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Efficacy of Oral Appliance for Upper Airway Resistance Syndrome

Not Applicable
Conditions
Upper Airway Resistance Syndrome
Interventions
Other: Placebo
Device: Brazilian Dental Appliance
Registration Number
NCT02636621
Lead Sponsor
Associação Fundo de Incentivo à Pesquisa
Brief Summary

Introduction: The Upper Airway Resistance Syndrome (UARS) is a sleep disorder characterized by airway resistance to breathing during sleep that leads to arousals and daytime sleepiness. There are few studies about UARS treatment and there is not any gold standard treatment for it yet.

Objective: Primary: To evaluate the efficacy of oral appliance on improving fatigue in patients with UARS. Secondary: Evaluate the effects of treatment with oral appliance (OA) in patients with UARS on sleepiness, mood, cognition, quality of life, metabolism and autonomic nervous system.

Methods: Subjects with UARS (Apnea/Hypopnea Index - AHI - ≤ 5 events per hour of sleep and Respiratory Disturbance Index - RDI - \> 5 events per hour or more than 30% of total sleep time with inspiratory flow limitation and with excessive daytime somnolence and/or fatigue) of both genders, with body mass index (BMI) lower than 30Kg/m2 and between 25 to 50 years of age will be included. Subjects will be randomly distributed in OA group and placebo (without treatment). At baseline evaluation, 6 months and 1 year after subjects will be submitted to sleep questionnaires, physical exam, otolaryngological evaluation, baseline polysomnography, Epworth sleepiness scale, Multiple Sleep Latency Test, fatigue scale, neurocognitive testing, autonomic nervous system analysis (heart rate variability) and metabolic evaluation. Mean and standard deviation will be used for descriptive statistical analysis if normal distribution, and median and percentiles (25%, 75%) for variables not normally distributed. To compare treatment groups T test (parametric) and Mann Whitney (non parametric) will be used. For adjusted analysis, linear regression analysis will be used.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Both genders
  • Body mass index (BMI) ≤ 30Kg/m2
  • Age from 25 to 50 years
  • Clinical and polysomnographic diagnosis of Upper Airway Resistance Syndrome: Apnea/Hypopnea Index (AIH) ≤ 5 events/hour and Respiratory Disturbance Index (RDI) > 5 events/hour or > 30% of total sleep time with inspiratory flow limitation with excessive daytime somnolence or fatigue
Exclusion Criteria
  • Unsatisfactory dental condition or severe temporomandibular disfunction;
  • Nasal obstruction;
  • Alcohol abuse and excessive consumption of psychotropic drugs;
  • Clinical, neurological or psychiatric diseases not treated
  • Less than 6 hours of sleep

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboOral device that does not change the volume of the airway
Brazilian Dental ApplianceBrazilian Dental ApplianceThe device increases the volume of the airway by mandibular traction.
Primary Outcome Measures
NameTimeMethod
FatigueFrom the baseline evaluation to one year after the treatment with oral appliance

Modified fatigue impact scale for Portuguese (MFIS- BR)

Secondary Outcome Measures
NameTimeMethod
Subjective excessive daytime sleepinessFrom the baseline evaluation to one year after the treatment with oral appliance

Epworth sleepiness scale

Objective excessive daytime sleepinessFrom the baseline evaluation to one year after the treatment with oral appliance

Multiple Sleep Latency Test

Mood - AnxietyFrom the baseline evaluation to one year after the treatment with oral appliance

Beck inventories (BAI)

Mood - DepressionFrom the baseline evaluation to one year after the treatment with oral appliance

Beck inventories (BDI)

Sustained attentionFrom the baseline evaluation to one year after the treatment with oral appliance

Psychomotor Vigilance Test (PVT)

Cognition - MemoryFrom the baseline evaluation to one year after the treatment with oral appliance

Digit Symbol Substitution Test (DSST)

Cognition - Learning strategiesFrom the baseline evaluation to one year after the treatment with oral appliance

Rey Auditory-Verbal Learning Test (RAVLT)

Cognition - Immediate and late memoriesFrom the baseline evaluation to one year after the treatment with oral appliance

Wechsler Memory Scale (WMS)

Cognition - Processing speed abilityFrom the baseline evaluation to one year after the treatment with oral appliance

Stroop Color Test

Cognition - Visual attentionFrom the baseline evaluation to one year after the treatment with oral appliance

Trail Making Test - TMT

Quality of sleepFrom the baseline evaluation to one year after the treatment with oral appliance

Pittsburgh Sleep Quality Index (PSQI)

Quality of lifeFrom the baseline evaluation to one year after the treatment with oral appliance

Functional Outcomes of Sleep Questionnaire (FOSQ)

StressFrom the baseline evaluation to one year after the treatment with oral appliance

Teste de Lipp

MetabolismFrom the baseline evaluation to one year after the treatment with oral appliance

Blood analysis of metabolism

Autonomic nervous system analysisFrom the baseline evaluation to one year after the treatment with oral appliance

Heart rate variability

Trial Locations

Locations (1)

Associação Fundo de Incentivo à Pesquisa (AFIP)

🇧🇷

São Paulo, Brazil

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