Baptista Peter, Di Frisco I Madeleine, Urrestarazu Elena, Alcalde Juan, Alegre Manuel, Sanchez Isabel, O'Connor-Reina Carlos, Plaza Guillermo
Otorhinolaryngology Department, University Clinic of Navarra, 31007 Pamplona, Spain.
Pulmonology Department, Clínica Universidad de Navarra, 31007 Pamplona, Spain.
Life (Basel). 2022 Oct 28;12(11):1737. doi: 10.3390/life12111737.
Patients with obstructive sleep apnea (OSA) that do not tolerate/accept continuous positive airway pressure (CPAP) are candidates for surgical alternatives. Hypoglossal nerve stimulation (HNS) through the implantation of the Inspire® device constitutes a minimally invasive operative option. The main objective of this study is to estimate, under real-world clinical practice conditions, the 3-month impact on the quality of life (IQoL) of the HNS in patients with moderate/severe OSA who do not tolerate or accept CPAP, compared to patients who did not receive HNS. As a baseline, the unadjusted EuroQol utility index was 0.764 (SD:0.190) in the intervention group (IGr) and 0.733 (SD:0.205) in the control group (CGr); three months later, the indexes were 0.935 (SD: 0.101) and 0.727 (SD:0.200), respectively. The positive impact on quality of life was estimated to be +0.177 (95% CI: 0.044−0.310; p = 0.010). All dimensions in the IGr improved compared to CGr, especially for usual activities (p < 0.001) and anxiety/depression (p > 0.001). At the end of the follow-up, there was no significant difference in the quality of life between the general Spanish population and the IGr (difference: 0.012; CI95%: −0.03 to −0.057; p = 0.0578) for the same age range; however, there was a difference concerning the CGr (difference: −0.196; CI95%: −0.257 to −0.135; p < 0.001). In conclusion, patients with moderate/severe OSA implanted with the Inspire® device showed a positive IQoL.
不耐受/不接受持续气道正压通气(CPAP)的阻塞性睡眠呼吸暂停(OSA)患者可选择手术治疗。通过植入Inspire®设备进行舌下神经刺激(HNS)是一种微创手术选择。本研究的主要目的是在真实世界的临床实践条件下,评估与未接受HNS的患者相比,HNS对不耐受或不接受CPAP的中重度OSA患者3个月生活质量(IQoL)的影响。作为基线,干预组(IGr)的未调整欧洲五维度健康量表效用指数为0.764(标准差:0.190),对照组(CGr)为0.733(标准差:0.205);三个月后,指数分别为0.935(标准差:0.101)和0.727(标准差:0.200)。对生活质量的积极影响估计为+0.177(95%置信区间:0.044 - 0.310;p = 0.010)。与CGr相比,IGr的所有维度均有所改善,尤其是日常活动(p < 0.001)和焦虑/抑郁(p > 0.001)。随访结束时,在相同年龄范围内,西班牙普通人群与IGr的生活质量无显著差异(差异:0.012;95%置信区间:-0.03至-0.057;p = 0.0578);然而,与CGr存在差异(差异:-0.196;95%置信区间:-0.257至-0.135;p < 0.001)。总之,植入Inspire®设备的中重度OSA患者显示出积极的IQoL。