Device-Assisted Oropharyngeal Rehabilitation in Obstructive Sleep Apnea Patients Using Continuous Positive Airway Pressure

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age20-68
SponsorNational Cheng-Kung University Hospital

About this trial

The goal of this clinical trial is to evaluate the effectiveness of device-assisted oropharyngeal rehabilitation (OPR) in improving upper airway muscle function and reducing obstructive sleep apnea (OSA) severity in adult patients diagnosed with OSA who are receiving continuous positive airway pressure (CPAP) therapy.

The main questions it aims to answer are:

1. Does combining OPR with CPAP increase upper airway space volume compared to using CPAP alone? 2. Does OPR improve tongue muscle strength, and is this improvement associated with reduced CPAP pressure requirements? 3. Do patients receiving OPR (alone or combined with CPAP) show greater improvements in OSA severity and clinical symptoms compared to those receiving CPAP alone or no intervention? Researchers will compare four groups-Control, OPR-only, CPAP-only, and CPAP + OPR-to see if device-assisted OPR enhances treatment outcomes beyond CPAP alone.

Participants will:

1. Be randomly assigned to one of four groups (Control, OPR-only, CPAP-only, CPAP+OPR). 2. Perform home-based OPR exercises (30-45 minutes/session, 1-2 sessions/day, 3-5 days/week for 3 months) in the OPR and CPAP+OPR groups. 3. Have their exercise monitored using a strength sensor, with intensity adjusted every 2-4 weeks during hospital visits. 4. Undergo assessments before and after the intervention, including:

(1) Polysomnography for OSA severity, (2) CT and ultrasound for upper airway and tongue muscle structure, (3) Tongue muscle strength/endurance tests, (4) Sleep quality questionnaires, (5) CPAP usage and pressure reports.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adults aged 20 to 68 years

Newly diagnosed with mild to severe pure obstructive sleep apnea based on polysomnography

Disqualifiers

Severe allergic rhinitis

Sinusitis with nasal polyps

Adenoid hypertrophy

Bilateral tonsillar hypertrophy (Friedman grade ≥ III)

Trial design

Design model

Parallel

Treatments tested in this trial

  • Control

    Other intervention

    Sleep hygiene education

  • Oropharyngeal Exercise

    Device

    Device-monitoring oropharyngeal exercise, 1-5 days a week for three months

  • Continuous positive airway pressure

    Device

    Continuous positive airway pressure, 1-5 days a week for three months

  • Continuous positive airway pressure and oropharyngeal exercise

    Device

    Continuous positive airway pressure and device-monitoring oropharyngeal exercise, 1-5 days a week for three months

Treatment groups

200 Participants
are divided into 4 treatment groups
Group A: Sleep hygiene educationSham comparator 1 intervention
Group B: Oropharyngeal rehabilitationExperimental treatment 1 intervention
Group C: Continuous positive airway pressureExperimental treatment 1 intervention
Group D: Continuous positive airway pressure and oropharyngeal rehabilitationExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Apnea-Hypopnea Index

The apnea-hypopnea index will be obtained from the overnight Polysomnography (PSG) study. PSG will be performed in the sleep center of National Cheng Kung University Hospital. Less than 5 events/hour indicates normal; AHI between 5-14 events/hour indicates mild Obstructive Sleep Apnea(OSA); AHI between 15-30 events/hour indicates moderate OSA; and AHI more than 30 events/hour indicates severe OSA.

Time frame
Baseline and 12 weeks post intervention

Secondary outcomes

1

Tongue Muscle Strength

The maximal muscle strength of genioglossus muscles using The Iowa Oral Performance Instrument (IOPI) system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA) (kPa)

Time frame
Baseline and 12 weeks post intervention
2

Tongue Muscle Endurance

The endurance of the genioglossus muscles using The Iowa Oral Performance Instrument (IOPI) system, model 2.2 (Northwest, Co., LLC, Carnation, WA, USA) (in seconds).

Time frame
Baseline and 12 weeks post intervention
3

Pharyngeal Airway Volume

Computer Tomography (CT) will be performed. The pharyngeal airway volume will be calculated from the hard palate to the epiglottis and the data will be presented in cm\^3. The minimum score is 0 and a higher score indicates greater in pharyngeal airway volume.

Time frame
Baseline and 12 weeks post intervention
4

Cross Section Area on the Tip of Epiglottis

Computer Tomography (CT) will be performed. Cross section area on the tip of the epiglottis was measured and the data will be presented in cm\^2. The minimum score is 0 and a higher score indicates greater in the cross-sectional area of the region.

Time frame
Baseline and 12 weeks post intervention

Other outcomes

Sponsors and contacts

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