The Influence of Mandibular Advancement Device Treating OSAHS on Primary Prevention of Ischemic Stroke
- The purpose of this study is to detect the differences of carotid atherosclerosis severity between patients with or without OSAHS(Obstructive Sleep Apnea and Hypopnea Syndrome) in a cross-sectional study in a large sample.
- Then a longitudinal control study is conducted to observe the progress of the carotid atherosclerosis by vascular ultrasonography and the occurrence of cerebrovascular events after the intervention of the oral appliance for treating OSAHS,and finally explore the feasibility of using oral appliance to treat OSAHS in primary prevention of ischemic stroke.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
- the relevance of OSAHS and carotid atherosclerosis Patients are distributed questionnaire and recruited from neurology clinic,vascular ultrasonography clinic of Xuanwu Hospital if they match the inclusion criteria. After initial screening, carotid atherosclerosis patients with skeptical OSAHS are sent to sleep center for polysomnography examination to determine the severity of OSAHS. At least 50 patients for mild, moderate, severe OSAHS each are recruited for OSAHS Group. At least 100 patients without snoring from questionnaire and without OSAHS after PSG screening are recruited for non OSAHS Group. Vascular ultrasonography examination for carotid are done for the two groups. Data of carotid vascular plaque from two groups are collected. Statistics are done to detect differences of carotid atherosclerosis severity between patients with and without OSAHS, also the severity of OSAHS.
- the relevance of the progress of carotid atherosclerosis and oral appliances intervention for treating OSAHS All carotid atherosclerosis patients with OSAHS are from patients of the first study. If they consent the treatment of oral appliances, they are recruited into this second study. At least 100 patients are recruited. They are divided into 2 groups by randomized block design by Evidence-based Medicine Center of Xuanwu Hospital. One group is oral appliance intervention group, the other group is no intervention group. The intervention group patients accept oral appliance treatment, and no intervention group patients do not accept OSAHS treatment. The two groups both accept anti-hypertension treatment or anti-diabetes treatment, or anti-hyperlipidemia treatment according to their own situation in neurology clinic.
At timepoint of initial time, one month after oral appliance treatment, one and a half year after oral appliance treatment, the intervention group should accept PSG(Polysomnography) examination to monitor the treatment of OSAHS.
At timepoint of initial time, one month after oral appliance treatment, one and a half year after oral appliance treatment, the two groups should accept breath holding test to monitor the cerebral vascular reserve.
At timepoint of initial time, one and a half year after oral appliance treatment, the two groups should accept carotid vascular ultrasonography examination to monitor the progress of carotid atherosclerosis.
Cerebrovascular events and death are recorded from initial time. Statistics are done to detect the influence of treatment of OSAHS on carotid atherosclerosis.
Tipo di studio
Tipo di studio
Iscrizione (Anticipato)
Iscrizione
Fase
Fase
- Non applicabile
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Bambino
- Adulto
- Adulto più anziano
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- diagnosed with atherosclerosis by vascular ultrasonography
- diagnosed with OSAHS by polysomnography
Exclusion Criteria:
- patients who have stroke already
- patients who can not wear oral appliances according to experiment requirements
- patients who have bad periodontal condition or teeth number less than 20
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Oral appliance intervention
|
mandibular advancement device to enlarge pharyngeal airway space to get rid of apnea and hypopnea events
|
|
Nessun intervento: Without oral appliance intervention
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
apnea hypopnea events 0 in Times
Lasso di tempo: initial time when patients are recruited
|
apnea and hypopnea times per hour
|
initial time when patients are recruited
|
|
apnea hypopnea events 1 in Times
Lasso di tempo: one month after oral appliance treatment
|
apnea and hypopnea times per hour
|
one month after oral appliance treatment
|
|
apnea hypopnea events 2 in Times
Lasso di tempo: one and a half years after oral appliance treatment
|
apnea and hypopnea times per hour
|
one and a half years after oral appliance treatment
|
|
longest apnea time 0 in Seconds
Lasso di tempo: initial time when patients are recruited
|
longest apnea or hypopnea time
|
initial time when patients are recruited
|
|
longest apnea time 1 in Seconds
Lasso di tempo: one month after oral appliance treatment
|
longest apnea or hypopnea time
|
one month after oral appliance treatment
|
|
longest apnea time 2 in Seconds
Lasso di tempo: one and a half years after oral appliance treatment
