Upper Airway Stimulation in Patients with Obstructive Sleep Apnea: Long-Term Surgical Success, Respiratory Outcomes, and Patient Experience

Abstract

Introduction Upper airway stimulation (UAS) with electric activation of the hypoglossal nerve has emerged as a promising treatment for patients with moderate-to-severe obstructive sleep apnea. Objective To retrospectively analyze objective and subjective outcome measures after long-term follow-up in obstructive sleep apnea patients receiving upper airway stimulation. Methods An observational retrospective single-center cohort study including a consecutive series of patients diagnosed with obstructive sleep apnea receiving upper airway stimulation. Results Twenty-five patients were included. The total median apnea-hypopnea index (AHI) significantly decreased from 37.4 to 8.7 events per hour at the 12-month follow-up (p < 0.001). The surgical success rate was 96%. Adverse events were reported by 28% of the patients. Conclusion Upper airway stimulation is an effective and safe treatment for obstructive sleep apnea in patients with continuous positive airway pressure (CPAP) failure or intolerance. However, it is possible that the existing in and exclusion criteria for UAS therapy in the Netherlands have positively influenced our results.

Hypoglossal Nerve Stimulation Effects on Obstructive Sleep Apnea Over Time: A Systematic Review and Meta‐analysis

“…HGSrelated adverse effects include procedure-related adverse events (postoperative discomfort related to incisions, hematoma, seroma, temporary tongue weakness, headache, other postoperative symptoms, infection) and therapy-related events (discomfort due to electrical It can be classified as stim, tongue abrasion, dry mouth, mechanical pain associated with the presence of the device, temporary device usability or functionality complaint, other acute symptoms). 63,[70][71][72] The most common procedure-related events were numbness/pain at the incision sites and the most common therapy-related events were tongue abrasions by the movement of the tongue over the mandibular dentition. Among these, tongue abrasion was analyzed as an adverse effect in most studies and was included in the statistical analysis of this study because it could be measured objectively through examination by a clinician.…”

“…Pretreatment measurements were defined as polysomnography outcomes and quality of life scores obtained before HGS. Outcomes analyzed during the 12‐month postoperative period included polysomnography parameters and disease‐specific quality of life scores 18‐63 . Comparisons between pretreatment and posttreatment values were analyzed during the follow‐up period.…”