Upper airway stimulation for obstructive sleep apnea : self-reported outcomes at 24 months
Faculty of Medicine and Health Sciences
Journal of clinical sleep medicine
, p. 43-48
University of Antwerp
Objectives: To evaluate the long-term (24-month) effect of cranial nerve upper airway stimulation (UAS) therapy on patient-centered obstructive sleep apnea (OSA) outcome measures. Methods: Prospective, multicenter, cohort study of 126 moderate-to-severe OSA patients who had difficulty adhering to positive pressure therapy and received the surgically-implanted UAS system. Outcomes were measured at baseline and postoperatively at 12 months and 24 months, and included self- and bedpartner-report of snoring intensity, Epworth Sleepiness Scale (ESS), and Functional Outcomes of Sleep Questionnaire (FOSQ). Additional analysis included FOSQ subscales, FOSQ-10, and treatment effect size. Results: Significant improvement in mean FOSQ score was observed from baseline (14.3) to 12 months (17.3), and the effect was maintained at 24 months (17.2). Similar improvements and maintenance of effect were seen with all FOSQ subscales and FOSQ-10. Subjective daytime sleepiness, as measured by mean ESS, improved significantly from baseline (11.6) to 12 months (7.0) and 24 months (7.1). Self-reported snoring severity showed increased percentage of no or soft snoring from 22% at baseline to 88% at 12 months and 91% at 24 months. UAS demonstrated large effect size (> 0.8) at 12 and 24 months for overall ESS and FOSQ measures, and the effect size compared favorably to previously published effect size with other sleep apnea treatments. Conclusions: In a properly selected group of patients with moderate-to-severe OSA, hypoglossal cranial nerve stimulation therapy can provide significant improvement in important sleep-related quality of life outcome measures and the effect is maintained across a 2-year follow-up.