Status:

COMPLETED

A Cardiosleep Research Program on Obstructive Sleep Apnea, Blood Pressure Control and Maladaptive Myocardial Remodeling

Lead Sponsor:

National University of Singapore

Collaborating Sponsors:

Ng Teng Fong General Hospital

National University Hospital, Singapore

Conditions:

Hypertension,Essential

Obstructive Sleep Apnea

Eligibility:

All Genders

40+ years

Phase:

NA

Brief Summary

The objective of this proposal is to evaluate whether mandibular advancement device (MAD) is non-inferior to continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea (OSA...

Eligibility Criteria

Inclusion

  • Age of at least 40 years
  • Chinese (based on the Identity Card or other Identity Document if the subject is a non-Singapore citizen or permanent resident)
  • Physician diagnosed essential hypertension, on at least 1 medication for BP control
  • High cardiovascular risk, as defined by one or more of the following: (a) diabetes mellitus, (b) stroke, (c) significant coronary artery disease (at least one stenosis of \>50% diameter in at least one major epicardial artery), (d) chronic kidney disease, excluding polycystic kidney disease, with an estimated glomerular filtration rate of \<60 ml/min/1.73m2, or (e) age of 75 years or older.

Exclusion

  • Known OSA on treatment
  • Cheyne-Stokes breathing or predominantly central sleep apnea (\>50%)
  • Known secondary hypertension: from renal (renal artery stenosis, chronic renal failure); endocrine (aldosterone excess, pheochromocytoma, cushing's syndrome, hyperthyroidism) or cardiac causes (aortic coarctation)
  • Contraindications to CMR: implantable devices, cerebral aneurysm clips, cochlear implants, renal impairment (GRF \<30ml/min/1.73m2), claustrophobia and pregnant women
  • Contraindications to MAD: \<6 to 10 teeth in each arch, inability to advance the mandible and open the jaw widely, pre-existing temporomandibular joint problems, severe bruxism
  • Limited life expectancy (\< 1 year)
  • Hypertensive crisis, acute coronary syndromes or acute heart failure in the past 30 days
  • Known AF (not suitable for CMR and affects remodelling analysis)

Key Trial Info

Start Date :

October 16 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

February 15 2024

Estimated Enrollment :

321 Patients enrolled

Trial Details

Trial ID

NCT04119999

Start Date

October 16 2019

End Date

February 15 2024

Last Update

February 20 2024

Active Locations (1)

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NUHS Cardiosleep research laboratory

Singapore, Singapore