive function. The study will partner with Missouri Breaks Industries Research Inc., and Missouri Breaks Durable Medical Equipment to monitor participants PAP use, which is uploaded automatically to the cloud. Outcomes will be measured at baseline, 3-months, and 9-months.

Study Timeline

• Study First Submitted: 2022-02-23
• Study First Submitted QC: 2024-01-25
• Study First Posted: 2024-01-29
• Status Verified: 2025-02
• Study Start: 2025-02-06
• Last Update Submitted: 2025-02-27
• Last Update Posted: 2025-03-04
• Primary Completion: 2027-05-01
• Study Completion: 2028-04-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 140

Inclusion Criteria

• Age 50 years and older
• Self report American Indian or Alaskan Native
• diagnosed with obstructive sleep apnea
• prescribed PAP therapy and have a device
• *Ability to understand written and spoken English; and
• *Ability and willingness to follow all study protocols.

Exclusion Criteria

• Living in a household with someone who is enrolled in the study
• Already using PAP device at Medicaid recommended standards
• Cognitive decline, unable to consent on their own

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention Group	CATNAP MI	The CATNAP MI intervention consists of 3 Motivational Interviewing sessions to address obstructive sleep apnea (OSA), positive airway pressure (PAP) adherence, and risk of Alzheimer's disease and related dementias (ADRD) in American Indians and electronic messaging to support PAP adherence, and usual care. Data will be collected at baseline, 3-months, and 9-months.

Primary Outcome Measures

Name	Time	Method
Nights of PAP use	9 months	Proportion of nights with 4+ hours of PAP use from PAP device
Positive Airway Pressure (PAP) minutes per night	9 months	Participant mask-on time data collected by the PAP equipment will be extracted as continuous minutes per night.
PAP adherence	9-months	Use of device for more than 240 minutes per night, on 21 or more days out of the past 30 days. From PAP device.

Secondary Outcome Measures

Name	Time	Method
Cognivue total score	9 months	The Cognivue Clarity device (Clarity: Comprehensive 10-Minute Cognitive Self Test \| Cognivue®) is a 10- to 15-minute patient-administered test that evaluates cognition in 6 domains: visuospatial, executive function, memory, naming/language, delayed recall, and abstraction. Study staff will be present to provide assistance in using the device, as needed. The device generates a summary score with scores 75 and above indicating normal cognitive function, 50-75 indicating mild cognitive impairment, and scores below 50 indicating severe cognitive impairment.
Montreal Cognitive Assessment total score	9 months	The Montreal Cognitive Assessment is a widely used self-report instrument to screen for cognitive impairment and probable dementia. It comprises 30 items and takes approximately 10 minutes to complete. The assessment generates a summary score with range of 0 to 30, with scores 25 and above indicating normal cognition. Scores of 19-25 are considered to indicate mild cognitive impairment, scores of 11-21 indicate probable dementia, and scores less than 10 indicating severe cognitive impairment and Alzheimer's disease.

Trial Locations

Locations (1)

Missouri Breaks Industries Research Inc; 🇺🇸 Eagle Butte, South Dakota, United States