Respiratory Muscle Training in Obstructive Sleep Apnea Syndrome (OSAS) Patients

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00936286
Recruitment Status : Completed
First Posted : July 10, 2009
Last Update Posted : March 10, 2010
Information provided by:
Idiag AG

Brief Summary:
The purpose of this study is to determine whether respiratory muscle training by means of normocapnic hyperpnea leads to clinical and polysomnographical improvements in patients with mild to intermediate sleep apnea syndrome.

Condition or disease Intervention/treatment Phase
Obstructive Sleep Apnea Syndrome Device: SpiroTiger Not Applicable

Detailed Description:

The obstructive sleep apnea syndrome (OSAS) is of great significance for affected individuals as well as for public health service. Patients suffer from reduced quality of life and show an increased accident risk in road traffic and on the job. Furthermore, OSAS represents an independent risk factor for cardiovascular diseases, in particular arterial hypertension.

In sleep apnea patients, the relatively early stimulation of the upper respiratory tract muscles compared to the thoracic respiratory muscles is abrogated in many cases. Alternatively, nerve damage with impaired sensory function in the pharynx area and impaired motor function of the upper air tract musculature, in particular the musculus genioglossus can be observed. The disturbed sensory function impairs the reflex activation of the genioglossus. Moreover, the pattern of neurogenic muscle damage with a loss of the pattern of different types of fibers changed to the point of adjoining atrophic and hypertrophic sections and a more monotonous appearance of fiber types could be detected. During waking hours the activity of the musculus genioglossus is enhanced compared with control persons, which is interpreted as a compensatory mechanism. During sleep time, however, this compensation seems to disappear.

In several studies either direct or indirect stimulation of the musculus genioglossus and its supplying nerves were deployed. Yet, the results were inconsistent. The direct muscle stimulation using intramuscular electrodes, although efficient, was no longer pursued due to technical reasons. Although the results of an external stimulation showed improvements regarding apneas and snoring, the findings were usually weakly pronounced. In a study ascertaining muscle training with transcutaneous electrical stimulation a significant improvement regarding snoring was achieved when compared to placebo. In general, no influence on sleep apnea syndrome could be accomplished, although there were individual cases showing a clinically relevant amelioration.

A preceding study compared habitual snorers with control persons. It was shown that respiratory muscle training by means of normocapnic hyperpnea was accompanied by enlargement of the musculus genioglossus and reduced snoring. Moreover, an increased physical performance was observed.

Thus, the question arises if training of the respiratory musculature by means of normocapnic hyperpnea leads to clinical and polysomnographical improvements in patients with mild to intermediate sleep apnea syndrome.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 10 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The Impact of Respiratory Muscle Training on the Therapy of Obstructive Sleep Apnea Syndrome (OSAS) Patients
Study Start Date : January 2009
Actual Primary Completion Date : January 2010
Actual Study Completion Date : March 2010

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Sleep Apnea

Arm Intervention/treatment
Experimental: Respiratory Muscle Training Device: SpiroTiger
Respiratory muscle training with SpiroTiger device, 1 week training initiation and 4 weeks training period with 5 training days per week, training duration 30 min each. Respiratory bag volume set at 50% VC, respiratory frequency starting from 50% MVV. Weekly control trainings.
Other Name: SpiroTiger Medical

Primary Outcome Measures :
  1. Apnea-hypopnea index, Snoring [ Time Frame: 5 weeks ]

Secondary Outcome Measures :
  1. Polysomnography (PSG) with sleep stages, total arousal count and respiratory arousal count [ Time Frame: 5 weeks ]
  2. Clinical symptoms according to self-assessment questionnaire (Epworth Sleepiness Scale) [ Time Frame: 5 weeks ]
  3. Lung function test parameters (VC, FEV1, MVV, etc.) [ Time Frame: 5 weeks ]
  4. Nocturnal partial pressure of oxygen and/or carbon dioxide in the blood (during PSG) [ Time Frame: 5 weeks ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Mild to intermediate sleep apnea syndrome with AHI of 10 - 30/h and clinical symptoms
  • Refusal of a primary nCPAP therapy
  • Epworth Sleepiness Scale (ESS) score ≥ 9
  • Signed informed consent form

Exclusion Criteria:

  • Therapy with pharmaceuticals which can influence the musculature
  • Psychiatric disease which negatively influences compliance
  • Acute and chronic diseases of the lung and/or the respiratory passages
  • BMI ≥ 35 kg/m²

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00936286

Wissenschaftliches Institut Bethanien e.V.
Solingen, Nordrhein-Westfalen, Germany, 42699
Sponsors and Collaborators
Idiag AG
Study Chair: Winfried J. Randerath, Prof. Dr. Wissenschaftliches Institut Bethanien e.V

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Prof. Dr. med. Winfried J. Randerath, Wissenschaftliches Institut Bethanien e.V. Identifier: NCT00936286     History of Changes
Other Study ID Numbers: WI_SpiroTiger_87/2008
First Posted: July 10, 2009    Key Record Dates
Last Update Posted: March 10, 2010
Last Verified: March 2010

Keywords provided by Idiag AG:
Obstructive Sleep Apnea Syndrome
Respiratory Muscle Training
Normocapnic Hyperpnea

Additional relevant MeSH terms:
Sleep Apnea Syndromes
Sleep Apnea, Obstructive
Pathologic Processes
Respiration Disorders
Respiratory Tract Diseases
Signs and Symptoms, Respiratory
Signs and Symptoms
Sleep Disorders, Intrinsic
Sleep Wake Disorders
Nervous System Diseases