Transoral awake state neuromuscular electrical stimulation therapy for mild obstructive sleep apnea
Por:
Nokes B, Baptista PM, de Apodaca PMR, Carrasco-Llatas M, Fernandez S, Kotecha B, Wong PY, Zhang H, Hassaan A and Malhotra A
Publicada:
1 may 2023
Ahead of Print:
1 may 2022
Resumen:
Introduction Obstructive sleep apnea (OSA) is a common disorder with major neurocognitive and cardiovascular sequelae. The treatment of symptomatic patients with mild OSA remains controversial given that adherence to positive airway pressure (PAP) has historically been suboptimal. With this notion in mind, we assessed a daily transoral neuromuscular electrical stimulation (NMES) device for individuals with mild OSA.
Methods The sample represents a subset of participants with a baseline AHI 5-14.9 events/hour, drawn from a parent study which also included participants with primary snoring. Outcome measures for the current study included changes in apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and snoring levels before and after use of the NMES.
Results Among 65 participants (68% men) with median age of 49 years (range 24 to 79) and median BMI of 27.7 kg/m(2) (range 20 to 34), the NMES device was used daily for 6 weeks. We observed a significant improvement in the AHI from 10.2 to 6.8 events/hour among all participants and from 10.4 to 5.0 events/h among responders. Statistically significant improvements in the ESS, PSQI, objectively measured snoring, and bed partner-reported snoring were observed. Adherence among all participants was 85%.
Discussion This NMES device has the benefit of being a treatment modality of daytime therapy which confers a high level of tolerability and patient acceptance. It alleviates the need for an in situ device during sleep and leads to improvements in OSA severity, snoring, and subjective sleep metrics, potentially crucial in mild OSA. Further studies are needed to define which individuals may benefit most from the device across the wider spectrum of OSA severity and assess long-term therapeutic outcomes.
Filiaciones:
Nokes B:
Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92121, USA.
VA San Diego Healthcare System, San Diego, CA, USA.
Baptista PM:
Otorhinolaryngology Clinical Consultant, Clinica Universidad de Navarra, Pamplona, Spain
:
Médico Especialista en Otorrinolaringología Y Cirugía de Cabeza Y Cuello, Hospital Universitario Doctor Peset, Valencia, Spain
:
Médico Especialista en Otorrinolaringología Y Cirugía de Cabeza Y Cuello, Hospital Universitario Doctor Peset, Valencia, Spain
Fernandez S:
Otorhinolaryngology Clinical Consultant, Clinica Universidad de Navarra, Pamplona, Spain
Kotecha B:
Queens Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, UK
Wong PY:
Queens Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, UK
Zhang H:
Queens Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, UK
Hassaan A:
Queens Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, UK
Malhotra A:
Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92121, USA
Green Published, hybrid
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