Table 1.
Summary of the main results in OSA-GG treatment and conclusions.
| Reference | Severity | n | Treatment | Follow-Up | Main Effect | Conclusion |
|---|---|---|---|---|---|---|
| Hypoglossal Nerve Electrical Stimulation | ||||||
| Strollo, 2014 [31] | Moderate to severe OSA | 126 | Inspire II Upper Airway Stimulation | 12 months | Decreases AHI 68% (from 29.3 to 9.0 events/h). Decreases ODI score 70% (from 25.4 to 7 events/h). Improve EDS and quality of life. | (1) Safe and effective for the treatment of moderate to severe OSA. (2) Could be an alternative to CPAP. (3) Significant improvements in objective (AHI) and subjective measurements. (4) Its invasive nature limits its application. |
| Woodson, 2016 [32] | Moderate to severe OSA | 116 | Inspire II Upper Airway Stimulation | 36 months | Decreases AHI > 50% (from 28.2 to 6.2 events/h). Improves quality of life. | |
| Gillespie, 2017 [33] | Moderate to severe OSA | 91 | Inspire II Upper Airway Stimulation | 48 months | Improves ESS and quality of life. | |
| Pharmacological Treatment | ||||||
| Berri, 1999 [37] | Severe OSA | 8 | Paroxetine | Single dose | Increases peak inspiratory GG activity during NREM. Does not improve AHI. | (1) Exciting new possibilities for OSA treatment. (2) Probably suitable for a determined phenotype of patients and/or in combination with another treatments. (3) It would be premature to use this combination as a treatment option for OSA at present. |
| Prasad, 2010 [38] |
AHI > 10 | 35 | Ondansetron + fluoxetine |
Days 7, 14 and 28 | Decreases AHI 40% at high dose (12.9 events/h reduction in AHI). Does not improve EDS. | |
| Taranto-Montemurro, 2016 [41] | AHI > 15 | 14 | Desipramine | Single dose | Decreases pharyngeal collapsibility (Pcrit). Very little effect on AHI. | |
| Taranto-Montemurro, 2019 [43] | 15/20 patients with OSA on placebo (AHI>10 events/h) | 20 | Atomoxetine + oxybutynin | Single dose | Median AHI change of 63% (from 28.5 to 7.5 events/h). Increases nadir oxygen saturation. Increases GG responsiveness. | |
| Myofunctional Therapy | ||||||
| Guimarães, 2009 [49] | Moderate OSA | 31 | Upper airway exercises | 3 months | Decreases AHI from 22.4 to 13.7/h. Increases nadir oxygen saturation. Improves EDS. | (1) It could be a useful tool in nonobese patients with mild to moderate OSA. (2) Can improve the effectiveness or patient adherence of CPAP treatment by reducing the absolute pressure required. (3) One of the most important limitation is that it requires high patient adherence to the therapy. |
| Diaferia, 2013 [55] | Moderate to severe OSA | 100 | Speech therapy | 3 months | Improves quality of life. | |
OSA: obstructive sleep apnea; AHI: apnea-hypopnea index; ODI: oxygen desaturation index; EDS: excessive daytime sleepiness; CPAP: continuous positive airway pressure; ESS: Epworth Sleepiness Scale; GG: genioglossus.