Three-year outcomes of cranial nerve stimulation for obstructive sleep apnea: the STAR trial

Objective: To describe the 36-month clinical and polysomnography (PSG) outcomes in an obstructive sleep apnea (OSA) cohort treated with hypoglossal cranial nerve upper airway stimulation (UAS). Study Design: A multicenter prospective cohort study. Setting: Industry-supported multicenter academic and...

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Bibliographic Details
Main Authors: Woodson, B. Tucker (Author) , Maurer, Joachim T. (Author)
Format: Article (Journal)
Language:English
Published: 2016
In: Otolaryngology - head and neck surgery
Year: 2015, Volume: 154, Issue: 1, Pages: 181-188
ISSN:1097-6817
DOI:10.1177/0194599815616618
Online Access:Verlag, Volltext: http://dx.doi.org/10.1177/0194599815616618
Verlag, Volltext: https://doi.org/10.1177/0194599815616618
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Author Notes:B. Tucker Woodson, MD, Ryan J. Soose, MD, M. Boyd Gillespie, MD, Kingman P. Strohl, MD, Joachim T. Maurer MD, Nico de Vries, MD, David L. Steward, MD, Jonathan Z. Baskin, MD, M. Safwan Badr, MD, Ho-sheng Lin, MD, Tapan A. Padhya, MD, Sam Mickelson, MD, W. McDowell Anderson, MD, Olivier M. Vanderveken, MD, PhD, and Patrick J. Strollo Jr, MD, on behalf of STAR Trial Investigators
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Summary:Objective: To describe the 36-month clinical and polysomnography (PSG) outcomes in an obstructive sleep apnea (OSA) cohort treated with hypoglossal cranial nerve upper airway stimulation (UAS). Study Design: A multicenter prospective cohort study. Setting: Industry-supported multicenter academic and clinical setting. Subjects: Participants (n = 116) at 36 months from a cohort of 126 implanted participants. Methods: Participants were enrolled in a prospective phase III trial evaluating the efficacy of UAS for moderated to severe OSA. Prospective outcomes included apnea-hypopnea index, oxygen desaturation index, other PSG measures, self-reported measures of sleepiness, sleep-related quality of life, and snoring. Results: Of 126 enrolled participants, 116 (92%) completed 36-month follow-up evaluation per protocol; 98 participants additionally agreed to a voluntary 36-month PSG. Self-report daily device usage was 81%. In the PSG group, 74% met the a priori definition of success with the primary outcomes of apnea-hypopnea index, reduced from the median value of 28.2 events per hour at baseline to 8.7 and 6.2 at 12 and 36 months, respectively. Similarly, self-reported outcomes improved from baseline to 12 months and were maintained at 36 months. Soft or no snoring reported by bed partner increased from 17% at baseline to 80% at 36 months. Serious device-related adverse events were rare, with 1 elective device explantation from 12 to 36 months. Conclusion: Long-term 3-year improvements in objective respiratory and subjective quality-of-life outcome measures are maintained. Adverse events are uncommon. UAS is a successful and appropriate long-term treatment for individuals with moderate to severe OSA.
Item Description:Gesehen am 23.01.2019
First Published November 17, 2015
Physical Description:Online Resource
ISSN:1097-6817
DOI:10.1177/0194599815616618