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This is a prospective study of the Attune Sleep Apnea System for the treatment of obstructive sleep apnea. The objective of the study is to demonstrate safety and effectiveness of the Attune Sleep Apnea System to support FDA marketing clearance of the device.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Experimental | Treatment with the Attune Sleep Apnea System |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Attune Sleep Apnea System | Device | Console and mouthpiece sleep apnea system |
|
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Success Defined as Apnea-hypopnea Index (AHI) Reduction of >50% and Treated AHI<20 | Comparing first treatment night AHI to control/baseline night. AHI is calculated by dividing the number of apnea/hypopnea events by the number of hours of sleep. AHI values are typically characterized as 5-15/hr = mild OSA, 15-30/hr = moderate OSA, and >30/hr = severe OSA. For each subject, Clinical success was defined as apnea-hypopnea index (AHI) reduction of >50% and treated AHI<20. The number of subjects with clinical success was determined to calculate the primary endpoint as the ratio of the number of subjects with clinical success to the number of subjects. | first treatment night |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Event Rate | Further categorized as serious and non-serious, device-related and non-device-related, unanticipated and anticipated, and based on level of severity. Adverse events will be evaluated during the trial at the following visits during 28-day take-home period: 7-day, 14-day, 21-day, 28-day follow-up, and any unscheduled visits. | 4 weeks |
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Inclusion Criteria:
Exclusion Criteria:
OSA treatment within two weeks prior to Medical/Dental screening visit.
Poor nasal patency as evidenced by Peak Nasal Inspiratory Flow (PNIF) less than 75 l/min (assessed at baseline medical visit). In addition, any ongoing process or condition that limits nasal breathing or indications thereof, including: obligate mouth-breathing, persistent blockage of one or both nostrils resulting in the inability to sleep with the mouth closed, chronic nasal congestion, chronic allergic rhinitis, and intermittent allergic rhinitis that does not respond to non-sedating/non-stimulating medical therapy.
Oral cavity infection or any other oral or dental condition or problem that would limit subject use of the Attune Sleep Apnea System (e.g. dentures, loose tooth/teeth, temporomandibular joint (TMJ) conditions, or any oral or dental condition that the Investigator believes could be exacerbated by the Attune Sleep Apnea System.
Prior use of the Attune Sleep Apnea System.
History of any OSA surgical treatment including uvulopalatopharyngoplasty surgery (UPPP), maxillomandibular advancement surgery (MMA), radio frequency (RF) ablation treatment, palatal stent devices, etc.
Current use or use within the previous 2 weeks of medications or other agents that may affect sleep or PSG, including:
Any concomitant diagnosed or suspected sleep or chronic neurological disorders, other than OSA, including insomnia, and central sleep apnea.
Currently working nights, rotating night shifts, planned travel across four or more time zones required during Study period, or within two weeks prior to Study enrollment, or sleep schedule not compatible with sleep lab practices.
Potential sleep apnea complications that, in the opinion of the investigator, may affect the health or safety of the participant, including: low blood oxygen, recent near-miss or prior automobile accident due to sleepiness, reported history of severe cardiovascular disease (including NYHA class III or IV heart failure, CAD with angina or MI/stroke in past 6 months, uncontrolled hypertension or hypotension, cardiac arrhythmias), reported respiratory disorders, or use of medication or other treatment which may pose additional risk to the subject or confound the results of the Study.
Female subjects who are pregnant or intend to become pregnant during the study period.
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| Name | Affiliation | Role |
|---|---|---|
| Ian Colrain, PhD | Stanford Reasearch Institute (SRI) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| REM Medical | Phoenix | Arizona | 85037 | United States | ||
| Peninsula Sleep Center |
Initial screening phase consisted of initial medical/dental and eligibility screening. Subjects then underwent an Oxygen Desaturation Index (ODI) screening (confirming ODI of 10-60) and one night of home use with the study device to screen for proper fit.
Subjects for the study were recruited from the Investigator's sleep clinic or through advertising. Advertisements were approved by the applicable Institutional Review Board (IRB) prior to use.
