Quality of life analysis of hypoglossal nerve stimulation with inspire (r) device in the treatment of patients with obstructive sleep apnea intolerant to continuous positive airway pressure therapy

Standard treatment of obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP), in patients with apnea-hypopnea index ≥15/h, excessive daytime sleepiness (Epworth >10), impaired sleep-related quality of life (QoL), and/or or high blood pressure. Up to 35.5% of patients does not tolerate CPAP requiring surgical alternatives. A minimally invasive option is the hypoglossal nerve stimulation (HNS) with the Inspire® device. The main objective is to estimate the variation of the QoL, under real practice conditions, associated with HNS in patients with OSA who do not tolerate CPAP. Observational retrospective study of QoL in the intervention group (IGr), made up of all intolerant patients to CPAP that accepted HNS with the device (n=22), compared to the control group (CGr), with intolerant patients to CPAP but that rejected the device (n=44). QoL was estimated using the utility index obtained with the EuroQol-5D-5L, in a follow-up of 3 month. The main reason why patients rejected the device was economic (81,8% of patients). The EuroQol-5D-5L utility index estimated in the IGr (0,935; SD=0,101) showed a significant difference (0,202; p<101) versus that of CGr (0,733; SD=0,205). Likewise, the IGr index did not show a significant difference (0,020; p=0,364) in respect of the Spanish population one (0,915; SD=0,222). However, the CGr index did show a significant difference (0,182; p<0,001) in respect the Spanish population. Patients who received the device Inspire® showed a higher QoL than those who refused the implant. Likewise, the implanted patients presented a utility index similar to that of the Spanish population. These results suggest that financing the device in the Spanish Health Service.