Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in Spain: Implementation Strategy and Early Results in a Tertiary Care Center

Baptista, Peter; Prieto-Matos, Carlos; Alegre-Esteban, Manuel; Urrestarazu-Bolumburu, Elena; Navarrete, Juan Alcade

doi:10.1007/s12070-021-02503-1

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…92% considered the treatment to be superior to PAP ventilation used prior to stimulation therapy. The same questionnaire was used by Baptista et al in a cohort of patients treated in Spain, for which comparable experiences were reported with values of 86%, 89%, 89% and 91%, respectively [ 41 ].…”

Section: Resultsmentioning

confidence: 99%

Patient-reported outcomes with hypoglossal nerve stimulation for treatment of obstructive sleep apnea: a systematic review and meta-analysis

Braun,

Stoerzel,

Wollny

et al. 2023

Eur Arch Otorhinolaryngol

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Introduction Hypoglossal nerve stimulation (HNS) has recently been introduced as an alternative treatment for patients with OSA. A large number of studies have demonstrated substantial changes in OSA with this therapy by reducing respiratory events and improving symptoms such as daytime sleepiness and quality of life. The objective of this review was to conduct a systematic review and meta-analysis to evaluate patient-reported outcomes and experience with HNS therapy. Methods A systematic literature search of MEDLINE, Cochrane, and Web of Science was performed to identify randomized controlled and observational studies reporting subjective outcomes with different HNS systems in patients with OSA. Abstracts of 406 articles were screened and a subset of 55 articles were reviewed for eligibility. Risk of bias was assessed using the ROBINS-I tool. Meta-analysis using RevMan was performed when > 2 studies were identified that reported data on a specific outcome. Results Thirty-four publications reporting data on 3785 patients with a mean follow-up of 11.8 ± 12.2 months were identified and included in the meta-analysis. The analysis revealed a pooled effect of 4.59 points improvement in daytime sleepiness as measured by the ESS questionnaire (Z = 42.82, p < .001), 2.84 points improvement in daytime functioning as measured by the FOSQ score (Z = 28.38, p < .001), and 1.77 points improvement in sleep quality as measured by the PSQI questionnaire (Z = 2.53, p = .010). Patient-reported experience was consistently positive and revealed additional relevant aspects from this perspective. Conclusion HNS therapy significantly improves quality of life in patients with OSA and reliably produces clinically meaningful effects on daytime sleepiness, daytime functioning, and sleep quality. Treatment regularly meets or exceeds the minimum clinically important differences defined for the respective instruments. Additional research is needed to further investigate effects on quality of life beyond improvements in daytime sleepiness and daytime functioning.

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Section: Resultsmentioning

confidence: 99%

Patient-reported outcomes with hypoglossal nerve stimulation for treatment of obstructive sleep apnea: a systematic review and meta-analysis

Braun,

Stoerzel,

Wollny

et al. 2023

Eur Arch Otorhinolaryngol

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“…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.…”

Section: Methodsmentioning

confidence: 99%

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

Kim,

Han

et al. 2023

Otolaryngol.--head neck surg.

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ObjectivesThis study aimed to determine the efficacy of hypoglossal nerve stimulation (HGS) in the treatment of obstructive sleep apnea.Data SourcesPubMed, Cochrane database, Embase, Web of Science, SCOPUS, and Google Scholar.Review MethodsFive databases were reviewed to identify relevant studies that measured polysomnography parameters such as the apnea‐hypopnea index (AHI) and oxygen desaturation index, as well as quality of life and functional outcomes of sleep questionnaire scores, before and after HGS.ResultsIn total, 44 studies involving 8670 patients met the inclusion criteria. At 12 months after treatment, approximately 47%, 72%, and 82% of patients achieved AHI values of <5, < 10, and <15, respectively. The reported clinical success rates according to Sher criteria were 80% within 12 months and 73% between 12 and 36 months. While the favorable effects exhibited a gradual reduction up to 12 months postimplantation, they generally maintained a consistent level between the 12th and 36th months, as assessed by AHI < 5, <15, and success rate according to Sher criteria.ConclusionHGS can enhance quality of life scores and polysomnography outcomes in obstructive sleep apnea patients. Although the positive effects gradually decreased until 12 months after implantation, they generally remained consistent between 12 and 36 months.

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“…Although shown to be safe and effective in clinical practice [15][16][17][18][19], our health system does not yet finance the device, and the patient must bear the cost of the device.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Impact of Hypoglossal Nerve Stimulation with Inspire® Device in Patients with Obstructive Sleep Apnea Intolerant to Continuous Positive Airway Pressure Therapy

Baptista¹,

Frisco

Urrestarazu³

et al. 2022

Life

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Patients with obstructive sleep apnea (OSA) that do not tolerate/accept continuous positive airway pressure (CPAP) are candidates for surgical alternatives. Hypoglossal nerve stimulation (HNS) through the implantation of the Inspire®® device constitutes a minimally invasive operative option. The main objective of this study is to estimate, under real-world clinical practice conditions, the 3-month impact on the quality of life (IQoL) of the HNS in patients with moderate/severe OSA who do not tolerate or accept CPAP, compared to patients who did not receive HNS. As a baseline, the unadjusted EuroQol utility index was 0.764 (SD:0.190) in the intervention group (IGr) and 0.733 (SD:0.205) in the control group (CGr); three months later, the indexes were 0.935 (SD: 0.101) and 0.727 (SD:0.200), respectively. The positive impact on quality of life was estimated to be +0.177 (95% CI: 0.044–0.310; p = 0.010. All dimensions in the IGr improved compared to CGr, especially for usual activities (p < 0.001) and anxiety/depression (p > 0.001). At the end of the follow-up, there was no significant difference in the quality of life between the general Spanish population and the IGr (difference: 0.012; CI95%: −0.03 to −0.057; p = 0.0578) for the same age range; however, there was a difference concerning the CGr (difference: −0.196; CI95%: −0.257 to −0.135; p < 0.001). In conclusion, patients with moderate/severe OSA implanted with the Inspire®® device showed a positive IQoL.

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Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in Spain: Implementation Strategy and Early Results in a Tertiary Care Center

Cited by 4 publications

References 22 publications

Patient-reported outcomes with hypoglossal nerve stimulation for treatment of obstructive sleep apnea: a systematic review and meta-analysis

Patient-reported outcomes with hypoglossal nerve stimulation for treatment of obstructive sleep apnea: a systematic review and meta-analysis

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

Quality of Life Impact of Hypoglossal Nerve Stimulation with Inspire® Device in Patients with Obstructive Sleep Apnea Intolerant to Continuous Positive Airway Pressure Therapy

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