|
longest apnea or hypopnea time
|
one and a half years after oral appliance treatment
|
|
Blood oxygen saturation less than 90% of the total monitoring time percentage 0 in percentage
Lasso di tempo: initial time when patients are recruited
|
Blood oxygen saturation less than 90% of the total monitoring time percentage
|
initial time when patients are recruited
|
|
Blood oxygen saturation less than 90% of the total monitoring time percentage 1 in percentage
Lasso di tempo: one month after oral appliance treatment
|
Blood oxygen saturation less than 90% of the total monitoring time percentage
|
one month after oral appliance treatment
|
|
Blood oxygen saturation less than 90% of the total monitoring time percentage 2 in percentage
Lasso di tempo: one and a half years after oral appliance treatment
|
Blood oxygen saturation less than 90% of the total monitoring time percentage
|
one and a half years after oral appliance treatment
|
|
lowest Oxygen Saturation 0 in percentage
Lasso di tempo: initial time when patients are recruited
|
blood lowest oxygen saturation during the whole night
|
initial time when patients are recruited
|
|
lowest Oxygen Saturation 1 in percentage
Lasso di tempo: one month after oral appliance treatment
|
blood lowest oxygen saturation during the whole night
|
one month after oral appliance treatment
|
|
lowest Oxygen Saturation 2 in percentage
Lasso di tempo: one and a half years after oral appliance treatment
|
blood lowest oxygen saturation during the whole night
|
one and a half years after oral appliance treatment
|
|
atherosclerosis plaque thickness 0 in common carotid artery in milimetre
Lasso di tempo: initial time when patients are recruited
|
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
|
initial time when patients are recruited
|
|
atherosclerosis plaque thickness 1 in common carotid artery in milimetre
Lasso di tempo: one and a half years after oral appliance treatment
|
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
|
one and a half years after oral appliance treatment
|
|
atherosclerosis plaque length 0 in common carotid artery in milimetre
Lasso di tempo: initial time when patients are recruited
|
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
|
initial time when patients are recruited
|
|
atherosclerosis plaque length 1 in common carotid artery in milimetre
Lasso di tempo: one and a half years after oral appliance treatment
|
atherosclerosis plaque length is distance from the beginning to the end of a separate plaqu
|
one and a half years after oral appliance treatment
|
|
atherosclerosis plaque thickness 0 in internal carotid artery in milimetre
Lasso di tempo: initial time when patients are recruited
|
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
|
initial time when patients are recruited
|
|
atherosclerosis plaque thickness 1 in internal carotid artery in milimetre
Lasso di tempo: one and a half years after oral appliance treatment
|
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
|
one and a half years after oral appliance treatment
|
|
atherosclerosis plaque thickness 0 in carotid bulb in milimetre
Lasso di tempo: initial time when patients are recruited
|
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
|
initial time when patients are recruited
|
|
atherosclerosis plaque thickness 1 in carotid bulb in milimetre
Lasso di tempo: one and a half years after oral appliance treatment
|
atherosclerosis plaque thickness is distance from the most convex point of plaque to carotid media
|
one and a half years after oral appliance treatment
|
|
atherosclerosis plaque length 0 in internal carotid artery in milimetre
Lasso di tempo: initial time when patients are recruited
|
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
|
initial time when patients are recruited
|
|
atherosclerosis plaque length 1 in internal carotid artery in milimetre
Lasso di tempo: one and a half years after oral appliance treatment
|
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
|
one and a half years after oral appliance treatment
|
|
atherosclerosis plaque length 0 in carotid bolb in milimetre
Lasso di tempo: initial time when patients are recruited
|
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
|
initial time when patients are recruited
|
|
atherosclerosis plaque length 1 in carotid bolb in milimetre
Lasso di tempo: one and a half years after oral appliance treatment
|
atherosclerosis plaque length is distance from the beginning to the end of a separate plaque
|
one and a half years after oral appliance treatment
|
|
breath holding index 0 in percentage/seconds
Lasso di tempo: initial time when patients are recruited
|
breath holding index = (v2-v1)/v2*100/t.
v2 is average velocity of middle cerebral artery after breath holding, v1 is average velocity of middle cerebral artery before breath holding, t is time for breath holding.
|
initial time when patients are recruited
|
|
breath holding index 0 in percentage/seconds
Lasso di tempo: one and a half years after oral appliance treatment
|
breath holding index = (v2-v1)/v2*100/t.
