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A Post-marketing Surveillance of the Negative Pressure Sleep Therapy System to Treat Obstructive Sleep Apnea

Primary Purpose

Obstructive Sleep Apnea (OSA)

Status
Unknown status
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
iNAP® Sleep Therapy System (iNAP)
Sponsored by
Somnics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Obstructive Sleep Apnea (OSA)

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • 1) Female or male adults with age between 18~65 years old. (S1)
  • 2) Non-obese patients with body mass index (BMI) <29 kg/m2. (S1)
  • 3) Patients able to read and sign on the informed consent form and able to comply with study requirements. (S1)
  • 4) Patients able to be properly fitted* with the oral interface as observed by the device feasibility test. (S1)
  • 5) Patients with oxygen desaturation index (ODI) between 10~40 (S2).
  • 6) Patients with oral negative vacuum time maintained* by iNAP® ≥4 hours/night and total sleep time (TST) ≥4 hours/night (S3).

    • iNAP® pressure more negative than -30 mmHg will be considered evidence of effective oral appliance application.
  • 7) Patients with apnea-hypopnea index (AHI) between 10~40 and TST ≥4 hours/night (Baseline PSG Night).
  • 8) Patients with oral negative vacuum time maintained* by iNAP® ≥4 hours/night and TST ≥4 hours/night (1st Tx PSG Night).

    • iNAP® pressure more negative than -30 mmHg will be considered evidence of effective oral appliance application.

Exclusion Criteria:

  • 1) Patients who are allergic to silicone.
  • 2) Patients with obstructed nasal passages as evidenced by the inability to breathe through the nose with the mouth closed.
  • 3) Patients who recently experienced a near-miss or prior automobile accident due to sleepiness.
  • 4) Patients who have or have had hypoxemia (SpO2 <80%) in the past six months caused by diseases other than OSA such as cardiac disease or severe pulmonary/respiratory disorders such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, pneumothorax, pneumonia, etc.
  • 5) Female patients who are lactating, pregnant or intend to become pregnant during the study period.
  • 6) Patients with primary insomnia or any concomitant diagnosed or suspected sleep disorder.
  • 7) Patients with muscle disease, central nervous disease or chronic neurological disorders, including central sleep apnea*.

    • Central sleep apnea is defined as a central apnea index (CAI) ≥ 5/hr or if central sleep apnea accounts for ≥ 50% of the total AHI.
  • 8) Patients in whom it is not suitable to use iNAP® in the opinion of the Investigator including, but not limited to, alcohol or substance abuse, loose teeth, missing teeth, or grinding teeth, completed deviated septum (Type IV or VII) or completed closed nostrils or advanced periodontal disease or tonsillar volumes greater than grade 3.
  • 9) Patients with an inability to sleep through the night including, but not limited to, menopausal hot flashes, working at nights or rotating night shifts, planned travel across four or more time zones during the study period or within one week prior to study participation, or a sleep schedule not compatible with study site practices.
  • 10) Patients with potential complications of sleep apnea that, in the opinion of the Investigator, may affect the study interpretation or the health or safety of the patients including, but not limited to, narcolepsy, restless leg syndrome, nasopharyngeal carcinoma (NPC), end stage renal failure, a history of severe cardiovascular disease (including New York Heart Association (NYHA) class III or IV cardiac failure, coronary artery disease with angina or myocardial infarction/stroke in the past six months, uncontrolled hypertension or hypotension or cardiac arrhythmias), unstable heart or renal transplantation or use of medicine or other treatment(s) that may confound the result of the study or pose additional risks to the patient, such as oral anticoagulants or other agents making patients prone to tongue hemorrhage.

Stage II Inclusion Criteria:

Patients who fulfill all the enrollment criteria of Stage I and whose treated AHI on the 1st Tx PSG Night is below 40.

Sites / Locations

  • INTERSOMRecruiting
  • SomnolabRecruiting
  • Alfred Krupp KrankenhausRecruiting
  • American Sleep ClinicRecruiting
  • HELIOS Klinik AmbrockRecruiting
  • Krankenhaus BethanienRecruiting
  • Mackay Memorial HospitalRecruiting
  • Shin Kong Wu Ho-Su Memorial HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Treated

Baseline/Control

Arm Description

iNAP® Sleep Therapy System Treatment

Self-controlled, pre-treatment baseline

Outcomes

Primary Outcome Measures

Clinical success rate* of apnea-hypopnea index (AHI)** on the 1st Tx PSG Night when compared to the Baseline PSG Night.
*Clinical success rate is defined as the ratio of the number of patients with an AHI reduction of >50% and treated AHI <20 to the number of patients who complete the 1st Tx PSG Night, where completion is defined as a total sleep time (TST) and device negative pressure maintenance ≥4 hours/night on the 1st Tx PSG Night. For completion of the Baseline PSG Study, a total sleep time (TST) ≥4 hours/night has to be met. **AHI is the number of apnea/hypopnea events divided by total sleep time (TST), i.e., the number of hours of sleep.

