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CompletedNCT03336515POSTURALUpdated Oct 3, 2019

Validity of a Vibrating Postural Device for the Treatment of Positional Obstructive Sleep Apnea (Postural)

An interventional study of Group C-Postural device activated and Group B-Postural device no activated in OSA, sponsored by Hospital Universitario Araba. Completed at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-10-03.

Sponsored by Hospital Universitario Araba · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
128
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The objective of the study is validity of the effectiveness of a vibrating postural device in reduce the respiratory events (Apnea-Hypopnea Index-AHI) in patients with positional Obstructive Sleep Apnea (OSA).

Read the detailed description

PURPOSE:

The objective of the study is validity of the effectiveness of a vibrating postural device in reduce the respiratory events (Apnea-Hypopnea Index-AHI) in patients with positional Obstructive Sleep Apnea (OSA).

The postural device is a vibratil device of 5x3 cm and a weight of about 30 grams integrating an accelerometer, a vibration and other sensors. The device is placed on the patient's forehead and when the device detects that the patient is in the supine position for 30 seconds or more, it starts a vibration, with increasing intensity, which ceases when the patient moves to lateral.

METHODOLOGY: DESIGN: A multicenter, randomized parallel study controlled by placebo. It will include patients with diagnosis of positional OSA in the Sleep Units of the Hospital Universitario Araba and Hospital Arnau de Vilanova de Lleida. These patients will be randomized to three groups: Group A: General recommendation not sleeping in supine position; Group B: General recommendation not sleeping in supine position and the device without any activation (placebo); Group C: General recommendation not sleeping in supine position and the device activated (intervention group).

Patients will undergo a basal conventional polysomnography (PSG) and after 12 weeks of treatment. In addition all patients will be visited at 1, 4, 8 and 12 weeks.

PRIMARY OUTCOME: Validity of the effectiveness of a vibrating postural device in reduce the respiratory events in patients with positional Obstructive Sleep Apnea . SECONDARY OUTCOMES: To determine the effectiveness of the device for: 1) To reduce the time spent in supine position; 2)To maintain the quantity and the quality of sleep; 3) The side effects ; 4) Reduction of snoring; 5) Cost-effectiveness analysis.

02

Conditions studied

  • OSA

Keywords

  • Positional Obstructive Sleep Apnea
  • Postural Device
  • Treatment
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Men and women ≥ 18 years old with diagnosis of positional OSA by PSG.
  • Apnea-Hypopnea index (AHI) ≥ 5
  • Apnea-Hypopnea index (AHI) in supine position doubling AHI in not supine position
  • Time in supine position ≥ 20% total sleep time.
  • Total sleep time at least 180 minutes
  • Not received any treatment for OSA in the last four weeks before inclusion at the study (Except hygienic measures)
  • Written informed consent signed.

Exclusion criteria

Exclusion Criteria:

  • Important problems of physical mobility
  • Body mass index > 40kg/m²
  • Presence of any previously diagnosed sleep disorders (narcolepsy, insomnia...) or difficulty in adopting a standard sleeping position
  • Cognitive impairment, professional driver, use dangerous machinery, workers in three shifts, pregnant women or patients with severe disease.
  • Patients with severe cardiovascular and/or respiratory comorbidity
  • Excessive daytime sleepiness, Epworth scale >12
  • Treatment with psychotropic drugs, central stimulant drugs, antidepressants, consumers of illegal drugs or consume > 80 grams of ethanol per day.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
128 participants (actual)

Study arms

  • Other
    Group A-General Recommendation

    General recommendation not sleeping in supine position without the postural device

    Behavioral: Group A-General Recommendation

  • Placebo comparator
    Group B-Postural device no activated

    General recommendation not sleeping in supine position and the postural device without any activation (placebo)

    Device: Group B-Postural device no activated

  • Experimental
    Group C-Postural device activated

    General recommendation not sleeping in supine position and the postural device activated (intervention group).

    Device: Group C-Postural device activated

Interventions

  • DeviceGroup C-Postural device activated

    General recommendation not sleeping in supine position and the postural device activated (intervention group).

    Also known as: Intervention

  • DeviceGroup B-Postural device no activated

    General recommendation not sleeping in supine position and the postural device without any activation (placebo)

    Also known as: Placebo

  • BehavioralGroup A-General Recommendation

    General recommendation not sleeping in supine position

    Also known as: Control

05

What researchers measure

Primary outcomes

  1. Apnea-Hypopnea Index (AHI)

    The effectiveness of the treatment will be measured by polysomnography (PSG), comparing the results of the basal PSG with the results of the final PSG (3 month), based on the results of the apnea hypopnea index (AHI).

    Time frame: three month

Secondary outcomes

  1. Reduce the time spent in supine position

    To determine the effectiveness of the device for to reduce the time spent in supine position, measured by polysomnography, comparing the results of the basal PSG with the results of the final PSG (3 month).

