Non-Inferiority Study of the FRESCA Mask Versus Existing CPAP Mask for Treatment of Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is a common chronic disorder and the most common of all sleep
disorders. OSA can occur in any age group, but prevalence increases between middle and older
age. Over the last two decades the prevalence of sleep disordered breathing seems to be
increasing in both men and women, likely due to increasing rates of obesity. Relative
increases reported are between 14% and 55% depending on the subgroup. For men, the current
prevalence estimates of moderate to severe sleep-disordered breathing are 10% for 30 to 49
year-olds and 17% for 50 to 70 year-olds. For women, the corresponding prevalence estimates
are 3% and 9%.

Common consequences of OSA include daytime sleepiness, extreme daytime fatigue, slow reaction
time, moodiness, belligerence and vision problems. OSA is also linked to hypertension,
increased cardiovascular morbidity, type 2 diabetes, neurocognitive dysfunction and possibly
cancer.

The study is a prospective, comparative, open label, randomized crossover assignment,
multi-center pivotal study.

Up to forty-five (45) subjects will be enrolled. It is desirable to have the subject
population distributed across the OSA severity criteria range.

The purpose of this study is to demonstrate that the FRESCA mask is non-inferior to a CPAP
nasal mask in maintaining AHI and ODI during a single night of PSG assessment.

Inclusion Criteria:

1. Male or Female 18-70 years old;

2. Qualifying diagnostic polysomnography (PSG): Resulting in AHI > 5/hr of sleep (using
conventional lab or home test);

3. Qualifying titration PSG: In lab titration within the past 12 months and therapeutic
pressure resulting in Apnea Hypopnea Index (AHI) < 5/hr;

4. Primary medical diagnosis of OSA/ Hypopnea syndrome and on CPAP treatment > 1 month;

5. Current user of nasal mask or nasal pillow mask;

6. Have regular usage of their CPAP machine ( at least 4 hrs per night and at least 5
nights per week) confirmed by secure digital (SD) card download;

7. No significant changes in the subject's general health and no change in weight greater
than ±10 lbs since titration PSG was performed and CPAP therapy initiated (confirmed
from medical records);

8. BMI < 35 kg/m2;

9. Must be able to be fit properly with FRESCA mask;

10. Must be able to comply with all study requirements as outlined in the protocol;

11. Must be able to understand English and be willing to provide written informed consent.

Exclusion Criteria:

1. Subjects with non OSA sleep disorders;

2. Substantial central or mixed apneas (Central and Mixed apnea index ≥ 5/hr);

3. Subjects actively using bi-level PAP or require oxygen therapy;

4. Subjects using a full face mask or chin strap;

5. History of severe cardiovascular disease, including New York Heart Association (NYHA)
Class III or IV heart failure, coronary artery disease (CAD) with angina or myocardial
infarction (MI)/stroke within past 6 months;

6. Subjects who are medically complicated or who are medically unstable (i.e. cancer,
dementia, unstable cardiac or respiratory disease, or unstable psychiatric illness);

7. Potential sleep apnea complications that in the opinion of the investigator may affect
the health and safety of the participant including: uncontrolled hypertension or
hypotension, low blood oxygen (oxygen desaturations nadirs below 75% on their
diagnostic PSG), or use of medication or other treatment which may pose additional
risk to the subject;

8. Subjects exhibiting any flu-like or any upper airway tract infection symptoms at time
of assessment;

9. Subjects with ongoing severe nasal allergies or sinusitis or difficulty breathing
through the nose; persistent blockage or one or both nostrils; or any nasal or facial
abnormalities that would not allow adequate placement of the device;

10. Subjects with prior surgical intervention for obstructive sleep hypopnea/ apnea
syndrome;

11. Currently working nights, rotating night shifts, planned travel across two or more
time zones required during study period, or within two weeks prior to study
enrollment, or sleep schedule not compatible with sleep lab practices;

12. Unstable use of medications or other agents that may affect sleep or PSG (sedatives or
hypnotics);

13. Pregnant (confirmed verbally);

14. Consumption of > 500mg caffeine per day (e.g. > 8 cola-type beverages, > 5 cups of
coffee);

15. Currently enrolled in any other research study