Clinical Research Directory

Inclusion Criteria: * Age 50 and older * 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 hours/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 Exclusion Criteria: * Age \<50 * AHI \<15 * Individuals with central or mixed sleep disordered breathing * Severe hypoxemia (\<80% for \>10% of recording time) during sleep * ESS \>15 * SBP ≥160 or DBP ≥120 * 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)