A Phase 2 interventional study of Interventional Arm and Conservative treatment Arm in Snoring, sponsored by Washington University School of Medicine. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-06-06.
Sponsored by Washington University School of Medicine · Phase 2, Interventional, and Treatment
This is a randomized controlled trial for non-apneic snorers. The primary goal of the study is to evaluate the efficacy of a mandibular advancement device (MAD) vs conservative treatment for adults with non-apneic snoring as measured by the partners report of response to treatment (CGI-I). The secondary goal is to evaluate the effectiveness of treatment of snoring on the Epworth Sleepiness Scale (ESS), a modified Symptoms of Nocturnal Obstruction and Related Events (SNORE-25) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Clinical Global Impression of Severity Scale (CGI-S)
Snoring is a problem which affects roughly half of adults, but rigorous studies on how to treat isolated snoring have not been completed. Mandibular advancement devices (MAD) show consistent improvements in sleep quality for patients with sleep apnea; however, their effect on patients with primary snoring remains less well known.
The primary hypothesis proposes that adults with non-apneic snoring treated with a MAD will experience a greater reduction of snoring as measured by the Clinical Global Impression - Improvement (GCI-I) Scale response of the sleeping partner.
The plan is to enroll 30 participants and 30 sleeping partner participants for each arm of the trial: 120 participants, or 60 pairs, in total. Participants will use the intervention nightly for a period of 4 weeks after which an end of study visit will occur. All post intervention outcomes will be recorded at the end of the study visit. Knowledge gained from this study will help guide treatment practice and evidence-based approaches regarding non-apneic snoring.
122 studies on the registry are indexed under Snoring; 15 are open to participants now.
This study's enrollment of 100 is above the median of 43 across 95 interventional studies indexed under Snoring.
Browse Snoring studies →Washington University School of Medicine is the lead sponsor of 1,803 studies on the registry; 271 are open to participants now.
Of its 329 completed or terminated interventional studies of FDA-regulated products, 216 (66%) have results posted.
Counted across the registry records on this site, refreshed daily.
Inclusion Criteria:
Inclusion criteria for the sleeping partner:
Exclusion Criteria:
Individuals will not be allowed to participate in this study if they meet one or more of the exclusion criteria:
Sleeping partners do not have any exclusion criteria defined for this study.
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
BMI (body mass index)
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The Mandibular Advancement Device for this study will be the ProSomnus Sleep Device. It is a sleep device intended to reduce nighttime snoring and mild to moderate Obstructive Sleep Apnea in adults by holding the lower jaw forward during sleep
Device: Interventional Arm
The conservative treatment will consist of four different interventions: Mometasone nasal rinse, External nasal dilatory therapy, Mouth taping and Lateral positional therapy.
Combination Product: Conservative treatment Arm
The MAD arm will consist of participants given a fitted mandibular advancement device that they will wear for the length of the study.
Also known as: MAD (anti-snoring mouthpiece)
Participant will undergo a nightly medicated nasal rinse that will occur for a 4 week period, prior to beginning of the other three conservative therapy interventions. The 4-part combination therapy will take place for 4 weeks total.
Percent Responders of Clinical Global Impression of Improvement Scale - Partner
This will occur asynchronously through email surveys distributed through the Washington University REDCap server or through a scheduled telephone call depending on the participant's preference. The Partner will grade the improvement of the snoring on the following continuous scale, which will be the Clinical Global Impression of Improvement (CGI-I) scale: Very Much Improved Much Improved Minimally Improved No Change Minimally Worse Much Worse Very Much Worse The percentage of responders to treatment will then be compared between the two arms of the trial. A responder will be defined as someone who rates the response to snoring as either "Very Much Improved" or "Much Improved"
Time frame: 4 weeks post intervention beginning
Change in Clinical Global Impression of Severity Scale
The CGI-Severity Scale poses the question "On average, how much of a problem does your \[partner's\] snoring pose?" The 5 response options will include: no problem, mild problem, moderate problem, severe problem, problem as severe as it can be. It will be measured both at baseline and after treatment. Change in CGI-S score will be calculated and reported as a secondary outcome measure as the change in CGI-S score between the two arms. In addition, the CGI-S will be measured by the sleeping partner on a daily basis both before and after treatment.
