Qian B, Chen ZJ, Wang YS, Hu XY, Hu XB, Zheng YH. Clinical efficacy and mechanism study of mid-frequency anti-snoring device in treating moderate obstructive sleep apnea-hypopnea syndrome. World J Clin Cases 2024; 12(5): 942-950 [PMID: 38414605 DOI: 10.12998/wjcc.v12.i5.942]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Author contributions: Qian B and Chen ZJ contributed equally to this work; Qian B and Chen ZJ performed the study; Wang YS performed the computed tomography scan examination; Hu XY and Hu XB analyzed the data; Zheng YH designed the research and wrote the manuscript; all authors read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Shanghai Jinshan Tinglin Hospital (Approval No. 2022-06-01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent before enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: November 2, 2023 Peer-review started: November 2, 2023 First decision: December 5, 2023 Revised: December 14, 2023 Accepted: January 23, 2024 Article in press: January 23, 2024 Published online: February 16, 2024 Processing time: 89 Days and 14.9 Hours
Abstract
BACKGROUND
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopharyngeal, oropharyngeal, soft palate, and tongue base areas. The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation. Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation. Nevertheless, there is a lack of clinical application and imaging evidence.
AIM
To investigate the clinical efficacy and mechanisms of a mid-frequency anti-snoring device in treating moderate OSAHS.
METHODS
We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023. They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep. Following the treatment, we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores. Additionally, we performed computed tomography scans of the oropharynx in the awake state, during snoring, and while using the mid-frequency anti-snoring device. Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas.
RESULTS
Compared to pretreatment measurements, patients exhibited a significant reduction in the apnea-hypopnea index, the percentage of time with oxygen saturation below 90%, snoring frequency, and the duration of the most prolonged apnea event. The lowest oxygen saturation showed a notable increase, and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved. Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state. Conversely, during mid-frequency anti-snoring device treatment, these areas increased compared to snoring.
CONCLUSION
The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS, thereby improving their quality of life and reducing daytime sleepiness. These therapeutic effects are attributed to the device’s ability to ameliorate the narrowing of the oropharynx in OSAHS patients.
Core Tip: We investigated the clinical efficacy and underlying mechanisms of a mid-frequency anti-snoring device in treating 50 moderate obstructive sleep apnea-hypopnea syndrome patients for 4 wk. Our results indicated significant improvements in the apnea-hypopnea index, the percentage of time with oxygen saturation below 90%, and the sleep apnea quality of life index and Epworth Sleepiness Scale scores. Additionally, we found compelling evidence that the mid-frequency anti-snoring device positively influenced the narrowing of the oropharynx in sleep apnea-hypopnea syndrome patients during snoring.
