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. 2017 Jun 23;3(2):79-84.
doi: 10.1016/j.wjorl.2017.05.001. eCollection 2017 Jun.

OSA treatment history in an upper airway stimulation trial cohort

Ryan J Soose  1 , Tapan A Padhya  2 , M Boyd Gillespie  3 , Oleg Froymovich  4 , Ho-Sheng Lin  5 , B Tucker Woodson  6 ; STAR Trial Investigators
Affiliations

OSA treatment history in an upper airway stimulation trial cohort

Ryan J Soose et al. World J Otorhinolaryngol Head Neck Surg. .

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.

Keywords: CPAP failure; Hypoglossal nerve stimulation; Obstructive sleep apnea; STAR trial; Upper airway stimulation.

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Figures

Fig. 1
Fig. 1
Forty-seven percent discontinued CPAP prior to enrollment and 43% were still attempting CPAP but struggling with inadequate adherence. Of the 835 participants with complete CPAP data available, 28% abandoned therapy within a year of starting it.
Fig. 2
Fig. 2
Of the 171 participants who attempted oral appliance (OA) therapy, 63% discontinued OA prior to enrollment whereas 37% were still attempting it with inadequate adherence or effectiveness. Abandonment rates were highest in the first year.
See this image and copyright information in PMC

References

    1. Young T., Palta M., Dempsey J., Peppard P.E., Nieto F.J., Hla K.M. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study. WMJ. 2009;108:246–249. - PMC - PubMed
    1. Weaver T.E., Maislin G., Dinges D.F. Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep. 2007;30:711–719. - PMC - PubMed
    1. McDaid C., Duree K.H., Griffin S.C. A systematic review of continuous positive airway pressure for obstructive sleep apnoea-hypopnoea syndrome. Sleep Med Rev. 2009;13:427–436. - PubMed
    1. Richard W., Venker J., den Herder C. Acceptance and long-term compliance of nCPAP in obstructive sleep apnea. Eur Arch Otorhinolaryngol. 2007;264:1081–1086. - PubMed
    1. Kushida C.A., Nichols D.A., Holmes T.H. Effects of continuous positive airway pressure on neurocognitive function in obstructive sleep apnea patients: the Apnea Positive Pressure Long-term Efficacy Study (APPLES) Sleep. 2012;36:1593–1602. - PMC - PubMed