0491 Use of Neuromuscular Stimulation device of Tongue to treat Mild obstructive sleep apnea in Veteran population

Abstract

Abstract Introduction Approximately 30 million adults in United States suffer from obstructive sleep apnea (OSA), with much higher prevalence in veterans. However, the treatment options of sleep apnea are currently limited due to CPAP device shortage, hence, unravelling a significant gap for alternative user-friendly therapeutic options. Neuromuscular stimulation device of the tongue is a novel FDA approved therapy becoming more relevant with the ongoing CPAP device shortage. Methods Neuromuscular stimulation device of tongue procured through regulatory process at VA Minneapolis, is offered to veterans with Mild OSA( AHI 5-15) on home sleep apnea testing.Baseline and post therapy data including patient's snoring, Epworth sleepiness score(ESS),Apnea - Hypopnea Index(AHI) was collected. Post therapy data was collected after initial 6 weeks of at least 20-minute daily followed by maintenance of 2 weeks of twice weekly use. Results A total of 112 patients with Mild OSA were offered the device as an alternative option of treatment during the period of December 2021 to August 2022. Of these, 39 patients completed therapy with mean age of 54.5 years (age ranging from 28y-80y), 36 were males and 3 were females. Among a total of 31 patients who completed their ESS pre and post questionnaire, and 22 patients who had pre and post AHI available, a paired t-test was obtained. In the 31 patients with pre and post ESS, the results of paired t- test showed a mean difference in ESS score of 1.90 with 95% CI (0.55 -3.25) with statistically significant P value of 0.0073. In the 22 patients with pre and post AHI, results of paired t -test showed Mean difference in AHI score of 2.54 with 95% CI (0.24-4.84) with statistically significant P value of 0.0316. Conclusion Findings suggest that the alternative treatment to CPAP provided to patients did result in improvement of Mild OSA both in subjective sleepiness symptoms and objective degree of residual apnea, and hence can be used as a feasible alternative therapy. However, the study is limited by small size (112) with a relatively low response rate from the participants (39), and availability of matched data (ESS -31, AHI -22). Therefore, larger studies are warranted. Support (if any)