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Trial registered on ANZCTR
Registration number
ACTRN12607000289415
Ethics application status
Approved
Date submitted
15/05/2007
Date registered
31/05/2007
Date last updated
9/11/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Randomised controlled trial of the effect of mandibular advancement splint (MAS) versus positive airway pressure (PAP) therapy on blood pressure in obstructive sleep apnoea
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Scientific title
Randomised controlled trial of the effect of mandibular advancement splint (MAS) versus positive airway pressure (PAP) therapy on blood pressure in obstructive sleep apnoea
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Secondary ID [1]
262252
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Nil
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Universal Trial Number (UTN)
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Trial acronym
MASPAP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
obstructive sleep apnoea
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Condition category
Condition code
Respiratory
1923
1923
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0
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Chronic obstructive pulmonary disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study will compare the gold standard treatment for Obstructive Sleep Apnoea, namely Continuous Positive Airway Pressure (CPAP), to oral appliance therapy. CPAP treatment involves the delivery of pressurised air from a pump to the nose via tubing and a nose mask. The pressurised air acts to prevent the airway from collapsing during sleep. Oral appliance therapy involves a titratable intra-oral device worn during sleep, that advances the mandible to improve upper airway calibre and function. The oral appliance being used is a Mandibular Advancement Splint (MAS). Following appropriate acclimatisation to both treatment modalities, patients will undergo 1 month intervention with each treatment (cross-over design) in order to compare the health effects of the treatments. Subjects will be encouraged to use each device every night during sleep. Following treatment on the first device, there will be a 2 week washout period before subjects are crossed over to the second device.
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Intervention code [1]
1759
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Treatment: Devices
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Comparator / control treatment
Continuous Positive Airway Pressure (CPAP)
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Control group
Active
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Outcomes
Primary outcome [1]
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24 hour mean arterial blood pressure (MAP)
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Assessment method [1]
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Timepoint [1]
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At 1 month after the use of CPAP and at 1 month after the use of Mandibular Advancement Splint.
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Secondary outcome [1]
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24 hr Systolic (SBP) and Diastolic (DBP) blood pressures
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Assessment method [1]
4612
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Timepoint [1]
4612
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [2]
4613
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Mean Waking and Sleeping blood pressures - Mean Arterial Pressure (MAP), SBP and DBP
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Assessment method [2]
4613
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Timepoint [2]
4613
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [3]
4614
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Central blood pressure (Central SBP and Augmentation Index)
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Assessment method [3]
4614
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Timepoint [3]
4614
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [4]
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Driving simulator performance (AusEd)
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Assessment method [4]
4615
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Timepoint [4]
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [5]
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Polysomnographic measures of treatment efficacy at the end of each 1 month treatment period (Apnoea Hypopnoea Index (AHI), Minimum Oxygen Saturation, Arousal Index)
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Assessment method [5]
4616
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Timepoint [5]
4616
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [6]
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Quality of life (SF-36, Functional Outcomes of Sleep Questionnaire (FOSQ))
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Assessment method [6]
4617
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Timepoint [6]
4617
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [7]
4618
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Subjective Daytime Sleepiness (Epworth Sleepiness Scale)
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Assessment method [7]
4618
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Timepoint [7]
4618
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [8]
4619
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Compliance
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Assessment method [8]
4619
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Timepoint [8]
4619
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Assessed at 1 month after the use of CPAP and at 1 month after the use of the Mandibular Advancement Splint.
