Comparison of clinical pathways for hypoglossal nerve stimulation management: in-laboratory titration polysomnography vs home-based efficacy sleep testing

In-laboratory polysomnography for hypoglossal nerve stimulator titration has not previously been compared to patient-controlled, home-based device adjustment centered on subjective sleep experience to evaluate whether patients experience similar improvements in objective and subjective outcomes for obstructive sleep apnea. This prospective, multicenter, randomized clinical trial randomly assigned patients to 1 of 2 management pathways to evaluate whether patients experienced similar outcomes. Home sleep apnea testing 6 months after activation demonstrated that patients experienced similar improvements in obstructive sleep apnea severity and daytime sleepiness regardless of whether they underwent device adjustment during in-laboratory polysomnography. Patient-controlled subjective adjustment of hypoglossal nerve stimulation with periodic home-based assessments of efficacy may be sufficient for many patients undergoing implantation.

https://link.springer.com/article/10.5664/jcsm.10712