Schiller-Frühwirth, I. and Kisser, A. (2016): Upper airway stimulation for moderate-to-severe sleep apnea. Decision Support Document 100.
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Obstructive sleep apnea is a sleep-related breathing disorder that is caused by a collapse of the upper airway due to insufficient muscular tone of the tongue and/or airway dilator muscles. Current standard therapy is the CPAP therapy, which is limited in its effectiveness due to poor compliance. A new functional therapy approach is the stimulation of the hypoglossal nerve (HNS) by an implantable device to restore the tone of the upper airway dilator muscles.
A systematic literature review yielded 2 RCTs and 7 single arm studies. One RCT showed a worsening of symptoms one week after withdrawal of the therapy, but only in a selected population of respondents to prior therapy. A second RCT did not show any significant differences between study groups 6 months after randomisation to HNS vs. sham stimulation.
Based on the current evidence, a reimbursement is not recommended for now, with a re-evaluation planned for 2018.
|Item Type:||Decision Support Document|
|Keywords:||Obstructive sleep apnea, hypoglossal nerve, electric stimulation|
|Subjects:||WB Practice of medicine > WB 300-962 Therapeutics|
W Health professions > W 100-275 Medical, dental and pharmaceutical service plans
WL Nervous system > WL 200-405 Central nervous system. Disorders. Therapeutics
WF Respiratory system
|Series Name:||Decision Support Document 100|
|Deposited on:||14 Jul 2016 23:51|
|Last Modified:||14 Jul 2016 23:51|
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