(Fast-Track proposals will be accepted.)
Number of anticipated awards: 3
Budget (total costs): Phase I: $225,000
for 6 months; Phase II: $1,500,000 for 2 years
It is strongly suggested that proposals
adhere to the above budget amounts and project periods. Proposals
with budgets exceeding the above amounts and project periods may not
be funded.
Summary
As a therapeutic option, an array of
existing oral appliances are approved for the medical treatment of
snoring and mild to moderate obstructive sleep apnea but lack
specific capabilities necessary to fulfill regulatory requirements
and conduct population-based effectiveness research. Integration of
oral appliance and electronic monitoring technologies is needed to
develop enhanced oral devices capable of addressing regulatory
requirements and facilitating population-based research and clinical
trials monitoring adherence and effectiveness of sleep apnea
treatment.
Project Goals
Adapt therapeutic oral appliances
currently used to maintain an open airway during sleep with
electronic and sensor technologies to quantitatively monitor and
evaluate patient adherence and the effectiveness of treatment.
Validate the implementation of monitoring technologies as needed to
fulfill regulatory requirements. Since oral appliances vary in how
an open airway is maintained, it is anticipated that 2-3 different
oral appliances with integrated monitoring capability. Proposals to
develop an oral appliance treatment as opposed to integrate
monitoring capabilities into an existing technology will not be
considered responsive to this request.
Phase I Activities and Expected
Deliverables
Development of a prototype oral appliance
with an integrated capability of monitoring treatment adherence and
efficacy up to 24 hours independent of external power sources and
connections. The enhanced oral appliance must be should not change
acceptance of the device by patients, interfere with therapeutic
efficacy of the device, increase patient burden, or introduce
potential electrical or biological risks to patient safety over the
anticipated life of the instrument. The prototype must demonstrate
that the proposed design specifications including sensitivity and
longevity of sensor technology have been achieved for successful
completion of phase I activities.
Phase II Activities and Expected
Deliverables
A sufficient number of working devices and
procedures for deployment and field testing must be developed. These
procedures should validate the capabilities of the monitoring
technology, demonstrate adherence to therapy, and the efficacy of
treatment fulfilling regulatory requirements of the commercial
transportation industry. Validation includes field testing in a
representative cohort of middle-age men and women diagnosed with
sleep apnea and physician-recommended treatment using an oral
appliance. The cohort must be designed to allow a stratified
analysis of the device capabilities among apnea patients with
Epworth Sleepiness Scale scores greater than or equal to 10 compared
to apnea patients with scores below 10. The results obtained from
device monitoring should be compared with correlative measures such
as actigraphy, daytime sleepiness and psychomotor vigilance task to
establish that the monitoring capabilities of the integrated device
can be used to accurately predict functional outcomes. Proposals to
enhance standard medical practice in diagnosis or treatment of sleep
apnea will not be considered responsive.