Secondary Outcome Measures

AE/SAE rate and type
Vital signs, Physical examination (PE) findings and change of body figure indexes, Electrocardiogram (ECG) findings as reflected in polysomnography (PSG), Adverse events (AEs), Serious adverse events (SAEs), Changes in the oral and dental condition
Clinical success rate* of apnea-hypopnea index (AHI)** on the 2nd Tx PSG Night when compared to the 1st Tx PSG Night.
*Clinical success rate is defined as the ratio of the number of patients with an AHI reduction of >50% and treated AHI <20 to the number of patients who complete the 2nd Tx PSG Night, where completion is defined as a total sleep time (TST) and device negative pressure maintenance ≥4 hours/night on the 2nd Tx PSG Night. For completion of the Baseline PSG Study, a total sleep time (TST) ≥4 hours/night has to be met. **AHI is the number of apnea/hypopnea events divided by total sleep time (TST), i.e., the number of hours of sleep.
Change of Oxygen Desaturation Index (ODI)* from the Baseline PSG Night compared to the 1st Tx PSG Night and the 2nd Tx PSG Night; and the change from the 1st Tx PSG Night compared to the 2nd Tx PSG Night.
*ODI is the event number of oxygen level drops by 3 percent or more from baseline divided by total sleep time (TST), i.e., the number of hours of sleep.

Full Information

First Posted
February 17, 2016
Last Updated
March 16, 2020
Sponsor
Somnics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02698059
Brief Title
A Post-marketing Surveillance of the Negative Pressure Sleep Therapy System to Treat Obstructive Sleep Apnea
Official Title
A Multi-center, Two-stage, Single-arm, Prospective, First-night Order Cross-over, Evaluator-blind Study to Evaluate the Efficacy, Safety and Tolerance of the iNAP® Sleep Therapy System in Adults With Obstructive Sleep Apnea (OSA)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Unknown status
Study Start Date
January 22, 2016 (Actual)
Primary Completion Date
February 18, 2020 (Actual)
Study Completion Date
May 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Somnics, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a post-marketing surveillance study to investigate the efficacy and safety of the Negative Pressure Sleep Therapy System for the treatment of obstructive sleep apnea.
Detailed Description
This is a multi-center, two-stage, single-arm, prospective, first-night order cross-over, evaluator-blind, post-marketing surveillance study to evaluate the efficacy, safety and tolerance of the iNAP® Sleep Therapy System (iNAP), a tongue and soft palate retaining intraoral device, in adults with obstructive sleep apnea (OSA).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obstructive Sleep Apnea (OSA)

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
63 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treated
Arm Type
Experimental
Arm Description
iNAP® Sleep Therapy System Treatment
Arm Title
Baseline/Control
Arm Type
No Intervention
Arm Description
Self-controlled, pre-treatment baseline
Intervention Type
Device
Intervention Name(s)
iNAP® Sleep Therapy System (iNAP)
Intervention Description
The iNAP provides pressure gradient within the oral cavity to pull the tongue toward upper palate and the soft palate forward, which aims to maintain better upper airway patency near the pharynx to prevent sleep-disordered breathing.
Primary Outcome Measure Information:
Title
Clinical success rate* of apnea-hypopnea index (AHI)** on the 1st Tx PSG Night when compared to the Baseline PSG Night.
Description
*Clinical success rate is defined as the ratio of the number of patients with an AHI reduction of >50% and treated AHI <20 to the number of patients who complete the 1st Tx PSG Night, where completion is defined as a total sleep time (TST) and device negative pressure maintenance ≥4 hours/night on the 1st Tx PSG Night. For completion of the Baseline PSG Study, a total sleep time (TST) ≥4 hours/night has to be met. **AHI is the number of apnea/hypopnea events divided by total sleep time (TST), i.e., the number of hours of sleep.
Time Frame
first treatment night
Secondary Outcome Measure Information:
Title
AE/SAE rate and type
Description
Vital signs, Physical examination (PE) findings and change of body figure indexes, Electrocardiogram (ECG) findings as reflected in polysomnography (PSG), Adverse events (AEs), Serious adverse events (SAEs), Changes in the oral and dental condition
Time Frame
The whole study period through study completion; up to 8 weeks
Title
Clinical success rate* of apnea-hypopnea index (AHI)** on the 2nd Tx PSG Night when compared to the 1st Tx PSG Night.
Description
*Clinical success rate is defined as the ratio of the number of patients with an AHI reduction of >50% and treated AHI <20 to the number of patients who complete the 2nd Tx PSG Night, where completion is defined as a total sleep time (TST) and device negative pressure maintenance ≥4 hours/night on the 2nd Tx PSG Night. For completion of the Baseline PSG Study, a total sleep time (TST) ≥4 hours/night has to be met. **AHI is the number of apnea/hypopnea events divided by total sleep time (TST), i.e., the number of hours of sleep.
Time Frame
second treatment night
Title
Change of Oxygen Desaturation Index (ODI)* from the Baseline PSG Night compared to the 1st Tx PSG Night and the 2nd Tx PSG Night; and the change from the 1st Tx PSG Night compared to the 2nd Tx PSG Night.
Description
*ODI is the event number of oxygen level drops by 3 percent or more from baseline divided by total sleep time (TST), i.e., the number of hours of sleep.
Time Frame
At the Baseline PSG Night, the 1st Tx PSG Night and/or the 2nd Tx PSG Night

