The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea-A Literature Review.
The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea-A Literature Review.
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DOI：
10.3390/ijerph18041642
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发表时间：
2021-02-09
影响因子：
--
通讯作者：
Parthasarathy S
中科院分区：
文献类型：
--
作者：
Mashaqi S;Patel SI;Combs D;Estep L;Helmick S;Machamer J;Parthasarathy S
阻塞性睡眠呼吸暂停 (OSA) 是一种常见的睡眠障碍，影响所有年龄段，并与许多共病疾病（尤其是心血管疾病）相关。持续气道正压通气 (CPAP) 是治疗 OSA 的金标准。然而，对 PAP 治疗的依从性一直是一个重大挑战，估计依从性在 20% 到 80% 之间。如果用于合适的患者，下颌前移装置 (MAD) 是一个很好的替代选择。 MAD 对轻度和中度 OSA 最有效，但对重度 OSA 无效。手术选择是侵入性的，不适合严重的 OSA，并且会带来疼痛和较长的愈合时间。舌下神经刺激 (HGNS) 或上气道刺激 (UAS) 是一种治疗不能耐受 CPAP 治疗的中度和重度 OSA 患者的新疗法。我们审查了 MEDLINE (PubMed) 数据库。搜索过程产生了 303 篇文章； 31 例符合纳入和排除标准并被纳入。我们的结论是，对于不能耐受 CPAP 治疗的中度和重度 OSA 患者，舌下神经刺激是一种非常有效且新颖的替代疗法。 HGNS 的依从性优于 CPAP。然而，需要更多的开发来确保最高的安全性。
Obstructive sleep apnea (OSA) is a common sleep disorder that affects all age groups and is associated with many co-morbid diseases (especially cardiovascular diseases). Continuous positive airway pressure (CPAP) is the gold standard for treating OSA. However, adherence to PAP therapy has been a major challenge with an estimated adherence between 20% and 80%. Mandibular advancement devices (MAD) are a good alternative option if used in the appropriate patient. MAD are most effective in mild and moderate OSA but not severe OSA. Surgical options are invasive, not appropriate for severe OSA, and associated with pain and long healing time. Hypoglossal nerve stimulation (HGNS), or upper airway stimulation (UAS), is a novel therapy in treating moderate and severe degrees of OSA in patients who cannot tolerate CPAP therapy. We reviewed the MEDLINE (PubMed) database. The search process yielded 303 articles; 31 met the inclusion and exclusion criteria and were included. We concluded that hypoglossal nerve stimulation is a very effective and novel alternative therapy for moderate and severe OSA in patients who cannot tolerate CPAP therapy. Adherence to HGNS is superior to CPAP. However, more developments are needed to ensure the highest safety profile.
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