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| ID | Title | Description |
|---|---|---|
| FG000 | Sleep Apnea Treatment (Primary Endpoint Cohort) | The Treatment group (Primary Endpoint Cohort) includes subjects with an evaluable control (without Attune system) and treatment (with Attune system) polysomnogram (PSG). |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Screening Cohort |
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| Safety Cohort |
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| Primary Endpoint Cohort |
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Baseline Demographics and Characteristics are presented for the Safety Cohort
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| ID | Title | Description |
|---|---|---|
| BG000 | Safety Cohort | Demographics and Baseline Characteristics are presented for the Safety Cohort (N=146) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Clinical Success Defined as Apnea-hypopnea Index (AHI) Reduction of >50% and Treated AHI<20 | Comparing first treatment night AHI to control/baseline night. AHI is calculated by dividing the number of apnea/hypopnea events by the number of hours of sleep. AHI values are typically characterized as 5-15/hr = mild OSA, 15-30/hr = moderate OSA, and >30/hr = severe OSA. For each subject, Clinical success was defined as apnea-hypopnea index (AHI) reduction of >50% and treated AHI<20. The number of subjects with clinical success was determined to calculate the primary endpoint as the ratio of the number of subjects with clinical success to the number of subjects. | All subjects in the primary endpoint cohort were analyzed. | Posted | Number | subjects with clinical success | first treatment night |
|
Adverse events were collect at screening, control and treatment PSG, 7 days, 14 days, 21 days, 28 days and after the final treatment PSG.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Safety Cohort | Device related adverse events are presented for the Safety Cohort. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Oral Tissue Discomfort | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Andrea Brown, Director, Clinical Affairs | ApniCure, Inc. | 650-361-9000 | 122 | abrown@apnicure.com |
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| ID | Term |
|---|---|
| D020181 | Sleep Apnea, Obstructive |
| ID | Term |
|---|---|
| D012891 | Sleep Apnea Syndromes |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| Last Treatment Night Response (AHI Reduction) | Comparing AHI at the last treatment night to the control/baseline night is reported as the percent change in AHI. AHI is calculated by dividing the number of apnea/hypopnea events by the number of hours of sleep. AHI values are typically characterized as 5-15/hr = mild OSA, 15-30/hr = moderate OSA, and >30/hr = severe OSA. Negative numbers represent a decrease/improvement in AHI, whereas positive numbers represent an increase/no improvement in AHI. | At completion of 28 day home use. |
| Percent Reduction in Oxygen Desaturation Index (ODI) | Comparing first treatment night to control/baseline night reported as percent change. Negative numbers represent a reduction/improvement in ODI, whereas positive numbers represent increases/no improvement in ODI. | First treatment night |
| Burlingame |
| California |
| 94010 |
| United States |
| SRI | Menlo Park | California | 94025 | United States |
| Sleep Disorders Center of Georgia (SDCG) | Atlanta | Georgia | 30342 | United States |
| SleepMed | Columbia | South Carolina | 29201 | United States |
| Sleep Medicine Associates of Texas (SMAT) | Dallas | Texas | 75231 | United States |
| Withdrawal by Subject |
|
|
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| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Secondary | Adverse Event Rate | Further categorized as serious and non-serious, device-related and non-device-related, unanticipated and anticipated, and based on level of severity. Adverse events will be evaluated during the trial at the following visits during 28-day take-home period: 7-day, 14-day, 21-day, 28-day follow-up, and any unscheduled visits. | The Safety Cohort consisted of all subjects who participated in at-home use of the device. | Posted | Number | subjects | 4 weeks |
|
|
|
| Secondary | Last Treatment Night Response (AHI Reduction) | Comparing AHI at the last treatment night to the control/baseline night is reported as the percent change in AHI. AHI is calculated by dividing the number of apnea/hypopnea events by the number of hours of sleep. AHI values are typically characterized as 5-15/hr = mild OSA, 15-30/hr = moderate OSA, and >30/hr = severe OSA. Negative numbers represent a decrease/improvement in AHI, whereas positive numbers represent an increase/no improvement in AHI. | All subjects in primary endpoint cohort with final evaluable treatment PSG. | Posted | Median | Inter-Quartile Range | AHI reduction (% change) | At completion of 28 day home use. |
|
|
|
| Secondary | Percent Reduction in Oxygen Desaturation Index (ODI) | Comparing first treatment night to control/baseline night reported as percent change. Negative numbers represent a reduction/improvement in ODI, whereas positive numbers represent increases/no improvement in ODI. | Posted | Median | Inter-Quartile Range | ODI reduction (% change) | First treatment night |
|
|
|
| 0 |
| 146 |
| 80 |
| 146 |
| Oral Tissue Irritation | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Occlusal Change | General disorders | Non-systematic Assessment |
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| Dental Discomfort | General disorders | Non-systematic Assessment |
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| Excessive Salivation | General disorders | Non-systematic Assessment |
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| Other Adverse Event | General disorders | Non-systematic Assessment | Other AEs included: blood in mucous/saliva, headache, jaw discomfort, keratosis on tongue, leukoplakia, metallic taste in mouth, nasal congestion, nausea, panic attack. |
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| D020919 |
| Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| Title | Measurements |
|---|---|
|
| Device related AEs categorized as mild |
|
| Device related AEs categorized as moderate |
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| Device related AEs categorized as severe |
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| Serious adverse events |
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