Acupuncture and Obstructive Sleep Apnoea

INTERVENTION: Acupuncture: Study Duration: the whole study will take 15 weeks starting from the screening, and including the baseline and end measurement sessions as well as twelve acupuncture treatment sessions. Intervention: each acupuncture treatment session will be one hour in duration with a total of 12 treatment sessions (2 x bi‐weekly treatments for two weeks, 1 x weekly treatments for the next 6 weeks and finally 2 x fortnightly treatments for the next four weeks). Mode of administration: The acupuncture treatment involves single‐use disposable acupuncture needles that vary between 13‐40mm in length and 0.18‐0.25mm in diameter. The points of application will vary depending on the stage of treatment but will be points that regulate activity of the respiratory tract, and tonify the Spleen, Kidneys and Lungs. CONDITION: Obstructive Sleep Apnoea PRIMARY OUTCOME: Mean daytime sleepiness as measured by the Epworth Sleepiness Scale Score on the Apnoea/Hypopnoea Index which is a measure of the average number of respiratory events experienced per hour of sleep as assessed during the baseline 1 night polysomnography. SECONDARY OUTCOME: Activity of the genioglossus muscle both during wakefulness and during sleep in response to airway occlusions as measured via intramuscular electrode wires inserted into the genioglossus muscle Mean arousal threshold defined as the maximal respiratory effort required to arouse from sleep in order to re‐open the airway thereby terminating an occlusion. This is taken as the average pressure in the throat just prior to termination of respiratory events. A pressure tipped catheter will be advanced through the nasal cavity to the back of the throat to take this measure. Upper Airway Resistance during wakefulness. Resistance is measured as a function of nasal to epiglottic pressure as measured by an epiglottic pressure catheter and a pressure catheter at the back of the nasal chonae. INCLUSION CRITERIA: Mild to moderate OSA (AHI between 5 and 30) Not currently receiving treatment for obstructive sleep apnoea Acupuncture naive (as defined as not having previously experienced acupuncture treatment)