Neuromuscular electrical stimulation for obstructive sleep apnoea: comparing adherence to active and sham therapy.
Level 2 - randomized trial
Randomized, sham-controlled, double-blind clinical trial
PubMed 38152084 · doi:10.1183/23120541.00474-2023
What was done
A randomized, sham-controlled, double-blind trial evaluated 40 patients with mild obstructive sleep apnoea (OSA) assigned to 6 weeks of either high-intensity (active) or low-intensity (sham) daytime neuromuscular electrical stimulation (NMES) of the tongue. The primary endpoint was adherence to therapy. Exploratory endpoints included changes in the respiratory event index (REI) and daytime sleepiness via the Epworth Sleepiness Scale (ESS).
What was found
More than 90% of participants in both the active and sham arms adhered to the therapy. Exploratory analyses showed a 32.7% reduction in REI (95% CI 15.5–49.9%) with active NMES, with no significant change in the sham group. Improvements were greater in the supine than non-supine position. Both apnoea and hypopnoea indices improved, and ESS scores improved with active but not sham NMES.
Why it matters
Daytime NMES of the tongue demonstrates high patient adherence and may provide a viable alternative treatment to improve breathing indices and daytime sleepiness in mild OSA.
Limits
The sample size was small (40 participants) with a short 6-week duration. Efficacy metrics (REI, apnoea/hypopnoea indices, ESS) were exploratory rather than primary outcomes. The study was restricted to mild OSA, precluding conclusions about moderate-to-severe disease or CPAP-intolerant populations.
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.