    Time frame: three month

  2. Maintain the quantity and the quality of sleep

    To determine the effectiveness of the device for to maintain the quantity and the quality of sleep, measured by polysomnography (PSG).

    Time frame: three month

  3. Side effects

    To determine the side effects.

    Time frame: three month

  4. Reduction of snoring

    To determine the effectiveness of the device for the reduction of snoring, measured by polysomnography (PSG).

    Time frame: three month

  5. Epworth Sleepiness Scale

    The Epworth Sleepiness Scale score (the sum of 8 items score, 0-3) can range from 0 to 24. Scores of 11-24 represent increasing levels of excessive daytime sleepiness.

    Time frame: at baseline and at three month of follow-up

  6. Blood pressure

    Blood pressure measurements: systolic blood pressure and diastolic blood pressure.

    Time frame: three month

  7. Anthropometric variables (Body mass index)

    Body mass index

    Time frame: three month

  8. Quality of life (EuroQOL test)

    Evaluate by EuroQOL test, is a standardised measure of health status. Description of the state of health in five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression), each of wich is defined with three levels of severity, as measured by a Likert scale type(no problems, some problems and many problems or inability to activity).

    Time frame: at baseline and at three month of follow-up

06

Study locations

1 site
  • Hospital Universitario Araba
    Gasteiz / Vitoria, Araba 01009, Spain
07

References and documents

Publications

  • Duran J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001 Mar;163(3 Pt 1):685-9. doi: 10.1164/ajrccm.163.3.2005065. PubMed 11254524 ↗
  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993 Apr 29;328(17):1230-5. doi: 10.1056/NEJM199304293281704. PubMed 8464434 ↗
  • Duran-Cantolla J, Mar J, de La Torre Munecas G, Rubio Aramendi R, Guerra L. [The availability in Spanish public hospitals of resources for diagnosing and treating sleep apnea-hypopnea syndrome]. Arch Bronconeumol. 2004 Jun;40(6):259-67. doi: 10.1016/s1579-2129(06)70096-9. Spanish. PubMed 15161592 ↗
  • Cartwright RD. Effect of sleep position on sleep apnea severity. Sleep. 1984;7(2):110-4. doi: 10.1093/sleep/7.2.110. PubMed 6740055 ↗
  • Oksenberg A, Silverberg DS, Arons E, Radwan H. Positional vs nonpositional obstructive sleep apnea patients: anthropomorphic, nocturnal polysomnographic, and multiple sleep latency test data. Chest. 1997 Sep;112(3):629-39. doi: 10.1378/chest.112.3.629. PubMed 9315794 ↗
  • Cartwright RD, Lloyd S, Lilie J, Kravitz H. Sleep position training as treatment for sleep apnea syndrome: a preliminary study. Sleep. 1985;8(2):87-94. doi: 10.1093/sleep/8.2.87. PubMed 4012159 ↗
  • Jokic R, Klimaszewski A, Crossley M, Sridhar G, Fitzpatrick MF. Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. Chest. 1999 Mar;115(3):771-81. doi: 10.1378/chest.115.3.771. PubMed 10084491 ↗
  • van Maanen JP, Richard W, Van Kesteren ER, Ravesloot MJ, Laman DM, Hilgevoord AA, de Vries N. Evaluation of a new simple treatment for positional sleep apnoea patients. J Sleep Res. 2012 Jun;21(3):322-9. doi: 10.1111/j.1365-2869.2011.00974.x. Epub 2011 Oct 22. PubMed 22017727 ↗
  • Ravesloot MJ, van Maanen JP, Dun L, de Vries N. The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea-a review of the literature. Sleep Breath. 2013 Mar;17(1):39-49. doi: 10.1007/s11325-012-0683-5. Epub 2012 Mar 24. PubMed 22441662 ↗
  • Hidalgo Armas L, Ingles S, Vaca R, Cordero-Guevara J, Duran Carro J, Ullate J, Barbe F, Duran-Cantolla J; Spanish Sleep Network. New forehead device in positional obstructive sleep apnoea: a randomised clinical trial. Thorax. 2021 Sep;76(9):930-938. doi: 10.1136/thoraxjnl-2020-216167. Epub 2021 Apr 22. PubMed 33888576 ↗
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Registry details

Key details

Study ID
NCT03336515
Lead sponsor
Hospital Universitario Araba
Collaborators
SIBEL SL, Hospital Arnau de Vilanova, Instituto de Salud Carlos III, Instituto Vasco de Investigación Sanitaria (BIOEF)
Responsible party
Joaquin Duran-Cantolla, MD (Principal Investigator. MD,PhD, Hospital Universitario Araba) — Principal investigator
First posted
Nov 8, 2017
Start date
Sep 1, 2015
Primary completion
Apr 27, 2018
Completion
Jul 27, 2018
Last update
Oct 3, 2019

Study contacts

Joaquin Duran-Cantolla, MD
principal investigator · Hospital Universitario Araba
Jordi Rigau, Ing
principal investigator · Sibel SA

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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