Obstructive Sleep Apnea: A good night's sleep is closer than you think


  • Nirmala David TWU


obstructive sleep apnea, oral mandibular devices, hypoglossal nerve stimulation, hypoglossal nerve stimulation and cardiovascular outcomes


Obstructive sleep apnea (OSA) is a pervasive problem that affects the adult population and it can lead to serious health complications. Continuous positive airway pressure (CPAP) is the gold standard for treating OSA, however, noncompliance and nonadherence to CPAP therapy continues to be a challenge. Oral mandibular devices (OMD) and hypoglossal nerve stimulation (HNS) are alternative therapies used in patients who cannot tolerate CPAP therapy. A comprehensive literature search was performed using reliable search engines using the PICO question and the results were analyzed. The benefits and deficiencies of the OMD and HNS were examined and identified. HNS seems to be a promising therapy for patients with moderate to severe sleep apnea who failed CPAP. However, HNS is an expensive invasive procedure with identified short-term benefits. However, long-term benefits and disadvantages are yet to be known.


Aslan, G., Afsar, B., Siriopol, D., Kanbay, A., Sal, O., Benli, C., Okcuoglu, J., Covic, A., & Kanbay, M. (2018). Cardiovascular effects of continuous positive airway pressure treatment in patients with obstructive sleep apnea: A meta-analysis. Angiology, 69(3), 195–204. https://doi.org/10.1177/0003319717709175

Centers for Medicare and Medicaid Services. (2020). Local coverage determination for hypoglossal nerve stimulation for the treatment of obstructive sleep apnea (L38310). https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=38310&ver=7&articleId=57948&bc=AAAAAAAAQAAA&

Certal, V. F., Zaghi, S., Riaz, M., Vieira, A. S., Pinheiro, C. T., Kushida, C., Capasso, R., & Camacho, M. (2015). Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: A systematic review and meta-analysis. The Laryngoscope, 125(5), 1254–1264. https://doi.org/10.1002/lary.25032

Cleveland Clinic. (2021, June 4). Hypoglossal Nerve: Function, Common Conditions & Disorders. https://my.clevelandclinic.org/health/body/21592-hypoglossal-nerve

The Cochrane Collaboration. (2021). Cochrane and systematic reviews. Retrieved November 9, 2021, from https://consumers.cochrane.org/cochrane-and-systematic-reviews

Costantino, A., Rinaldi, V., Moffa, A., Luccarelli, V., Bressi, F., Cassano, M., Casale, M., & Baptista, P. (2020). Hypoglossal nerve stimulation long-term clinical outcomes: A systematic review and meta-analysis. Sleep and Breathing, 24(2), 399–411. https://doi.org/10.1007/s11325-019-01923-2

Dedhia, R. C., Shah, A. J., Bliwise, D. L., Quyyumi, A. A., Strollo, P. J., Li, Q., Da Poian, G., & Clifford, G. D. (2019). Hypoglossal nerve stimulation and heart rate variability: Analysis of STAR trial responders. Otolaryngology–Head and Neck Surgery, 160(1), 165–171. https://doi.org/10.1177/0194599818800284

de Vries, G. E., Wijkstra, P. J., Houwerzijl, E. J., Kerstjens, H. A. M., & Hoekema, A. (2018). Cardiovascular effects of oral appliance therapy in obstructive sleep apnea: A systematic review and meta-analysis. Sleep Medicine Reviews, 40, 55–68. https://doi.org/10.1016/j.smrv.2017.10.004

Holfinger, S., Chan, L., & Donald, R. (2021). All you need is sleep: The effects of sleep apnea and treatment benefits in the heart failure patient. Current Heart Failure Reports, 18(3), 144–152. https://doi.org/10.1007/s11897-021-00506-1

Kompelli, A. R., Ni, J. S., Nguyen, S. A., Lentsch, E. J., Neskey, D. M., & Meyer, T. A. (2019). The outcomes of hypoglossal nerve stimulation in the management of OSA: A systematic review and meta-analysis. World Journal of Otorhinolaryngology—Head and Neck Surgery, 5, 41–48. https://doi.org/10.1016/j.wjorl.2018.04.006

Mashaqi, S., Patel, S., Combs, D., Estep, L., Helmick, S., Machamer, J., & Parthasarathy, S. (2021). The hypoglossal nerve stimulation as a novel therapy for treating obstructive sleep apnea—A literature review. International Journal of Environmental Research and Public Health, 18(4), 1642. https://doi.org/10.3390/ijerph18041642

Mayo Clinic Staff. (n.d.). Obstructive sleep apnea. https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090

McEwen, M., & Willis, E. M. (2018). Theoretical basis for nursing (5th ed.). Wolters Kluwer.

Rodriguez, J. (2018, February 22). What is hypoglossal nerve stimulation therapy for sleep apnea? Advanced Sleep Medicine Services, Inc. https://www.sleepdr.com/the-sleep-blog/what-is-hypoglossal-nerve-stimulation-therapy-for-sleep-apnea/

Sato, K., & Nakajima, T. (2020). Review of systematic reviews on mandibular advancement oral appliance for obstructive sleep apnea: The importance of long-term follow-up. The Japanese Dental Science Review, 56, 32–37. https://doi.org/10.1016/j.jdsr.2019.10.002

Suni, E. (2021, July 9). Sleep apnea. Sleep Foundation. https://www.sleepfoundation.org/sleep-apnea

Woodson, B. T., Gillespie, M. B., Soose, R. J., Maurer, J. T., de Vries, N., Steward, D. L., Baskin, J. Z., Padhya, T. A., Lin, H.-S., Mickelson, S., Badr, S. M., Strohl, K. P., & Strollo, P. J., Jr. (2014). Randomized controlled withdrawal study of upper airway stimulation on OSA: Short- and long-term effect. Otolaryngology–Head and Neck Surgery, 151(5), 880–887. https://doi.org/10.1177/0194599814544445




How to Cite

David, N. (2023). Obstructive Sleep Apnea: A good night’s sleep is closer than you think. TWU Student Journal, 2(1), 29–43. Retrieved from https://twusj-ojs-twu.tdl.org/twusj/article/view/49