Treatment of obstructive sleep apnea with mandibular positioner

该项目将开发一种自适应控制下颌前伸器（ACMP）。ACMP是一种医疗器械，将用于治疗4000多万患有阻塞性睡眠呼吸暂停和高上气道阻力的人。ACMP是由John Remmers博士设计和开发的口腔器械，他被广泛认为是现代睡眠呼吸暂停治疗（CPAP）的创始人。Remmers博士在这一领域的持续工作强调了对新设备和管理过程的需求，这些设备和管理过程可以解决与CPAP等主要治疗方案相关的低依从性问题。虽然口腔矫正器在阻塞性睡眠呼吸暂停的管理中不是新概念，但是已知当前的矫正器由于在整个晚上将下颌骨保持在固定位置所需的力而引起牙齿和下颌关节问题。ACMP将对许多测量的生理参数做出响应，不断优化下颌骨的位置，并最大限度地减少施加到下颌骨上的总力。ACMP有望提高牙科器械的治疗效果，同时最大限度地减少副作用，如牙齿移动。该设备的最终开发将利用小型化和生理监测方面的技术进步，并在所要求的资金期限结束时生产一个先进的原型，以供监管测试。

The project will develop an adaptive controlled mandibular protruder (ACMP). The ACMP is a medical device that will be used for the treatment of the 40+ million people who suffer from obstructive sleep apnea and high upper airway resistance. ACMP is an oral appliance designed and developed by Dr. John Remmers who is widely recognized as the founder of modern sleep apnea treatment (CPAP). Dr. Remmers ongoing work in this field has highlighted a need for new devices and management process that address low compliance issues associated with primary treatment options like CPAP. While oral appliances are not a new concept in the management of obstructive sleep apnea, current appliances, are known to cause dental and mandibular joint problems as a result of the forces needed to maintain the mandible in a fixed position throughout the night. The ACMP will respond to a number of measured physiologic parameters, continually optimizing the position of the mandible and minimizing the total forces applied to the mandible. The ACMP is expected to improve the therapeutic efficacy of dental devices, while minimizing side effects, such as tooth movement. The final development of the device will take advantage of technological advancements in miniaturization and physiologic monitoring, and produce an advanced prototype ready for regulatory testing at the end of the requested funding term.