A novel intraoral neuromuscular stimulation device for treating sleep-disordered breathing.
Level 4 - case-series / case-control
Uncontrolled prospective before-and-after cohort without a sham or control group
PubMed 33772397 · doi:10.1007/s11325-021-02355-7
What was done
A prospective single-arm cohort study evaluated the efficacy of a daytime intraoral neuromuscular electrical stimulation device used for 20 minutes once daily over 6 weeks to tone tongue musculature in 70 adults with primary snoring and mild obstructive sleep apnea (OSA). Respiratory parameters and snoring were objectively measured using two consecutive nights of WatchPAT home sleep testing before and after treatment. Secondary outcomes included partner- and patient-reported snoring visual analogue scale scores, the Epworth Sleepiness Scale, and quality of life metrics.
What was found
Objective snoring reduction occurred in 95% of participants, with an average snoring time reduction of 48%. Partner-reported snoring scores similarly improved in 95% of patients, with an average reduction of 40%. In a subset of 38 patients with mild OSA, the apnea-hypopnea index decreased from 9.8 to 4.7 events per hour (a 52% reduction), the oxygen desaturation index dropped from 7.8 to 4.3 events per hour (a 45% reduction), and Epworth Sleepiness Scale scores improved from 9.0 to 5.1. Reported adverse effects were minimal.
Why it matters
Daytime intraoral neuromuscular stimulation provides an alternative treatment option for primary snoring and mild OSA that eliminates the need for nighttime oral appliances or positive airway pressure masks.
Limits
The study lacked a randomized or sham-controlled comparison group, leaving results vulnerable to placebo effects and regression to the mean. The sample size was modest (70 total, 38 with mild OSA), follow-up was limited to 6 weeks with no long-term adherence or durability data, and sleep testing relied on peripheral arterial tonometry rather than attended polysomnography.
Cited by
- supports Daytime intraoral neuromuscular electrical stimulation of the tongue (such as eXciteOSA) improves upper airway muscle tone during sleep to reduce mild obstructive sleep apnea and snoring.