MRA Therapy Versus CPAP Therapy in Moderate OSAS (REST)
Sleep Apnea, Obstructive
About this trial
This is an interventional treatment trial for Sleep Apnea, Obstructive focused on measuring cost-effectiveness, effectiveness, treatment, CPAP, MRA, compliance
Eligibility Criteria
Inclusion Criteria:
- Individuals who have been subjected to polysomnography and are diagnosed as having moderate (AHI 15-30) OSAS;
- Aged ≥ 18 years;
Exclusion Criteria:
Medical and psychological criteria:
- Patients previously treated for OSAS (e.g. CPAP, MRA);
- Morphologic abnormalities of the upper airway (e.g., a compromised nasal passage, enlarged tonsils or adenoids, or upper airway soft-tissue or craniofacial abnormality);
- Reported or documented unstable endocrine dysfunction (hypothyroidism, acromegaly, or pituitary adenoma); Reported or documented severe cardiovascular- or pulmonary co-morbidity
- Clinically concurrent cardiovascular disease (coronary artery disease, heart failure,cardiac arrhythmias)
- CVA within 6 months prior to randomisation
- Daytime respiratory insufficiency
- Severe Chronic Obstructive Pulmonary Disease (COPD) (GOLD 3 or 4; FEV1 / FVC < 70% and FEV1 < 50%);
- Other diseases that may impact the evaluation of the results of the study according to the investigator's judgement.
- Reported or documented psychological condition precluding informed consent (e.g., mental retardation, depression or schizophrenia);
Whether the patient has unstable endocrine dysfunction, severe cardiovascular- or pulmonary co-morbidity or a psychological condition precluding informed consent, will be assessed by evaluating the patient's medical record.
Dental exclusion criteria:
- Extensive periodontal disease or tooth decay;
- Active temporomandibular joint disease (including severe bruxism);
- Restrictions in mouth opening (< 25mm) or advancement of the mandible <5mm);
- Partial or complete edentulism (less than eight teeth in upper or lower jaw).
Sites / Locations
- Medisch Centrum Leeuwarden
- University Medical Center Groningen
- Martini Ziekenhuis Groningen
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
MRA therapy
CPAP therapy
During 12 months patients will be treated with a bibloc MRA (SomnoDent® MAS, SomnoMed Australia/Europe AG). The MRA will be customized by certified dentists or dental-specialists experienced in the field of dental sleep medicine.
During 12 months patients will be treated with Continuous positive airway pressure (CPAP).Treatment with CPAP prevents upper airway collapse by pneumatically "splinting" the upper airway during sleep.