Additive Effect of Multilevel Radiofrequency Ablation in Elderly Patients with Sleep Apnea

Elderly patients with Obstructive sleep apnea (OSA) often struggle with positive airway therapy due to low adherence. This study explores Radiofrequency ablation (RFA) as a treatment alongside weight loss and tongue-retaining device for OSA in older adults. Through a randomized trial, we compare RFA effectiveness to a control group, aiming to establish its potential role in managing OSA in this vulnerable population. The control group received only weight loss and tongue-retaining device recommendations. In the intervention group, these measures were supplemented with RFA of the soft palate and inferior turbinates. After three months, both groups were assessed for changes in sleep study parameters, BMI, and tongue-retaining device adherence. Twenty patients in the control group and 23 in the intervention group completed the trial. The average age was 60.25 years old (SD = 5.88) in the control group and 61.83 years old (SD = 5.21) in the RFA group. Both groups experienced significant BMI reductions, with the control group averaging a decrease of 1.5 kg/m² (SD = 2.4 kg/m²) and the RFA group averaging a decrease of 1.3 kg/m² (SD = 1.1 kg/m²). Tongue-retaining device adherence was 50% in the control group and 56.5% in the RFA group. The RFA group achieved a significantly greater proportionate reduction in AHI compared to the control group (p = 0.04, effect size=-0.38). This randomized controlled trial showed that RFA on the soft palate and inferior turbinate is a well-tolerated and potentially effective treatment option for elderly patients with OSA. Further research with larger samples and longer follow-ups is needed to confirm these findings and assess long-term durability.