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Treating OSA: Current and emerging therapies beyond CPAP.
Geraldo Lorenzi-Filho1, Fernanda R Almeida2, Patrick J Strollo3
1Sleep Laboratory, Pulmonary Division, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Respirology (Carlton, Vic.)
|September 14, 2017
Summary
Continuous positive airway pressure (CPAP) is standard for obstructive sleep apnea (OSA), but adherence is low. Several non-CPAP therapies, including oral appliances and upper airway stimulation, offer effective alternatives for OSA management.
Area of Science:
- Sleep Medicine
- Respiratory Medicine
- Otolaryngology
Background:
- Continuous positive airway pressure (CPAP) is the primary treatment for moderate-to-severe obstructive sleep apnea (OSA).
- Limited patient adherence to CPAP necessitates exploration of alternative therapies.
- Oral appliances (OA) and other non-CPAP treatments are increasingly utilized for OSA management.
Purpose of the Study:
- To review the efficacy and effectiveness of various non-CPAP therapies for obstructive sleep apnea.
- To compare the outcomes of different treatment modalities for OSA.
- To provide an overview of available alternative treatments for patients with OSA.
Main Methods:
- Review of existing studies on non-CPAP therapies for OSA, including oral appliances, upper airway stimulation, oropharyngeal exercises, nasal EPAP, and the Winx device.
- Analysis of reported efficacy, effectiveness, adherence, and limitations of each therapy.
- Synthesis of data from systematic reviews and clinical trials.
Main Results:
- Oral appliance therapy shows similar effectiveness to CPAP in improving sleepiness and quality of life, despite lower objective efficacy.
- Upper airway stimulation (STAR study) demonstrated a 68% reduction in OSA severity.
- Oropharyngeal exercises and nasal EPAP showed significant reductions in OSA severity (30-40% and 53%, respectively).
- The Winx device offers potential therapeutic benefits for 30-40% of OSA patients.
Conclusions:
- Multiple non-CPAP therapies are available and effective for managing obstructive sleep apnea.
- Patient adherence and subjective effectiveness are key considerations in OSA treatment selection.
- These alternative therapies offer viable options for individuals who do not tolerate or adhere to CPAP therapy.
Keywords:
continuous positive airway pressurehypoglossal nerve stimulationoral appliancesleep apnea treatmentMore Related Videos
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