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1) Female or male adults with age between 18~65 years old. (S1) 2) Non-obese patients with body mass index (BMI) <29 kg/m2. (S1) 3) Patients able to read and sign on the informed consent form and able to comply with study requirements. (S1) 4) Patients able to be properly fitted* with the oral interface as observed by the device feasibility test. (S1) 5) Patients with oxygen desaturation index (ODI) between 10~40 (S2). 6) Patients with oral negative vacuum time maintained* by iNAP® ≥4 hours/night and total sleep time (TST) ≥4 hours/night (S3). iNAP® pressure more negative than -30 mmHg will be considered evidence of effective oral appliance application. 7) Patients with apnea-hypopnea index (AHI) between 10~40 and TST ≥4 hours/night (Baseline PSG Night). 8) Patients with oral negative vacuum time maintained* by iNAP® ≥4 hours/night and TST ≥4 hours/night (1st Tx PSG Night). iNAP® pressure more negative than -30 mmHg will be considered evidence of effective oral appliance application. Exclusion Criteria: 1) Patients who are allergic to silicone. 2) Patients with obstructed nasal passages as evidenced by the inability to breathe through the nose with the mouth closed. 3) Patients who recently experienced a near-miss or prior automobile accident due to sleepiness. 4) Patients who have or have had hypoxemia (SpO2 <80%) in the past six months caused by diseases other than OSA such as cardiac disease or severe pulmonary/respiratory disorders such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, pneumothorax, pneumonia, etc. 5) Female patients who are lactating, pregnant or intend to become pregnant during the study period. 6) Patients with primary insomnia or any concomitant diagnosed or suspected sleep disorder. 7) Patients with muscle disease, central nervous disease or chronic neurological disorders, including central sleep apnea*. Central sleep apnea is defined as a central apnea index (CAI) ≥ 5/hr or if central sleep apnea accounts for ≥ 50% of the total AHI. 8) Patients in whom it is not suitable to use iNAP® in the opinion of the Investigator including, but not limited to, alcohol or substance abuse, loose teeth, missing teeth, or grinding teeth, completed deviated septum (Type IV or VII) or completed closed nostrils or advanced periodontal disease or tonsillar volumes greater than grade 3. 9) Patients with an inability to sleep through the night including, but not limited to, menopausal hot flashes, working at nights or rotating night shifts, planned travel across four or more time zones during the study period or within one week prior to study participation, or a sleep schedule not compatible with study site practices. 10) Patients with potential complications of sleep apnea that, in the opinion of the Investigator, may affect the study interpretation or the health or safety of the patients including, but not limited to, narcolepsy, restless leg syndrome, nasopharyngeal carcinoma (NPC), end stage renal failure, a history of severe cardiovascular disease (including New York Heart Association (NYHA) class III or IV cardiac failure, coronary artery disease with angina or myocardial infarction/stroke in the past six months, uncontrolled hypertension or hypotension or cardiac arrhythmias), unstable heart or renal transplantation or use of medicine or other treatment(s) that may confound the result of the study or pose additional risks to the patient, such as oral anticoagulants or other agents making patients prone to tongue hemorrhage. Stage II Inclusion Criteria: Patients who fulfill all the enrollment criteria of Stage I and whose treated AHI on the 1st Tx PSG Night is below 40.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
C.C. Chen, Ph.D.
Email
chungchu1@somnics.com
First Name & Middle Initial & Last Name or Official Title & Degree
C.N. Huang, Ph.D.
Email
huangcn@somnics.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hartmut Schneider, M.D.
Organizational Affiliation
American Sleep Clinic Frankfurt
Official's Role
Principal Investigator
Facility Information:
Facility Name
INTERSOM
City
Cologne
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lennart Knaack
Facility Name
Somnolab
City
Dortmund
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hans-Christian Blum
Facility Name
Alfred Krupp Krankenhaus
City
Essen
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ricardo Stoohs
Facility Name
American Sleep Clinic
City
Frankfurt
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hartmut Schneider
Facility Name
HELIOS Klinik Ambrock
City
Hagen
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Georg Nilius
Facility Name
Krankenhaus Bethanien
City
Solingen
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Randerath
Facility Name
Mackay Memorial Hospital
City
Taipei
ZIP/Postal Code
104
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ying-Piao Wang
Facility Name
Shin Kong Wu Ho-Su Memorial Hospital
City
Taipei
ZIP/Postal Code
111
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chia-Mo Lin

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Post-marketing Surveillance of the Negative Pressure Sleep Therapy System to Treat Obstructive Sleep Apnea

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