Time frame: 4 weeks post intervention beginning
Change in Epworth Sleepiness Scale (ESS) Score
The ESS is a commonly used measure to evaluate the propensity to of a participant to fall asleep in 8 everyday scenarios "in recent times". The participant rates each situation on a scale of 0-3, with 0 being least likely to fall asleep and 3 being the most likely. Final score can range from 0-24. Epworth Sleepiness Scale (ESS) score will be recorded by both the partner and the snorer at baseline and follow up. Change in ESS score will be calculated and reported as a secondary outcome measure as the change in ESS score or the difference in percentage of participates recording an ESS improvement above the Minimal Clinically Important Difference between the two arms.
Time frame: Baseline and 4 weeks post intervention beginning
Change in Symptoms of Nocturnal Obstruction and Related Events (SNORE-25)
The SNORE-25 is a modification of the Obstructive Sleep Apnea Patient-Oriented Severity Index (OSAPOSI) which includes 25 total items. Symptoms of Nocturnal Obstruction and Related Events (SNORE-25) score will be recorded by both the partner and the snorer at baseline and follow up. The SNORE-25 score is calculated as the mean item score for all 25 items. The possible range for the SNORE-25 score is 0-5, with higher scores indicating greater sleep disordered-related health burden. Impact of treatment is assessed with the SNORE-25 Change Score. The SNORE-25 Change Score is the difference between SNORE-25 Pre-treatment and SNORE-25 Post-Treatment scores. Minimal Clinically Important Difference. A SNORE-25 Change Score of 0.5 should be considered the minimal clinically important difference and change scores greater than this should be considered clinically meaningful.
Time frame: Baseline and 4 weeks post intervention beginning
Change in Pittsburgh Sleep Quality Index (PSQI)
The Pittsburgh Sleep Quality Index is a self-rate questionnaire which assess sleep quality and disturbances over a 1-month time interval. It is composed of 19 items which contribute to 7 different component scores:A global sum of these components \> 5 signifies poor sleep quality with a sensitivity of 89.6% and a specific of 86.5%2 Change in Pittsburgh Sleep Quality Index score will be calculated and reported as a secondary outcome measure as the change in Pittsburgh Sleep Quality Index score or the difference in percentage of participates recording a Pittsburgh Sleep Quality Index improvement above the Minimal Clinically Important Difference (4.4) compared between the two arms. The questionnaire consists of a combination of Likert type and open-ended questions (later converted to scaled scores).Scores for each question range from 0 to 3, with higher scores indicating more acute sleep disturbances.
Time frame: Baseline and follow up
Percent Responder of Clinical Global Impression of Improvement Scale - Snorer
The Snorer will grade the improvement of their own snoring on the following scale, which will be the Clinical Global Impression of Improvement (CGI-I) scale: Very Much Improved Much Improved Minimally Improved No Change Minimally Worse Much Worse Very Much Worse The percentage of responders to treatment will then be compared between the two arms of the trial. A responder will be defined as someone who rates the response to snoring as either "Very Much Improved" or "Much Improved"
Time frame: 4 weeks post intervention beginning
We only enrolled 100 study participants.
| Milestone | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Arm: Partners |
|---|---|---|---|---|
| Started | 25 | 25 | 25 | 25 |
| Completed | 23 | 19 | 23 | 19 |
| Not completed | 2 | 6 | 2 | 6 |
This will occur asynchronously through email surveys distributed through the Washington University REDCap server or through a scheduled telephone call depending on the participant's preference. The Partner will grade the improvement of the snoring on the following continuous scale, which will be the Clinical Global Impression of Improvement (CGI-I) scale: Very Much Improved Much Improved Minimally Improved No Change Minimally Worse Much Worse Very Much Worse The percentage of responders to treatment will then be compared between the two arms of the trial. A responder will be defined as someone who rates the response to snoring as either "Very Much Improved" or "Much Improved"
| percent of snorer responders | Interventional Arm | Conservative Treatment Arm |
|---|---|---|
| Percent Responders of Clinical Global Impression of Improvement Scale - Partner | 91 | 58 |
The CGI-Severity Scale poses the question "On average, how much of a problem does your \[partner's\] snoring pose?" The 5 response options will include: no problem, mild problem, moderate problem, severe problem, problem as severe as it can be. It will be measured both at baseline and after treatment. Change in CGI-S score will be calculated and reported as a secondary outcome measure as the change in CGI-S score between the two arms. In addition, the CGI-S will be measured by the sleeping partner on a daily basis both before and after treatment.
