0439 Patient-Reported Experience with Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea – Influence of symptom improvements

Abstract

Abstract Introduction Hypoglossal Nerve Stimulation (HNS) is routinely used as an alternative treatment for patients with obstructive sleep apnea (OSA). Significant and clinically relevant improvements in disease severity and OSA symptoms such as daytime sleepiness as well as overall quality of life have been reported in randomized-controlled trials and large real-world cohort studies. However, so far little data exists on patient-relevant experience with the treatment. Methods A structured survey with 22 questions was constructed using five-level Likert scales (1 = no agreement, 5 = complete agreement) to evaluate patient experience with HNS in the dimensions “Overall experience with therapy”, “Experience with treatment process” and “Side effects”. Additional data was collected on current symptom status and OSA disease history. Results 45 patients from Germany that received a breathing-synchronized HNS system were enrolled (mean age 57.8 years, 78% male). Two-thirds of participants had an OSA history of 5 years or longer (67%). Of all patients, 76% had normalized OSA symptoms at time of the study (ESS: 6.4 ± 5.0) and 97.6% reporting every night use of stimulation therapy. Patients with normalized daytime sleepiness, reported significantly more positive experience across all major domains investigated, compared to patients with residual daytime sleepiness (ESS ≤ 10 versus ESS > 10). HNS therapy was well tolerated in all patients, though patients with higher ESS values reported significantly less improvements of sleep quality and more often waking up from therapy. Only 2.2% of participants though had side effects that made them reduce or even discontinue stimulation therapy. Conclusion Overall patient-reported experience with HNS therapy is positive and high satisfaction with the treatment process was observed. Subjective experience is influenced by residual daytime sleepiness under stimulation. Side effects occur, but rarely impact subjective therapy use. Additional studies are warranted to confirm the findings from this evaluation in larger cohorts. Support (if any)