Research project The project investigates different exercise methods to reduce snoring and sleepiness and increase quality of life in patients with mild or moderate sleep apnea.
The research project is part of Innosleep, an EU project on sleep apnea where Swedish, Norwegian and Danish university hospitals collaborate. The goal is to develop a number of technical solutions for sleep apnoea patients that improve their and their relatives' quality of life. The plan is to develop and implement a standardized assessment plan that leads to more patients receiving treatment that they are motivated to maintain.
Interreg Öresund-Kattegat-Skagerrak
Asbjørn Kørvel-Hanquist, M.D., Ph.d, Zealand University Hospital
Frida Enoksson, M.D., Ph.d, Lund University
The aims of the present project is to assess the impact of 1) oral screen training, group training and the use of neuromuscular electrical training (NMES) as orofacial myofunctional therapy (OMT) methods for reducing the apnea-hypopnea index (AHI) among adults with mild to moderate sleep apnea and 2) if these different training methods can reduce snoring and affect level of sleepiness and quality of life.
Study design
The study will use a prospective randomized open blinded end-point (PROBE) design with baseline measurements, intervention phase and follow-up measurements.
Methods
140 consecutive adult subjects, 70 men and 70 women, referred to hospital, due to symptoms of snoring and/or mild to moderate sleep apnea will be randomized, included, and examined. One hundred-five of them, 35 in each treatment group, will receive one of the 3 different forms of training and the final 35 persons serving as controls, age/AHI matched. Patients in Umeå will be randomized to either training with IQoro or serving as controls. Patients in Köge will be randomized to either training with Exciteosa or group training.
Outcomes
The primary outcome is change in AHI before and after three months of training with the different methods, according to overnight ambulatory sleep apnea recordings. The secondary outcomes are change in snoring frequency, sound level db(A) according to a questionnaire, the Basic Nordic Sleep Questionnaire (BNSQ) and daytime sleepiness using the Epworth Sleepiness Scale (ESS) before and after treatment. Change in quality of life using the short form -36 (SF-36).
Sleep apnoea is a serious chronic condition in which patients experience many prolonged nocturnal pauses in breathing (apnoea) due to narrowing of the airways, leading to interrupted sleep and the risk of a wide range of serious sequelae, reduced quality of life and traffic accidents. The incidence of sleep apnea is increasing worldwide. InnoSleep is a collaborative project on sleep apnoea between Danish, Norwegian and Swedish partners, based on research results and the strong network that the previous project Sleep Across Waters has built up.
The project consists of a collaboration between healthcare and patients, as well as companies that want to turbocharge knowledge about the treatment of sleep apnea with a focus on innovative technology and patients' individual characteristics. Among other things, InnoSleep expects to have developed a number of technical solutions for sleep apnea patients that improve patients' and relatives' quality of life. The plan is to develop and implement a standardized assessment plan that leads to more patients receiving treatment that they are motivated to maintain. The project expects that many more will be examined and receive treatment early. In collaboration with patients, the project also wants to develop and implement patient education that motivates sleep apnea patients to continue their lifelong treatment.
It is estimated that around 1 million citizens in the ØKS region suffer from sleep apnea. In addition, only about one in three has been offered assessment and treatment, usually with CPAP (continuous positive airway pressure), which works by keeping the airway open during sleep. Of the citizens offered treatment with CPAP, about half discontinue treatment because it is perceived as an unmanageable intervention in everyday life. This is a problem, as untreated sleep apnea carries a high risk of complications (including high blood pressure, atrial fibrillation, fatigue, depression and stroke). Faster diagnosis and treatment will improve the quality of life of patients and relatives, better and longer links with the labour market, increase road safety and prevent a wide range of complications, in particular fatigue, cardiovascular disease and type 2 diabetes.
