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Variable Negative External Pressure (vNEP) - An Alternative to Continuous Positive Airway Pressure (CPAP) for the Treatment of Obstructive Sleep Apnea (OSA): A Pilot Study

Primary Purpose

Obstructive Sleep Apnea

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
vNEP
Sponsored by
Somne, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Obstructive Sleep Apnea focused on measuring negative pressure, variable negative external pressure

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • a polysomnogram study or home sleep test within the previous six months that shows either an AHI > 15 and AHI <= 30
  • able, in the opinion of the investigator, to understand and comply with all study procedures
  • the vNEP collar is determined by the investigator to properly fit the subject and is well-tolerated after application to the neck.

Sites / Locations

  • California Center for Sleep Disorders

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

vNEP with various shapes and sizes and overnight PSG

Arm Description

Administer vNEP therapy to study participants on the throat's anterior surface with a variable negative pressure ranging from -20 cmH2O up to -35 cmH2O. Assess participants for a reduction in Apnea-Hypopnea Index (AHI) for at least 120 minutes using polysomnography (PSG) and treatment tolerance compared to CPAP.

Outcomes

Primary Outcome Measures

Complete response
Decrease in AHI <=5
Response
Decrease in AHI of >=50% from baseline

Secondary Outcome Measures

No response
Did not achieve Primary Outcome Measure

Full Information

First Posted
January 14, 2021
Last Updated
March 30, 2021
Sponsor
Somne, LLC
Collaborators
California Center for Sleep Disorders
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1. Study Identification

Unique Protocol Identification Number
NCT04718142
Brief Title
Variable Negative External Pressure (vNEP) - An Alternative to Continuous Positive Airway Pressure (CPAP) for the Treatment of Obstructive Sleep Apnea (OSA): A Pilot Study
Official Title
Variable Negative External Pressure (vNEP) - An Alternative to Continuous Positive Airway Pressure (CPAP) for the Treatment of Obstructive Sleep Apnea (OSA): A Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Completed
Study Start Date
October 19, 2020 (Actual)
Primary Completion Date
March 15, 2021 (Actual)
Study Completion Date
March 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Somne, LLC
Collaborators
California Center for Sleep Disorders

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
Non-compliance rates estimated at 50% pose a major issue for CPAP therapy, the primary treatment for OSA. Negative external pressure, applied over the anterior neck under the mandible, has shown encouraging results as an alternative therapy. This study assessed a variety of sizes and shapes of collars and a range of pressures for variable negative external pressure (vNEP) treatment in subjects having moderate OSA to identify combinations that improve the efficacy and comfort of this emerging therapy. Observations made in this study may be used to plan a more definitive follow-on investigation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obstructive Sleep Apnea
Keywords
negative pressure, variable negative external pressure

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
vNEP with various shapes and sizes and overnight PSG
Arm Type
Experimental
Arm Description
Administer vNEP therapy to study participants on the throat's anterior surface with a variable negative pressure ranging from -20 cmH2O up to -35 cmH2O. Assess participants for a reduction in Apnea-Hypopnea Index (AHI) for at least 120 minutes using polysomnography (PSG) and treatment tolerance compared to CPAP.
Intervention Type
Device
Intervention Name(s)
vNEP
Intervention Description
Apply vNEP therapy to the anterior surface of the throat with a variable negative pressure ranging from -20 cmH2O up to -35 cmH2O and vNEP devices of varying shapes and sizes.
Primary Outcome Measure Information:
Title
Complete response
Description
Decrease in AHI <=5
Time Frame
For 120 min
Title
Response
Description
Decrease in AHI of >=50% from baseline
Time Frame
For 120 min
Secondary Outcome Measure Information:
Title
No response
Description
Did not achieve Primary Outcome Measure
Time Frame
For 120 min

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: a polysomnogram study or home sleep test within the previous six months that shows either an AHI > 15 and AHI <= 30 able, in the opinion of the investigator, to understand and comply with all study procedures the vNEP collar is determined by the investigator to properly fit the subject and is well-tolerated after application to the neck.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jerrold Kram, MD
Organizational Affiliation
California Center for Sleep Disorders
Official's Role
Principal Investigator
Facility Information:
Facility Name
California Center for Sleep Disorders
City
San Leandro
State/Province
California
ZIP/Postal Code
94578
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
18788645
Citation
Lee SA, Amis TC, Byth K, Larcos G, Kairaitis K, Robinson TD, Wheatley JR. Heavy snoring as a cause of carotid artery atherosclerosis. Sleep. 2008 Sep;31(9):1207-13.
Results Reference
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PubMed Identifier
24263288
Citation
Friedman M, Shnowske K, Hamilton C, Samuelson CG, Hirsch M, Pott TR, Yalamanchali S. Mandibular advancement for obstructive sleep apnea: relating outcomes to anatomy. JAMA Otolaryngol Head Neck Surg. 2014 Jan;140(1):46-51. doi: 10.1001/jamaoto.2013.5746.
Results Reference
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PubMed Identifier
17589736
Citation
Gelardi M, Del Giudice AM, Cariti F, Cassano M, Farras AC, Fiorella ML, Cassano P. Acoustic pharyngometry: clinical and instrumental correlations in sleep disorders. Braz J Otorhinolaryngol. 2007 Mar-Apr;73(2):257-65. doi: 10.1016/s1808-8694(15)31075-2.
Results Reference
background
PubMed Identifier
27110692
Citation
Kais SS, Klein KB, Rose RM, Endemann S, Coyle WJ. Continuous negative external pressure (cNEP) reduces respiratory impairment during screening colonoscopy: a pilot study. Endoscopy. 2016 Jun;48(6):584-7. doi: 10.1055/s-0042-102533. Epub 2016 Apr 25.
Results Reference
background
PubMed Identifier
27529798
Citation
Kendzerska T, Grewal M, Ryan CM. Utility of Acoustic Pharyngometry for the Diagnosis of Obstructive Sleep Apnea. Ann Am Thorac Soc. 2016 Nov;13(11):2019-2026. doi: 10.1513/AnnalsATS.201601-056OC.
Results Reference
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PubMed Identifier
8464434
Citation
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.
Results Reference
background
PubMed Identifier
34596039
Citation
Kram JA, Pelayo R. Variable negative external pressure-an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea: a pilot study. J Clin Sleep Med. 2022 Jan 1;18(1):305-314. doi: 10.5664/jcsm.9680.
Results Reference
derived
Links:
URL
http://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2011&index=18&absnum=7646
Description
Rose RM, Aarestad J, Flicker W et al. Effect of continuous negative external pressure (cNEP) on upper airway (UA) structure and function: implications for obstructive sleep apnea and anesthesia care. Presented at the annual meeting of the America Society

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Variable Negative External Pressure (vNEP) - An Alternative to Continuous Positive Airway Pressure (CPAP) for the Treatment of Obstructive Sleep Apnea (OSA): A Pilot Study

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