Upper Airway Stimulation vs Positive Airway Pressure Impact on BP and Sleepiness Symptoms in OSA

Walia, Harneet K.; Thompson, Nicolas R.; Strohl, Kingman P.; Faulx, Michael D.; Waters, Tina; Kominsky, Alan; Foldvary‐Schaefer, Nancy; Mehra, Reena

doi:10.1016/j.chest.2019.06.020

Cited by 26 publications

(22 citation statements)

References 31 publications

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“…There were no significant changes in REM sleep [56]. Comparing the effects of CPAP and UAS on blood pressure and sleepiness symptoms, CPAP yielded greater improvements in blood pressure, while UAS led to greater improvements in sleepiness symptoms [57]. Recent studies have shown that OSA patients with an elevated BMI or those older than 65 years can be successfully treated with UAS [58,59].…”

Section: Treatment Outcomesmentioning

confidence: 91%

Maxillomandibular Advancement and Upper Airway Stimulation: Extrapharyngeal Surgery for Obstructive Sleep Apnea

Ibrahim

Riley

et al. 2020

Clin Exp Otorhinolaryngol

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There are many ways to categorize surgery for obstructive sleep apnea (OSA), one of which is to distinguish between intrapharyngeal and extrapharyngeal procedures. While the general otolaryngologist treating OSA is familiar with intrapharyngeal procedures, such as uvulopalatopharyngoplasty and tongue base reduction, extrapharyngeal sleep operations such as maxillomandibular advancement (MMA) and upper airway stimulation (UAS) have evolved rapidly in the recent decade and deserve a dedicated review. MMA and UAS have both shown predictable high success rates with low morbidity. Each approach has unique strengths and limitations, and for the most complex of OSA patients, the two in combination complement each other. Extrapharyngeal airway operations are critical for achieving favorable outcomes for sleep surgeons.

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Section: Treatment Outcomesmentioning

confidence: 91%

Maxillomandibular Advancement and Upper Airway Stimulation: Extrapharyngeal Surgery for Obstructive Sleep Apnea

Ibrahim

Riley

et al. 2020

Clin Exp Otorhinolaryngol

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“…A meta-analysis among 837 OSA patients (517 patients were treated by positive airway pressure, 320 patients with upper airway stimulation implantation) showed that positive airway pressure had more improvement in diastolic blood pressure compared with upper airway stimulation (3.7 mm Hg vs. 2.8 mm Hg). The adherence of upper airway stimulation was better than positive airway pressure [118]. Outcome comparison of HGNS and conventional surgery UPPP in OSA patients showed that mean AHI reduction from 38.9 ± 12.5 to 4.5 ± 4.8 with HGNS and 40.3 ± 12.4 to 28.8 ± 25.4 with UPPP.…”

Section: Electrical Stimulationmentioning

confidence: 92%

Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review

Xia

2021

Sensors

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Obstructive sleep apnea (OSA), a common sleep disorder disease, affects millions of people. Without appropriate treatment, this disease can provoke several health-related risks including stroke and sudden death. A variety of treatments have been introduced to relieve OSA. The main present clinical treatments and undertaken research activities to improve the success rate of OSA were covered in this paper. Additionally, guidelines on choosing a suitable treatment based on scientific evidence and objective comparison were provided. This review paper specifically elaborated the clinically offered managements as well as the research activities to better treat OSA. We analyzed the methodology of each diagnostic and treatment method, the success rate, and the economic burden on the world. This review paper provided an evidence-based comparison of each treatment to guide patients and physicians, but there are some limitations that would affect the comparison result. Future research should consider the consistent follow-up period and a sufficient number of samples. With the development of implantable medical devices, hypoglossal nerve stimulation systems will be designed to be smart and miniature and one of the potential upcoming research topics. The transcutaneous electrical stimulation as a non-invasive potential treatment would be further investigated in a clinical setting. Meanwhile, no treatment can cure OSA due to the complicated etiology. To maximize the treatment success of OSA, a multidisciplinary and integrated management would be considered in the future.

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“…Of note, Walia et al . recently reported greater improvement in blood pressure with CPAP therapy as compared to HGNS . In contrast, the subjective improvement in sleepiness was greater with HGNS compared to CPAP, again suggesting a role for an individualized approach to OSA therapy. From the standpoint of pharmacology, several advances were reported in the past year.…”

Section: Obstructive Sleep Apnoeamentioning

confidence: 98%