Control of Tongue Position in Patients with Obstructive Sleep Apnea: Concept and Protocol for a Randomized Controlled Crossover Trial

Int J Environ Res Public Health. 2023 Jun 1;20(11):6026. doi: 10.3390/ijerph20116026.

Abstract

We hypothesize that the control of tongue position using a newly developed tongue position retainer, where the tongue is held in a protruded position (i.e., intervention A) or in its resting position (i.e., intervention B), is effective for maintaining upper airway patency in obstructive sleep apnea (OSA) compared with no control of tongue position. This is a randomized, controlled, non-blinded, crossover, and two-armed trial (i.e., sequence AB/BA) in 26 male participants (i.e., sample size) who are scheduled to undergo a dental operation under intravenous sedation with OSA (10 ≤ respiratory event index < 30/h). Participants will be randomly allocated into either sequence by a permuted block method, stratified by body mass index. Under intravenous sedation, participants will undergo two interventions, separated by a washout period after receiving intervention A or intervention B using a tongue position retainer after baseline evaluation, before each intervention is provided. The primary outcome is the abnormal breathing index of apnea as determined by the frequency of apnea per hour. We expect that, compared with no control of tongue position, both intervention A and intervention B will improve the abnormal breathing events with superior effects achieved by the former, offering a therapeutic option for OSA.

Keywords: intravenous sedation; obstructive sleep apnea; randomized controlled trial; tongue position retainer.

Publication types

  • Clinical Trial Protocol
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Over Studies
  • Humans
  • Male
  • Nose
  • Randomized Controlled Trials as Topic
  • Sleep Apnea, Obstructive* / surgery
  • Tongue

Grants and funding

This research was funded by Grants-in-Aid for Scientific Research (KAKENHI) (grant numbers 20K10085, 19K10236, and 22K10069) from Japan Society for the Promotion of Science (JSPS).