Mandibular Advancement vs Home Treatment for Primary Snoring

NCT ID: NCT05756647

Last Updated: 2025-06-06

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-07

Study Completion Date

2023-07-03

Brief Summary

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This is a randomized controlled trial for non-apneic snorers. The primary goal of the study is to evaluate the efficacy of a mandibular advancement device (MAD) vs conservative treatment for adults with non-apneic snoring as measured by the partners report of response to treatment (CGI-I). The secondary goal is to evaluate the effectiveness of treatment of snoring on the Epworth Sleepiness Scale (ESS), a modified Symptoms of Nocturnal Obstruction and Related Events (SNORE-25) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Clinical Global Impression of Severity Scale (CGI-S)

Detailed Description

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Snoring is a problem which affects roughly half of adults, but rigorous studies on how to treat isolated snoring have not been completed. Mandibular advancement devices (MAD) show consistent improvements in sleep quality for patients with sleep apnea; however, their effect on patients with primary snoring remains less well known.

The primary hypothesis proposes that adults with non-apneic snoring treated with a MAD will experience a greater reduction of snoring as measured by the Clinical Global Impression - Improvement (GCI-I) Scale response of the sleeping partner.

The plan is to enroll 30 participants and 30 sleeping partner participants for each arm of the trial: 120 participants, or 60 pairs, in total. Participants will use the intervention nightly for a period of 4 weeks after which an end of study visit will occur. All post intervention outcomes will be recorded at the end of the study visit. Knowledge gained from this study will help guide treatment practice and evidence-based approaches regarding non-apneic snoring.

Conditions

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Snoring

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study is a randomized control trial with an active control group.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
* Due to the nature of the randomization process, blinding during the data collection phase will not be possible.
* Participants cannot be blinded either as the treatment modalities differ in a way which makes adequate blinding not possible.
* Prior to data analysis, Dr. Kallogjeri will blind groups as "A" and "B" so that the team will not know which intervention corresponds to A and B throughout both the data analysis and manuscript writing process.

Study Groups

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Interventional Arm

The Mandibular Advancement Device for this study will be the ProSomnus Sleep Device. It is a sleep device intended to reduce nighttime snoring and mild to moderate Obstructive Sleep Apnea in adults by holding the lower jaw forward during sleep

Group Type EXPERIMENTAL

Interventional Arm

Intervention Type DEVICE

The MAD arm will consist of participants given a fitted mandibular advancement device that they will wear for the length of the study.

Conservative treatment Arm

The conservative treatment will consist of four different interventions: Mometasone nasal rinse, External nasal dilatory therapy, Mouth taping and Lateral positional therapy.

Group Type ACTIVE_COMPARATOR

Conservative treatment Arm

Intervention Type COMBINATION_PRODUCT

Participant will undergo a nightly medicated nasal rinse that will occur for a 4 week period, prior to beginning of the other three conservative therapy interventions. The 4-part combination therapy will take place for 4 weeks total.

Interventions

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Interventional Arm

The MAD arm will consist of participants given a fitted mandibular advancement device that they will wear for the length of the study.

Intervention Type DEVICE

Conservative treatment Arm

Participant will undergo a nightly medicated nasal rinse that will occur for a 4 week period, prior to beginning of the other three conservative therapy interventions. The 4-part combination therapy will take place for 4 weeks total.

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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MAD (anti-snoring mouthpiece)

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18
* Report of snoring
* Prior polysomnogram (PSG) within the past 60 months showing AHI (Apnea Hypopnea Index) \< 5 and no more than 10% gain in body weight since the prior polysomnogram OR reasonable clinical suspicion that the participant does not have sleep apnea \[Reasonable Clinical Suspicion is defined as: BMI \<35, Neck circumference \<16.5 inches, lack of uncontrolled hypertension, no witnessed episodes of apnea, or multiple sleep studies in the past all showing lack of sleep apnea but with \>5 years since the most recent one.\]
* Possess a sleeping partner who sleeps in the same room as the participant for \>= 4 nights a week and who can report outcomes
* Access to the internet
* Ability to follow up within 1 month after adequate fitting of MAD or 4 weeks of Mometasone


* Age ≥ 18
* Possess a sleeping partner who sleeps in the same room as the participant for \>= 4 nights a week and who can report outcomes
* Access to the internet

Exclusion Criteria

* Significant hypoxemia as defined as SaO2 (oxygen saturation) below 89% for ≥ 12% of the total nocturnal monitoring time
* Inability to wear a MAD defined as missing more than 50% of their dentition or their dentition is not in good condition.
* Prior intolerance of MAD
* Current treatment for OSA
* Concurrent use of sedatives or \> 2 alcoholic drinks per night
* Chronic nasal obstruction due to structural anatomic defects, nasal polyps, or history of unresponsiveness to nasal rinses.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Jay F. Piccirillo, MD

Vice chair for Research Department of Otolaryngology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jay Piccirillo, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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Washington University

St Louis, Missouri, United States

Site Status

Countries

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United States

References

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Reference Type DERIVED
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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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202208175

Identifier Type: -

Identifier Source: org_study_id

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