Influence of subjective sleep quality on the effectiveness of upper airway stimulation

Introduction:

Upper airway stimulation (UAS) is a new treatment option for patients with obstructive sleep apnea (OSA). However, it is believed that sleep quality negatively influences the effectiveness of this therapy. This study aims to analyze different parameters of sleep quality and its influence on the effectiveness of UAS.

Material and Methods:

Included in this study were patients with OSA and CPAP-incompliance who underwent UAS implantation. A home sleep study was conducted 12 months after implantation and was compared to baseline results, as well as Epworth sleepiness scale (ESS) and hours of usage of UAS. Preoperatively patients filled in the Pittsburgh Sleep Quality Index (PSQI), which is a standardized questionnaire for measuring subjective sleep quality in the last 4 weeks. It consists of 7 components, such as: sleep quality, sleep latency, sleep duration, etc. With the PSQI patients can be divided into good and poor sleepers.

Results:

66 patients were included in this study. They were divided into two groups according to the PSQI. 12 patients classified as good sleepers (PSQI≤5) and 54 as bad sleepers (PSQI> 5). The good sleepers had an average preoperative AHI of 45,8/h, which was reduced to 10,7/h after 12 months (p < 0,001). In the group of bad sleepers, the average baseline AHI was 36,7/h and could be reduced to 9,8/h after 12 months (p < 0,001). Concerning ESS the good sleepers started with an ESS of 7,9 which was improved to 2,5 after 12 months, the bad sleepers started from 12,5 and showed an ESS of 6,7 after 12 months (each p < 0,01). There was no difference between both groups concerning hours of usage after 12 months (p = 0,4).

Conclusion:

These results show that patients with a subjectively bad sleep quality in PSQI can be sufficiently treated with UAS.

Publication History

Publication Date:
23 April 2019 (online)