Table 1.

Inclusion and exclusion criteria.

Inclusion

Exclusion

• Age 50–80 years • Ability to understand study procedures and to comply with them for the entire length of the study • Ability to provide informed consent; • Willing to accept random assignment to condition • AHI ≥15 • Individuals with who are unwilling or unable to adhere to CPAP • Individuals who are adherent to CPAP therapy (i.e., 4 h/night on 70%/nights over 30 days in the first 3 months of initial usage) • Individuals who are adherent to mandibular advancement device each night • Above-normal SBP (i.e., SBP ≥120) • BMI ≤ 40 kg/m2 • Weight stable in the prior 3 months (<3.0 kg weight change) and willing to remain weight stable throughout the study • No change in anti-hypertensive medications or other medications (prescription or dosing) in the prior 3 months and willingness to maintain current medication regimen throughout the study • Absence of unstable clinical disease as determined by medical history, physical examination, and blood chemistries • Total cholesterol <240 mg/dL • Fasting plasma glucose <300 mg/dL

• Age <50 or >80 years • AHI <15 • BMI > 40 kg/m2 • Individuals with central or mixed sleep disordered breathing • Severe hypoxemia (<80% for >10% of recording time) during sleep • ESS >15 • SBP ≤ 120 or >160 • DBP >100 • Current smoker • Chronic overt and poorly controlled medical condition (e.g., diabetes, chronic kidney disease, cancer, congestive heart failure) • Cheyne-Stokes Respiration • Alcohol or illegal drug dependence or abuse • Uncontrolled thyroid disease or change in thyroid medication within previous 3 months • Regular/vigorous aerobic exercise (> 4 bouts/week, >30 min/bout at high workload >6 METS)

AHI, apnea hypopnea index; BMI, body mass index; CPAP, continuous positive airway pressure; DBP, diastolic blood pressure; ESS, Epworth Sleepiness Scale; METS, metabolic equivalents; SBP, systolic blood pressure.