Patient experience with upper airway stimulation in the treatment of obstructive sleep apnea
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Selective upper airway stimulation (sUAS) is a new treatment modality for patients with obstructive sleep apnea (OSA) and continuous positive airway pressure (CPAP) failure. The aim of this study was to analyze therapy adherence and to structure patient experience reports.
Patients from two German implantation centers were included. Besides demographic and OSA characteristics of that cohort, patients answered a questionnaire on subjective sensation of the stimulation, use of different functions, side effects, and an inventory for the description of the attitude towards sUAS. The use of the sUAS was evaluated as a read-out of the implanted system.
The overall apnea-hypopnea-index (AHI) of that 102 assessed patients reduced from initially 32.8/h to 12.6/h at the last available assessment. The responder rate was 75%. There was an objective therapy usage of 5.7 h and subjective reports of 6.8 nights per week. The attitude resulted in strong agreement towards the statement “UAS reduces the problems caused by my sleep apnea”. Information on sensing the stimulation and usage habits could be gathered such as that stimulation is only sensed by 67.9% of the patients upon waking in the morning and that 73.6% of the patients do not change the voltage in general.
This investigation on the sUAS therapy revealed a high adherence to the therapy. The AHI or daytime sleepiness do not have obvious influence on adherence. Patients expressed a positive attitude towards sUAS. These patient reports upon stimulation experiences are of great help to consult candidates for sUAS in future.
KeywordsHypoglossal nerve stimulation Sleep apnea Adherence Upper airway stimulation
The authors would like to express their gratitude to the study nurses and colleagues of the local sleep laboratories Sabrina Wenzel, Katharina Eckbauer, and Nicole Behn for their commitment in collecting and processing the necessary data for this study.
Compliance with ethical standards
Conflict of interest
Armin Steffen and Clemens Heiser are study investigators and received honoraria, travel and research support from Inspire Medical Systems. Katrin Hasselbacher and Benedikt Hofauer received travel expenses from Inspire Medical Systems. The article submitted is related to this relationship. Andreas Knopf received research support from Optima Pharmazeutische GmbH. The article submitted is not related to this relationship.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethikkommission, Fakultät für Medizin, Technical University Munich) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participant included in the study.
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