Research Paper
OSA treatment history in an upper airway stimulation trial cohort
World Journal of Otorhinolaryngology-Head and Neck Surgery, 2017,03(02) : 79-84. DOI: 10.3760/cma.j.issn.2095-8811.2017.02.103
Abstract
Objectives:

Analyze the obstructive sleep apnea (OSA) treatment history in a group of participants who enrolled in a hypoglossal nerve stimulation trial.

Methods:

Moderate-severe OSA patients with difficulty adhering to CPAP presented for enrollment in a multicenter trial. Self-reported history on prior OSA medical therapy was collected at enrollment, including OSA diagnosis date, CPAP start and stop dates, oral appliance trial, and reasons for discontinuation or non-adherence.

Results:

The cohort consisted of 929 participants, 83% male, with a mean age (53.9 ± 10.5) years. Ninety percent (n = 835) had complete CPAP information including 47% (n = 435) who discontinued therapy prior to enrollment and 43% (n = 400) who were still attempting CPAP but had inadequate adherence. Abandonment rates were 60% at 1-year, 73% at 3- years, and 86% at 5-years. Oral appliance therapy was attempted by 171 patients for mean (1.8 ± 2.3) years, with 81% abandonment at 1 year, 89% at 3-years, and 94% at 5-years.

Conclusions:

In this CPAP-refractory cohort, high rates of CPAP abandonment were reported in the first several years with approximately half of the participants not receiving any treatment despite being diagnosed for >5 years. Close clinical follow-up and consideration of alternative treatment options is indicated in all OSA patients in order to ensure adequate longitudinal care.

Cite as: Soose Ryan J., Padhya Tapan A., Gillespie M. Boyd, et al.  OSA treatment history in an upper airway stimulation trial cohort [J]. World Journal of Otorhinolaryngology-Head and Neck Surgery,2017,03(02): 79-84. DOI: 10.3760/cma.j.issn.2095-8811.2017.02.103
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Introduction

Moderate-to-severe obstructive sleep apnea (OSA) has been associated with increased vascular and metabolic health risks as well as patient reported symptoms that include excessive daytime sleepiness, neurocognitive dysfunction, and impaired quality of life.1 Continuous positive airway pressure (CPAP) therapy is the most thoroughly studied therapy with data supporting its safety and effectiveness in accomplishing treatment goals including reduction of cardiovascular risk and improvement in alertness, cognitive function, and quality of life measures.2,3 CPAP therefore remains the standard first-line therapy for moderate to severe OSA.

 
 
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Keyword
STAR trial
Hypoglossal nerve stimulation
Upper airway stimulation
obstructive sleep apnea
CPAP failure