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Trial registered on ANZCTR
Registration number
ACTRN12612000992808
Ethics application status
Approved
Date submitted
5/09/2012
Date registered
17/09/2012
Date last updated
22/12/2021
Date data sharing statement initially provided
22/12/2021
Date results provided
22/12/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Acupuncture and Obstructive Sleep Apnoea
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Scientific title
The effect of acupuncture on upper airway function in obstructive sleep apnoea
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Secondary ID [1]
281171
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Nil
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Universal Trial Number (UTN)
U1111-1134-3349
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obstructive Sleep Apnoea
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Condition category
Condition code
Respiratory
287675
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0
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Sleep apnoea
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Alternative and Complementary Medicine
287680
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0
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Other alternative and complementary medicine
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Acupuncture:
Study Duration: the whole study will take 15 weeks starting from the screening, and including the baseline and end measurement sessions as well as twelve acupuncture treatment sessions.
Intervention: each acupuncture treatment session will be one hour in duration with a total of 12 treatment sessions (2 x bi-weekly treatments for two weeks, 1 x weekly treatments for the next 6 weeks and finally 2 x fortnightly treatments for the next four weeks).
Mode of administration: The acupuncture treatment involves single-use disposable acupuncture needles that vary between 13-40mm in length and 0.18-0.25mm in diameter. The points of application will vary depending on the stage of treatment but will be points that regulate activity of the respiratory tract, and tonify the Spleen, Kidneys and Lungs.
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Intervention code [1]
285619
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Treatment: Other
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Comparator / control treatment
Sham Acupuncture:
Study Duration: the whole study will take 15 weeks starting from the screening, and including the baseline and end measurement sessions as well as twelve acupuncture treatment sessions.
Sham Intervention: each session will be one hour long in duration with a total of 12 sham treatment sessions (2 x bi-weekly treatments for two weeks, 1 x weekly treatment for the next 6 weeks and finally 2 x fortnightly treatments for the next four weeks).
Mode of administration: The sham acupuncture will be sham laser acupuncture treatment in which the diode has been removed from the laser to ensure that the treatment is biologically inactive. The points used in treatment will be identical to the points used in the needle acupuncture treatments. Patients will be told that they are receiving laser acupuncture. Participants will be aware before consenting that some participants will receive a placebo treatment.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Score on the Apnoea/Hypopnoea Index which is a measure of the average number of respiratory events experienced per hour of sleep as assessed during the baseline 1 night polysomnography.
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Assessment method [1]
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Timepoint [1]
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at baseline and at 13 weeks after intervention commencement
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Primary outcome [2]
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Mean daytime sleepiness as measured by the Epworth Sleepiness Scale
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Assessment method [2]
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Timepoint [2]
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at screening and at 13 weeks after intervention commencement
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Secondary outcome [1]
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Activity of the genioglossus muscle both during wakefulness and during sleep in response to airway occlusions as measured via intramuscular electrode wires inserted into the genioglossus muscle
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Assessment method [1]
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Timepoint [1]
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at baseline and at 13 weeks after intervention commencement
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Secondary outcome [2]
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Mean arousal threshold defined as the maximal respiratory effort required to arouse from sleep in order to re-open the airway thereby terminating an occlusion. This is taken as the average pressure in the throat just prior to termination of respiratory events. A pressure tipped catheter will be advanced through the nasal cavity to the back of the throat to take this measure.
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Assessment method [2]
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Timepoint [2]
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at baseline and at 13 weeks after intervention commencement
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Secondary outcome [3]
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Upper Airway Resistance during wakefulness. Resistance is measured as a function of nasal to epiglottic pressure as measured by an epiglottic pressure catheter and a pressure catheter at the back of the nasal chonae.
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Assessment method [3]
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Timepoint [3]
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at baseline and at 13 weeks after intervention commencement
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Eligibility
Key inclusion criteria
Mild to moderate OSA (AHI between 5 and 30)
Not currently receiving treatment for obstructive sleep apnoea
Acupuncture naive (as defined as not having previously experienced acupuncture treatment)
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Minimum age
20
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Excessive daytime sleepiness.
Pregnant women.
Individuals dependent on a carer or guardian.
Individuals unable by reason of cognitive impairment, or inadequate English language skill to give informed consent.
Individuals with concurrent sleep disorders other than OSA or a co-morbid condition that is a significant threat to mortality or significantly alters respiratory or cardiovascular anatomy or physiology (e.g., patients who have had an acute cardiac or cerebral event in the previous 3 month, or patients with cardiac disease and oxygen saturation less than 90% for more than 10 minutes during sleep).