| responders | Interventional Arm: Snorer | Conservative Treatment Arm: Snorer | Interventional Arm: Partner | Conservative Treatment Arm: Partner |
|---|---|---|---|---|
| None | 6 | 2 | 9 | 2 |
| Mild | 8 | 8 | 8 | 9 |
| Moderate | 7 | 7 | 4 | 6 |
| Severe | 2 | 2 | 2 | 1 |
| As bad as it can be | 0 | 0 | 0 | 1 |
The ESS is a commonly used measure to evaluate the propensity to of a participant to fall asleep in 8 everyday scenarios "in recent times". The participant rates each situation on a scale of 0-3, with 0 being least likely to fall asleep and 3 being the most likely. Final score can range from 0-24. Epworth Sleepiness Scale (ESS) score will be recorded by both the partner and the snorer at baseline and follow up. Change in ESS score will be calculated and reported as a secondary outcome measure as the change in ESS score or the difference in percentage of participates recording an ESS improvement above the Minimal Clinically Important Difference between the two arms.
| score on a scale | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm:Partners |
|---|---|---|---|---|
| Change in Epworth Sleepiness Scale (ESS) Score | 2 (0 to 13) | 4 (0 to 14) | 4 (0 to 12) | 6 (0 to 14) |
The SNORE-25 is a modification of the Obstructive Sleep Apnea Patient-Oriented Severity Index (OSAPOSI) which includes 25 total items. Symptoms of Nocturnal Obstruction and Related Events (SNORE-25) score will be recorded by both the partner and the snorer at baseline and follow up. The SNORE-25 score is calculated as the mean item score for all 25 items. The possible range for the SNORE-25 score is 0-5, with higher scores indicating greater sleep disordered-related health burden. Impact of treatment is assessed with the SNORE-25 Change Score. The SNORE-25 Change Score is the difference between SNORE-25 Pre-treatment and SNORE-25 Post-Treatment scores. Minimal Clinically Important Difference. A SNORE-25 Change Score of 0.5 should be considered the minimal clinically important difference and change scores greater than this should be considered clinically meaningful.
| score on a scale | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners |
|---|---|---|---|---|
| Change in Symptoms of Nocturnal Obstruction and Related Events (SNORE-25) | 0.2 (0.04 to 1.6) | 0.54 (0.12 to 1.84) | 0.2 (0.04 to 2.04) | 0.88 (0.04 to 2.48) |
The Pittsburgh Sleep Quality Index is a self-rate questionnaire which assess sleep quality and disturbances over a 1-month time interval. It is composed of 19 items which contribute to 7 different component scores:A global sum of these components \> 5 signifies poor sleep quality with a sensitivity of 89.6% and a specific of 86.5%2 Change in Pittsburgh Sleep Quality Index score will be calculated and reported as a secondary outcome measure as the change in Pittsburgh Sleep Quality Index score or the difference in percentage of participates recording a Pittsburgh Sleep Quality Index improvement above the Minimal Clinically Important Difference (4.4) compared between the two arms. The questionnaire consists of a combination of Likert type and open-ended questions (later converted to scaled scores).Scores for each question range from 0 to 3, with higher scores indicating more acute sleep disturbances.
