Dental Device for Treatment of Sleep Apnea (OSA-MAD)
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Purpose
This study is being done to see if treatment of obstructive sleep apnea (OSA) with a mandibular advancement device (MAD) shows an increase in the quality of life. Many patients prefer to call them mandibular advancers, jaw advancers, jaw advancement splints, jaw advancement devices, anti-snoring mouthpieces, or oral appliances for the treatment of snoring and mild to moderate obstructive sleep apnea. The investigators will also see how helpful the mandibular advancement device is on insulin resistance.
| Condition | Intervention |
|---|---|
|
Sleep Apnea Syndromes |
Device: Mandibular advancement device |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Health Outcomes of Treatment of Obstructive Sleep Apnea With Dental Devices |
- Treatment of OSA with mandibular advancement device results in improvements in insulin sensitivity [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
- Treatment of OSA with mandibular advancement device increases the levels of high-molecular-weight adiponectin in the circulation [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
- Treatment of OSA with mandibular advancement device improves psychological adjustment. [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 40 |
| Study Start Date: | January 2010 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Mandibular advancement device
Subject is evaluated when receiving intervention with mandibular advancement device.
|
Device: Mandibular advancement device
Mandibular advancement device made to subject specific specifications
|
|
No Intervention: No mandibular advancement device
Subject is evaluated when not receiving treatment with mandibular advancement device.
|
Detailed Description:
Patients with obstructive sleep apnea (OSA) will be included in this prospective controlled trial. OSA patients who are unable to tolerate CPAP or refuse CPAP(Continuous positive airway pressure) (and who are deemed appropriate by their attending physician for dental device treatment of OSA will be randomized to a control group (no MAD treatment) or to active MAD therapy.
Epidemiologic studies suggest that OSA is associated with insulin resistance independent of other known risk factors such as obesity. The cyclic intermittent hypoxia in OSA is the primary stimulus that leads to insulin resistance, a primary risk factor for the development of type 2 diabetes. There is an association between the level of hypoxic stress in OSA and insulin resistance.
The overall hypothesis to be tested is that treatment of OSA with MAD will improve insulin sensitivity, increase levels of HMW (High-molecular- weight) adiponectin, and improve psychological adjustment.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Apnea-hypopnea index (AHI) of at least 20 events/hr based on overnight polysomnography
- > 18 years of age
- Unable to tolerate or refuse CPAP treatment
Exclusion Criteria:
- Known diabetes mellitus
- Body mass index (BMI) > 45 kg/m2
- Uncontrolled hypertension
- Known congestive heart failure
- Use of illicit drugs
Excessive alcohol consumption, defined as:
- More than 3 glasses of wine a day
- More than 3 beers a day
- More than 60 mL of hard liquor a day
- Room air oxyhemoglobin saturation < 90%
- Use of home oxygen
- Use of corticosteroids
- Unable to give voluntary consent
Contacts and Locations| Contact: Pulmonary Clinical Trials Office | 614-293-4978 | Lung.Research@osumc.edu |
| Contact: Melissa Michetti | 614-366-2761 | melissa.michetti@osumc.edu |
| United States, Ohio | |
| The Ohio State University | Recruiting |
| Columbus, Ohio, United States, 43210 | |
| Contact 614-293-4978 Lung.Research@osumc.edu | |
| Principal Investigator: | Ulysses Magalang, M.D. | Ohio State University |
More Information
No publications provided
| Responsible Party: | Ulysses Magalang MD, Professor-Clinical, The Ohio State University |
| ClinicalTrials.gov Identifier: | NCT01005940 History of Changes |
| Other Study ID Numbers: | 2009H0131 |
| Study First Received: | October 30, 2009 |
| Last Updated: | May 13, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Ohio State University:
|
Sleep Apnea Syndromes Insulin Resistance Mandibular advancement device |
Additional relevant MeSH terms:
|
Sleep Apnea Syndromes Sleep Apnea, Obstructive Apnea Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory |
Signs and Symptoms Sleep Disorders, Intrinsic Dyssomnias Sleep Disorders Nervous System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013