Individuals for whom withholding treatment would lead to a significant risk to them or the general population (e.g., bus/taxi drivers or heavy machinery operators, those with severe daytime sleepiness - defined as Epworth Sleepiness Score >16, or those in whom, in the opinion of their treating physician, it is unsafe to withold definitive treatment for a period of 15 weeks).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will be randomly assigned to either the treatment or placebo groups. Allocation concealment will be ensured through use of sealed, consecutively numbered opaque envelopes. A master document with information about which treatment group each participant was involved in will be kept in electronic format on a secure computer.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomization will involve randomly allocating all participants to the two groups according to a computer-generated random number schedule (www.randomizer.org) that will be performed by an individual that is not a member of the research team.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
19/09/2012
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Actual
19/03/2013
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Date of last participant enrolment
Anticipated
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Actual
6/08/2014
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Date of last data collection
Anticipated
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Actual
21/04/2015
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Sample size
Target
30
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of Melbourne
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Address [1]
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12th Floor Redmond Barry Building
The University of Melbourne
Parkville, 3010
Victoria
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr. Amy Jordan
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Address
Institute for Breathing and Sleep
First floor, Bowen Centre
Austin Health
145 Studley Road
Heidelberg, Victoria, 3084
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Austin Health
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Address [1]
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First Floor, Bowen Centre
Austin Health
145 Studley Road
Heidelberg, Victoria, 3084
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Dr. Fergal O'Donoghue
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Address [1]
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Department of Respiratory and Sleep Medicine
First Floor, Bowen Centre
Austin Health
145 Studley Road
Heidelberg, Victoria, 3084
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Prof. John Trinder
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Address [2]
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The University of Melbourne
12th Floor Redmond Barry Building,
Parkville, Victoria, 3010
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Country [2]
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Prof. Charlie Xue
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Address [3]
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RMIT University
Building 201, Level 2, Room 06
Bundoora, Victoria, 3083
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Country [3]
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Peter Rochford
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Address [4]
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Institute for Breathing and Sleep
First Floor, Bowen Centre
Austin Health
145 Studley Road
Heidelberg, Victoria, 3084
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Country [4]
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Australia
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Other collaborator category [5]
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Individual
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Name [5]
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Therese Thornton
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Address [5]
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Room 922 Redmond Barry Building,
The University of Melbourne,
Parkville, Victoria, 3000
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Country [5]
277057
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Austin Health Human Research Ethics Committee
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Ethics committee address [1]
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Office for Research Level 6 HSB, Austin Health, Studley Road, Heidelberg, Victoria, 3084
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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29/08/2012
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Approval date [1]
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04/09/2012
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Ethics approval number [1]
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H2012/04654
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Summary
Brief summary
Obstructive sleep apnoea (OSA) is a disorder characterised by repetitive obstruction of the throat during sleep. People who suffer from OSA have increased risk of heart disease and are often very tired during the daytime. Currently, continuous positive airway pressure (CPAP) is the most common treatment for OSA because it treats the disorder in almost all patients. Many patients, however, do not like using CPAP for several reasons (for example it is bulky, or is uncomfortable), and therefore choose not to use it. For this reason, we wish to find an alternative treatment that is effective and well tolerated by patients. A recent research paper has suggested that acupuncture can lower the severity of OSA. However, the authors did not investigate how acupuncture caused the change in OSA severity. Our study aims to 1) see whether acupuncture treats OSA, and 2) try and work out how acupuncture is improving the severity of OSA. It is hypothesized that patients will experience fewer respiratory events and experience less daytime sleepiness after twelve treatments of acupuncture, but that placebo acupuncture will have no effect on the severity of OSA or sleepiness. It is also hypothesized that for those patients who experience reductions in the severity of their OSA symptoms will show changes in the activity of the airway muscles, changes in the resistance to airflow in their throat and changes in the amount of effort required to wake them from sleep while they are having a respiratory event.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Therese Thornton
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Address
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room 922, Level 9 Redmond Barry Building
The University of Melbourne
Parkville, 3010, VIC
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Country
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Australia
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Phone
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+61414382816
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Therese Thornton
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Address
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Room 922 Redmond Barry Building,
The University of Melbourne,
Parkville, Victoria, 3010
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Country
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Australia
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Phone
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+61 3 83444911
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Amy Jordan
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Address
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Institute for Breathing and Sleep
First Floor, Bowen Centre
Austin Health
145 Studley Road
Heidelberg, Victoria, 3084.
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Country
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Australia
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Phone
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+61 3 83446357
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
The data is confidential and no further trials are planned
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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