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Long-term outcomes of hypoglossal nerve stimulation for obstructive sleep apnea

JAMA Otolaryngology—Head & Neck Surgery Nov 17, 2021

Pascoe M, Wang L, Aylor J, et al. - Hypoglossal nerve stimulation (HNS) for obstructive sleep apnea (OSA) results in sustained improvements with respect to insomnia, sleepiness, quality of life, and depressive symptoms and these improvements are comparable to those associated with positive airway pressure (PAP) therapy.

  • A retrospective cohort study of 85 OSA patients receiving HNS (mean [SD] age, 62.8 [9.5] years) vs 217 matched patients receiving PAP (mean [SD] age, 62.1 [9.9] years).

  • Patient Health Questionnaire-9 (PHQ-9; depression) scores improved significantly for HNS vs PAP (least square means, −4.06 vs −2.58; mean difference, −1.48) with comparable improvements in Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), and Insomnia Severity Index (ISI) scores.

  • In the HNS group vs PAP group, clinically meaningful differences were evident for ESS scores in 64.6% vs 54.5% of patients, for FOSQ scores (59.2% vs 30.9%), for PHQ-9 scores (29.2% vs 24.4%), and also for ISI scores (46.9% vs 36.4%).

  • Following HNS, a consistent as well as sustained improvement of patient-reported outcomes was noted during a 12-month observation span with comparable/increased improvement vs PAP at 3 months in 217 patients.

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