v2 is average velocity of middle cerebral artery after breath holding, v1 is average velocity of middle cerebral artery before breath holding, t is time for breath holding.
|
one and a half years after oral appliance treatment
|
|
End systolic velocity of common carotid artery 0 in cm/s
Lasso di tempo: initial time when patients are recruited
|
the velocity of common carotid artery at the end of systolic period
|
initial time when patients are recruited
|
|
End systolic velocity of common carotid artery 1 in cm/s
Lasso di tempo: one and a half years after oral appliance treatment
|
the velocity of common carotid artery at the end of systolic period
|
one and a half years after oral appliance treatment
|
|
End systolic velocity of internal carotid artery 0 in cm/s
Lasso di tempo: initial time when patients are recruited
|
the velocity of internal carotid artery at the end of systolic period
|
initial time when patients are recruited
|
|
End systolic velocity of internal carotid artery 1 in cm/s
Lasso di tempo: one and a half years after oral appliance treatment
|
the velocity of internal carotid artery at the end of systolic period
|
one and a half years after oral appliance treatment
|
|
End systolic velocity of carotid bulb 0 in cm/s
Lasso di tempo: initial time when patients are recruited
|
the velocity of carotid bulb at the end of systolic period
|
initial time when patients are recruited
|
|
End systolic velocity of carotid bulb 1 in cm/s
Lasso di tempo: one and a half years after oral appliance treatment
|
the velocity of carotid bulb at the end of systolic period
|
one and a half years after oral appliance treatment
|
|
end diastolic velocity of common carotid artery 0 in cm/s
Lasso di tempo: initial time when patients are recruited
|
the velocity of common carotid artery at the end of diastolic period
|
initial time when patients are recruited
|
|
end diastolic velocity of common carotid artery 1 in cm/s
Lasso di tempo: one and a half years after oral appliance treatment
|
the velocity of common carotid artery at the end of diastolic period
|
one and a half years after oral appliance treatment
|
|
end diastolic velocity of internal carotid artery 0 in cm/s
Lasso di tempo: initial time when patients are recruited
|
the velocity of internal carotid artery at the end of diastolic period
|
initial time when patients are recruited
|
|
end diastolic velocity of internal carotid artery 1 in cm/s
Lasso di tempo: one and a half years after oral appliance treatment
|
the velocity of internal carotid artery at the end of diastolic period
|
one and a half years after oral appliance treatment
|
|
end diastolic velocity of carotid bulb 0 in cm/s
Lasso di tempo: initial time when patients are recruited
|
the velocity of carotid bulb at the end of diastolic period
|
initial time when patients are recruited
|
|
end diastolic velocity of carotid bulb 1 in cm/s
Lasso di tempo: one and a half years after oral appliance treatment
|
the velocity of carotid bulb at the end of diastolic period
|
one and a half years after oral appliance treatment
|
Collaboratori e investigatori
Sponsor
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
- Qin L, Li N, Tong J, Hao Z, Wang L, Zhao Y. Impact of mandibular advancement device therapy on cerebrovascular reactivity in patients with carotid atherosclerosis combined with OSAHS. Sleep Breath. 2021 Sep;25(3):1543-1552. doi: 10.1007/s11325-020-02230-x. Epub 2021 Jan 7.
- Hao Z, Qin L, Tong J, Li N, Zhai Y, Zhao Y. The differences of carotid atherosclerosis among non-OSAHS and OSAHS patients of different severities: a cross-sectional study. Sleep Breath. 2021 Jun;25(2):639-648. doi: 10.1007/s11325-020-02145-7. Epub 2020 Jul 27.
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Inizio studio (Effettivo)
Inizio studio
Completamento primario (Effettivo)
Completamento primario
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Malattia cardiovascolare
- Malattie vascolari
- Disturbi cerebrovascolari
- Malattie del cervello
- Malattie del sistema nervoso centrale
- Malattie del sistema nervoso
- Malattie delle vie respiratorie
- Arteriosclerosi
- Malattie arteriose occlusive
- Apnea
- Disturbi respiratori
- Disturbi del sonno, intrinseci
- Dissonnie
- Disturbi del sonno e della veglia
- Ictus
- Sindromi da apnee notturne
- Ictus ischemico
- Aterosclerosi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- CSA-Z2015-06
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
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