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Secondary outcome [9]
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Side-effects (nature and frequency)
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Assessment method [9]
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Timepoint [9]
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Reported by questionnaire at the end of each 1 month treatment period
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Eligibility
Key inclusion criteria
Presence of at least 2 symptoms of obstructive sleep apnoea (snoring, fragmented sleep, witnessed apneas, daytime sleepiness); proven obstructive sleep apnoea on polysomnography (AHI>10)
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Minimum age
20
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Previous treatment of Obstuctive Sleep Apnoea; central sleep apnea, need for immediate treatment, co-existing sleep disorder, contraindications to oral appliance therapy, regular use of sedatives or narcotics, pre-existing lung disease, active psychiatric disease
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sequentially numbered opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random Permuted Blocks generated by computer program
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 3 / Phase 4
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Type of endpoint/s
Bio-equivalence
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
8/06/2007
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Actual
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Date of last participant enrolment
Anticipated
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Actual
22/12/2010
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
108
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal North Shore Hospital - St Leonards
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Recruitment hospital [2]
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Royal Prince Alfred Hospital - Camperdown
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Funding & Sponsors
Funding source category [1]
2068
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Government body
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Name [1]
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National Health & Medical Research Council of Australia (Project grant 457557)
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Address [1]
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Level 1, 16 Marcus Clarke St Canberra ACT 2601
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Country [1]
2068
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Australia
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Primary sponsor type
Other
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Name
Woolcock Institute of Medical Research
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Address
PO BOX M77, Missenden Road NSW 2050
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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University of Sydney
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Address [1]
1873
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University of Sydney, NSW 2006
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Country [1]
1873
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
3840
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Northern Sydney Central Coast Area Health Service
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Ethics committee address [1]
3840
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Ethics committee country [1]
3840
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Australia
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Date submitted for ethics approval [1]
3840
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Approval date [1]
3840
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28/11/2006
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Ethics approval number [1]
3840
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0610-192M
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Ethics committee name [2]
3841
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University of Sydney
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Ethics committee address [2]
3841
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Ethics committee country [2]
3841
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Australia
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Date submitted for ethics approval [2]
3841
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Approval date [2]
3841
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15/12/2006
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Ethics approval number [2]
3841
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9778
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Ethics committee name [3]
3842
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Sydney South West Area Health Service
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Ethics committee address [3]
3842
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Ethics committee country [3]
3842
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Australia
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Date submitted for ethics approval [3]
3842
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Approval date [3]
3842
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Ethics approval number [3]
3842
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Summary
Brief summary
The broad aim of the project is to compare MAS and CPAP treatment in patients with Obstructive Sleep Apnoea to test the hypothesis that these treatments have equivalent health effects in terms of important clinical outcomes as a result of the superior efficacy of CPAP being offset by lower treatment compliance than MAS.
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Trial website
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Trial related presentations / publications
Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med. 2013 Apr 15;187(8):879-87.
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Public notes
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Contacts
Principal investigator
Name
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Prof Peter Cistulli
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Address
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Department of Respiratory & Sleep Medicine
Royal North Shore Hospital
St Leonards
NSW 2065
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Country
27862
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Australia
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Phone
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0294632920
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Address
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Woolcock Institute of Medical Research
PO Box M77
Missenden Road
Camperdown NSW 2050
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Country
10948
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Australia
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Phone
10948
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+61 2 95155678
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Fax
10948
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+61 2 95505865
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Email
10948
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[email protected]
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Contact person for scientific queries
Name
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Address
1876
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Woolcock Institute of Medical Research
Level 7 Building 14 Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050
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Country
1876
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Australia
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Phone
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+61 2 95156417
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Fax
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+61 2 95575059
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Email
1876
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: A randomized controlled trial.
2013
https://dx.doi.org/10.1164/rccm.201212-2223OC
Dimensions AI
Sleep Apnea Cardiovascular Clinical Trials—Current Status and Steps Forward: The International Collaboration of Sleep Apnea Cardiovascular Trialists
2013
https://doi.org/10.5665/sleep.2790
Embase
Health outcomes of continuous positive airway pressure versus mandibular advancement device for the treatment of severe obstructive sleep apnea: An individual participant data meta-analysis.
2021
https://dx.doi.org/10.1093/sleep/zsab015
N.B. These documents automatically identified may not have been verified by the study sponsor.
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