Results of electromyostimulation therapy in obstructive sleep apnea

Innovative muscle stimulation techniques have become alternatives for therapy of obstructive sleep apnea syndrome breathing disorders. In group I, an individually shaped mouth floor electrode (IME) and in group II, an individually adaptable multi-point electrode (MPE) on a silicone carrier has been used for electromyostimulation (EMS) therapy in patients with obstructive sleep apnea. The enoral-cutaneous EMS was carried out with the low-frequency stimulation apparatus I-pulse over a period of 8 weeks, two times daily for 30 min during daytime hours only. In group III, the patients used EMS therapy for half a year continuously. Before and after stimulation treatment, three-dimensional volumetric sonographical measurement of the geniohyoid muscle was carried out. All patients (n = 14) totally applied the EMS therapy. Under IME and MPE application after 4 weeks of EMS therapy, a median volume increase of 19.6% (minimum 9.7%, maximum 27.9%) was registered, the median after 8 weeks IME was 27.6% and in MPE 24.0%). No significant difference (analysis of variance type: P > 0.05) between electrodes could be found. In all groups, a reduction of the muscle length of 4.7% was proved. In groups I and II after 26 weeks, the volume was near baseline before stimulation (+4.3%). In the third group, the increase of volume persisted (+29.4%) over the observation period of 12-26 weeks. Opposed to established stimulation techniques, a threefold effectiveness enhancement could be verified by using both individually adaptable electrodes. The EMS therapy should be carried out as continuous long-term therapy or as interval therapy.