| score on a scale | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners |
|---|---|---|---|---|
| Change in Pittsburgh Sleep Quality Index (PSQI) | 2 (1 to 10) | 4 (1 to 10) | 4 (1 to 12) | 6 (1 to 17) |
The Snorer will grade the improvement of their own snoring on the following scale, which will be the Clinical Global Impression of Improvement (CGI-I) scale: Very Much Improved Much Improved Minimally Improved No Change Minimally Worse Much Worse Very Much Worse The percentage of responders to treatment will then be compared between the two arms of the trial. A responder will be defined as someone who rates the response to snoring as either "Very Much Improved" or "Much Improved"
| percentage of responders | Interventional Arm - Snorer | Conservative Treatment Arm- Snorer | Interventional Arm - Partner | Conservative Treatment Arm - Partner |
|---|---|---|---|---|
| Percent Responder of Clinical Global Impression of Improvement Scale - Snorer | 91 | 44 | 91 | 58 |
Collected over Serious adverse events (within 1week) Any other problems ( within 2 weeks) Intervention treatment time frame was 4 weeks.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Interventional Arm: Snorers | 0/23 (0%) | 0/23 (0%) | 10/23 (43.5%) |
| Conservative Treatment Arm: Snorers | 0/19 (0%) | 0/19 (0%) | 5/19 (26.3%) |
| Interventional Arm:Partners | 0/23 (0%) | 0/23 (0%) | 0/23 (0%) |
| Conservative Treatment Arm:Partners | 0/19 (0%) | 0/19 (0%) | 0/19 (0%) |
| Event | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm:Partners | Conservative Treatment Arm:Partners |
|---|---|---|---|---|
| Jaw painGeneral disorders | 10/23 | 0/19 | 0/23 | 0/19 |
| sinus headacheGeneral disorders | 0/23 | 5/19 | 0/23 | 0/19 |
| Unable to tolerate side effects of the treatmentGeneral disorders | 1/23 | 1/19 | 0/23 | 0/19 |
| Unable tolerate the side effects of the treatmentGeneral disorders | 1/23 | 1/19 | 0/23 | 0/19 |
We enrolled snoring individuals and their sleeping partners.
| Age, Continuous(years) | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners | Total |
|---|---|---|---|---|---|
| Mean | 49.8 ± 12.8 | 45.5 ± 14.4 | 47.1 ± 16.8 | 43.0 ± 16.2 | 47.9 ± 13.6 |
| Sex: Female, Male(Participants) | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners | Total |
|---|---|---|---|---|---|
| Female | 15 | 11 | 10 | 9 | 45 |
| Male | 8 | 8 | 13 | 10 | 39 |
| Race (NIH/OMB)(Participants) | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners | Total |
|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 | 0 |
| Asian | 1 | 0 | 2 | 1 | 4 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 1 | 0 | 1 |
| Black or African American | 0 | 0 | 0 | 0 | 0 |
| White | 22 | 19 | 20 | 18 | 79 |
| More than one race | 0 | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 |
| CGI-S(Participants) | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners | Total |
|---|---|---|---|---|---|
| None | 0 | 1 | 2 | 0 | 3 |
| Mild | 8 | 9 | 3 | 7 | 27 |
| Moderate | 12 | 7 | 9 | 6 | 34 |
| Severe | 3 | 2 | 9 | 5 | 19 |
| As bad as it can be | 0 | 0 | 0 | 1 | 1 |
| ESS(score on a scale 0-24) | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners | Total |
|---|---|---|---|---|---|
| Median | 4 (0 to 16) | 6 (2 to 14) | 4 (0 to 12) | 6 (0 to 14) | 4.5 (0 to 16) |
| PSQI(score on a scale 0-21) | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners | Total |
|---|---|---|---|---|---|
| Median | 6 (1 to 17) | 7 (3 to 16) | 6 (2 to 14) | 6 (3 to 18) | 7 (1 to 17) |
| SNORE-25(score on a scale 0-5) | Interventional Arm: Snorers | Conservative Treatment Arm: Snorers | Interventional Arm: Partners | Conservative Treatment Arm: Partners | Total |
|---|---|---|---|---|---|
| Median | 0.48 (0.08 to 1.8) | 1.20 (0.28 to 2.08) | 1 (0.1 to 2.2) | 1.04 (0.2 to 2.16) | 0.72 (0.08 to 2.08) |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
Ran from Nov 2022 to primary completion in Jul 2023, 7 months.
Results were first posted in Jun 2025, 1 year 11 months after primary completion.
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