Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.
University and Department of Pharmacy Practice, Purdue University, USA; Department of Clinical Pharmacy, Mansoura University, Egypt.
Respir Med. 2024 Nov-Dec;234:107826. doi: 10.1016/j.rmed.2024.107826. Epub 2024 Oct 12.
This study aims to evaluate the efficacy of Apnex, Inspire, and ImThera hypoglossal nerve stimulation (HGNS) devices in changing the severity of obstructive sleep apnea (OSA).
ology: A systematic search was conducted across the databases to collect baseline and postoperative outcome measures. Articles were then filtered and data from post-filtration was extracted. The efficacy of each device was assessed individually, and the reported outcomes were analyzed at short-term (≤1 year) and long-term (>1 year) intervals.
A total of 30 papers were included; 26 were single-arm studies encompassing 549 middle-aged overweight patients. Four RCTs included 273 participants. Results show that HGNS is an effective and safe treatment option. The Inspire device significantly improved, reducing the apnea-hypopnea index (AHI) by -20.14 events/h in the short term and -15.91 events/h in the long term. It also decreased the oxygen desaturation index (ODI) by -14.16 events/h (short term) and -12.95 events/h (long term). Patient-reported outcomes showed decreased Epworth Sleepiness Scale (ESS) scores by -5.02 (short term) and -4.90 (long term) and improved Functional Outcomes of Sleep Questionnaire (FOSQ) scores by 3.58 (short term) and 3.28 (long term). The Apnex and the ImThera devices featured similar improvements but to a lesser extent.
Hypoglossal nerve stimulation is a safe and effective treatment for patients with OSA, exhibiting high adherence and satisfaction rates. However, it is important to note the potential for refining selection criteria to include a wider spectrum of patients with OSA.
本研究旨在评估 Apnex、Inspire 和 ImThera 舌下神经刺激（HGNS）设备在改变阻塞性睡眠呼吸暂停（OSA）严重程度方面的疗效。
研究设计：系统检索数据库以收集基线和术后结果测量数据。然后筛选文章并提取过滤后的数据。单独评估每种设备的疗效，并在短期（≤1 年）和长期（>1 年）间隔分析报告的结果。
共纳入 30 篇论文；26 篇为单臂研究，共纳入 549 名中年超重患者。4 项 RCT 纳入 273 名参与者。结果表明，HGNS 是一种有效且安全的治疗选择。Inspire 设备在短期内显著改善，使呼吸暂停-低通气指数（AHI）降低 20.14 次/小时，长期降低 15.91 次/小时。它还使氧减饱和度指数（ODI）降低 14.16 次/小时（短期）和 12.95 次/小时（长期）。患者报告的结果显示，Epworth 睡眠量表（ESS）评分降低了-5.02（短期）和-4.90（长期），功能睡眠问卷（FOSQ）评分提高了 3.58（短期）和 3.28（长期）。Apnex 和 ImThera 设备的改善程度相似，但程度较轻。
舌下神经刺激是 OSA 患者的一种安全有效的治疗方法，具有较高的依从性和满意度。然而，需要注意的是，可能需要进一步完善选择标准，以纳入更广泛的 OSA 患者。
