TY - JOUR
T1 - Transcutaneous electrical stimulation in obstructive sleep apnoea
T2 - current developments and concepts of the TESLA-home programme
AU - Nasser, Ebrahim
AU - Ratneswaran, Deeban
AU - Alsharifi, Abdulaziz
AU - Williams, Adrian J.
AU - Steier, Joerg
N1 - Funding Information:
Professor Steier's contributions were partially supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London, UK. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Purpose of reviewObstructive sleep apnoea (OSA) is a highly prevalent condition affecting about 1 billion people worldwide. The first line therapy for most patients with OSA is continuous positive airway pressure (CPAP) therapy. However, there are significant limitations with long-term adherence to CPAP therapy, which may be as low as 30-60%.Recent findingElectrical stimulation of the hypoglossal nerve has been studied in recent years. It achieves upper airway patency by causing a contraction of the genioglossus muscle, the strongest dilator of the upper airway, and by maintaining its neuromuscular tone in the asleep patient with OSA. Electrical stimulation can be delivered invasively, hypoglossal nerve stimulation (HNS), and noninvasively, transcutaneous electrical stimulation in OSA (TESLA). However, randomised controlled trials, the STAR and the TESLA trial, have provided promising results on efficacy and safety of the methods.SummaryPatient and public involvement underlines the interest in TESLA and HNS and highlights the need to provide non-CPAP therapeutic options to those who may find it difficult to cope with first line therapies. The relatively low costs and the favourable safety profile of the TESLA approach provide the chance to offer this treatment to patients with OSA following further development of the evidence.
AB - Purpose of reviewObstructive sleep apnoea (OSA) is a highly prevalent condition affecting about 1 billion people worldwide. The first line therapy for most patients with OSA is continuous positive airway pressure (CPAP) therapy. However, there are significant limitations with long-term adherence to CPAP therapy, which may be as low as 30-60%.Recent findingElectrical stimulation of the hypoglossal nerve has been studied in recent years. It achieves upper airway patency by causing a contraction of the genioglossus muscle, the strongest dilator of the upper airway, and by maintaining its neuromuscular tone in the asleep patient with OSA. Electrical stimulation can be delivered invasively, hypoglossal nerve stimulation (HNS), and noninvasively, transcutaneous electrical stimulation in OSA (TESLA). However, randomised controlled trials, the STAR and the TESLA trial, have provided promising results on efficacy and safety of the methods.SummaryPatient and public involvement underlines the interest in TESLA and HNS and highlights the need to provide non-CPAP therapeutic options to those who may find it difficult to cope with first line therapies. The relatively low costs and the favourable safety profile of the TESLA approach provide the chance to offer this treatment to patients with OSA following further development of the evidence.
KW - continuous positive airway pressure
KW - hypoglossal nerve stimulation
KW - noncontinuous positive airway pressure
KW - obstructive sleep apnoea
UR - http://www.scopus.com/inward/record.url?scp=85139469243&partnerID=8YFLogxK
U2 - 10.1097/MCP.0000000000000910
DO - 10.1097/MCP.0000000000000910
M3 - Review article
C2 - 35993267
AN - SCOPUS:85139469243
SN - 1070-5287
VL - 28
SP - 529
EP - 536
JO - Current Opinion in Pulmonary Medicine
JF - Current Opinion in Pulmonary Medicine
IS - 6
ER -