2 The condition, current treatments and procedure

2 The condition, current treatments and procedure

The condition

2.1 Obstructive sleep apnoea (OSA) is a condition in which the upper airway narrows or closes during sleep when the throat muscles intermittently relax. This causes reduced breathing (hypopnoea) or breathing to temporarily stop (apnoea). OSA can lead to major neurocognitive and cardiovascular sequelae.

Current treatments

2.2 Management of OSA includes lifestyle changes (such as weight loss), continuous positive airway pressure, oral devices (mandibular advancement devices), neuromuscular electrical stimulation and upper airway surgery.

The procedure

2.3 In this procedure, an intraoral removable device is used to deliver neuromuscular electrical stimulation to the intrinsic and extrinsic (genioglossus) muscles of the tongue. The aim is to improve tongue endurance and reduce airway obstruction during sleep.

2.4 A mouthpiece with an electrode array that fits onto the tongue is placed in the mouth by the person during the daytime while they are awake. Bipolar biphasic current is then delivered for about 20 minutes with predetermined low frequency stimulation and rest periods. The mouthpiece is removed once the session is complete. The intensity of the stimulation is controlled by the person, for example by using a smartphone app. An entire therapy usually lasts about 6 weeks, with a 20-minute daytime session each day while awake.

  • National Institute for Health and Care Excellence (NICE)