Transcutaneous electrical nerve stimulation of the hypoglossal nerve as adjuvant treatment of obstructive sleep apnea

Abstract EN

Background Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely; implantable devices for hypoglossal nerve stimulation have shown potential functional improvement.

Objective The aim of this study was to determine the effect of transcutaneous electrical nerve stimulation (TENS) of the hypoglossal nerve as a noninvasive adjuvant therapy for obstructive sleep apnea (OSA).

Patients and methods A total of 25 patients with OSA were examined.

Snoring, the apnea–hypopnea index, daytime sleepiness, Mallampati grading, and Friedman tongue position were examined at baseline and after TENS application.

Nerve conduction studies including amplitude and distal motor latency were performed before and after TENS application.

TENS was applied for stimulation of the hypoglossal nerve for three sets per week for 1 month.

Results Hypoglossal nerve stimulation using TENS showed a significant improvement in daily snoring, severe apnea–hypopnea index, moderately excessive daytime sleepiness, and Friedman tongue position grade III in the studied patients after the physiotherapy program compared with before (Po0.01).

The frequency of patients with delayed distal latency of the hypoglossal nerve decreased after TENS therapy (50% of patients had delayed latency in the left and 37.5% of patients had the same in the right hypoglossal nerve).

The mean left distal latency of the patients decreased significantly after TENS therapy when compared with before therapy (2.23± 0.52 vs.

3.17± 0.98 ms, respectively, P= 0.0026).

The mean right distal latency of the patients also decreased significantly after TENS therapy when compared with before therapy (2.31 ±0.29 vs.

3.32± 1.12 ms, respectively, P= 0.023).

Conclusion The findings demonstrate the feasibility and therapeutic potential of hypoglossal nerve stimulation using TENS in OSA.