Sleep Disorders

Hypoglossal Nerve Stimulation and Patient Reported Outcomes (N = 199)

2016 – 2019

Upper airway stimulation (UAS) is increasingly being used for obstructive sleep apnea (OSA) treatment; however, data comparing changes in patient reported outcomes (PROs) in response to positive airway pressure (PAP) vs UAS are limited. UAS and PAP groups were frequency matched by 1:3 on age, sex, body mass index (BMI) and Apnea-Hypopnea Index (AHI, category 15–30, > 30). Linear mixed models assessed the difference of change in Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Patient Health Questionnaire (PHQ9), and Insomnia Severity Index (ISI) measures on matched strata of UAS vs PAP groups with adjustment of baseline and matching factors.

ESS = Epworth Sleepiness Scale, FOSQ = Functional Outcomes of Sleep Questionnaire, ISI = Insomnia Severity Index, PAP = positive airway pressure, PHQ9 = Patient Health Questionnaire, UAS = upper airway stimulation

ESS in PAP (N = 199) reduced by -2.63 (-3.38 to -1.88) and in UAS (N = 56) reduced by -2.22 (-3.34 to -1.10), with a mean difference of 0.41 (-0.70 to 1.52). FOSQ in PAP (N = 188) showed a change of 1.38 (0.99 to 1.78) and in UAS (N = 49) a change of -1.82 (1.17 to 2.46), with a mean difference of 0.43 (-0.23 to 1.09). PHQ9 in PAP (N = 185) showed a significant change of -2.24 (-3.0 to 1.47) and in UAS (N = 45) a change of -3.75 (-5.07 to -2.42), with a mean difference of -1.51 (-2.93 to -0.089). ISI in PAP (N = 193) showed a significant change of -3.20 (-4.3 to -2.02) and in UAS (N = 47) a change of -4.83 (-6.77 to -2.90), with a mean difference of -1.63 (-3.62 to 0.37). Similar improvements in PROs were observed in both UAS and PAP patient groups; however, UAS appeared to confer greater benefit in depressive symptoms relative to PAP. Randomized clinical trials should be designed to confirm these findings.