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2015 ; 7
(8
): 1286-97
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Emerging technology: electrical stimulation in obstructive sleep apnoea
#MMPMID26380757
Pengo MF
; Steier J
J Thorac Dis
2015[Aug]; 7
(8
): 1286-97
PMID26380757
show ga
Electrical stimulation (ES) of the upper airway (UAW) dilator muscles for
patients with obstructive sleep apnoea (OSA) has been used for several decades,
but in recent years research in this field has experienced a renaissance; the
results of several studies have triggered a steady rise in the interest in this
topic. Prospective trials, although still lacking a sham-controlled and
randomised approach, have revealed the potential of ES. Hypoglossal nerve
stimulation (HNS) leads to a significant reduction in the apnoea-hypopnoea index
and the oxygen desaturation index (ODI). There are similar results published from
feasibility studies for transcutaneous ES. A limitation of HNS remains the
invasive procedure, the costs involved and severe adverse events, while for the
non-invasive approach complications are rare and limited. The limiting step for
transcutaneous ES is to deliver a sufficient current without causing arousal from
sleep. Despite the progress up to date, numerous variables including optimal
stimulation settings, different devices and procedures remain to be further
defined for the invasive and the non-invasive method. Further studies are
required to identify which patients respond to this treatment. ES of the UAW
dilator muscles in OSA has the potential to develop into a clinical alternative
to continuous positive airway pressure (CPAP) therapy. It could benefit selected
patients who fail standard therapy due to poor long-term compliance. It is likely
that international societies will need to review and update their existing
guidance on the use of ES in OSA.