Endotype-Targeted Therapy to Rescue OSA Patients Struggling with CPAP Adherence (TOPCPAP): A Pilot Trial

2022 American Board of Sleep Medicine Junior Faculty Grant

Christopher Schmickl, MD, PhD
University of California San Diego

Key Project Outcomes

Obstructive sleep apnea (OSA) is a common sleep disorder with serious health consequences. While continuous positive airway pressure (CPAP) therapy is highly effective, many patients struggle to use it consistently, which limits its benefits. This pilot study tested whether short-term treatment with eszopiclone—a sleep aid—could help patients with low CPAP usage improve their adherence to the therapy long-term.

We conducted a randomized, placebo-controlled trial in patients with moderate to severe OSA who had been using CPAP inconsistently. In addition to evaluating overall improvements in CPAP use, we investigated whether an individual sleep characteristic, called arousal threshold (how easily someone wakes up), could help predict who would benefit most from this treatment.

Although final data collection is still ongoing, we expect to complete enrollment shortly and anticipate results later this year. This project was part of a career development award, which has provided valuable experiences and training for the principal investigator. Regardless of the results, the data from this trial will support follow up investigations and funding applications. Ultimately this award will help develop targeted, personalized treatments that help more people with OSA benefit from effective therapies like CPAP—supporting healthier lives through better sleep.