Combination of acute intermittent hypoxia and intermittent transcutaneous electrical stimulation in obstructive sleep apnea: a randomized controlled crossover trial.
Respir Physiol Neurobiol
; 327: 104298, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38885891
ABSTRACT
Intermittent hypoxia (IH) and intermittent transcutaneous electrical stimulation (ITES) might benefit patients with obstructive sleep apnea (OSA). However, the therapeutic value of combined IH and ITES in OSA is unknown. In this prospective, randomized, controlled crossover study, normoxia (air exposure for 50â¯min before sleep and sham stimulation for 6â¯h during sleep), IH (5 repeats of 5â¯min 10-12â¯% O2 alternating with 5â¯min air for 50â¯min, and sham stimulation for 6â¯h), ITES (air exposure for 50â¯min and 6 repeats of 30â¯min transcutaneous electrical stimulation alternating with 30â¯min of sham stimulation for 6â¯h), and IH&ITES (10-12â¯% O2 alternating with air for 50â¯min and transcutaneous electrical stimulation alternating with sham stimulation for 6â¯h) were administered to patients with OSA over four single-night sessions. The primary endpoint was difference in OSA severity between the interventions according to apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). The efficacy was response to IH, ITES, IH&ITES defined as a ≥50â¯% reduction in AHI compared with normoxia. Twenty participants (17 male, 3 female) completed the trial. The median (IQR) AHI decreased from 14.5 (10.8, 17.5) events/h with normoxia to 6.9 (3.9, 14.8) events/h with IH (p=0.020), 5.7 (3.4, 9.1) events/h with ITES (p=0.001), and 3.5 (1.8, 6.4) events/h with IH&ITES (p=0.001). AHI was significantly different between IH and IH&ITES (p=0.042) but not between ITES and IH&ITES (p=0.850). For mild-moderate OSA (n=17), IH, ITES, and IH&ITES had a significant effect on AHI (p=0.013, p=0.001, p=0.001, respectively) compared with normoxia, but there were no differences in post hoc pairwise comparisons between intervention groups. No serious adverse events were observed. In conclusion, IH, ITES, and IH&ITES significantly reduced OSA severity. IH&ITES showed better efficacy in mild-moderate OSA than IH and was comparable to ITES. Our data do not support recommending IH&ITES over ITES for OSA.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Transcutaneous Electric Nerve Stimulation
/
Cross-Over Studies
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Sleep Apnea, Obstructive
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Hypoxia
Limits:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Respir Physiol Neurobiol
Year:
2024
Document type:
Article
Affiliation country:
China