OBJECTIVES:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.