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  1. Candy Lee
  1. Correspondence to Dr Candy Lee, ST7 Specialty Trainee in Respiratory Medicine and General Internal Medicine, Abertawe Bro Morgannwg University Health Board, Singleton Hospital, Sketty Lane, Swansea SA2 8 QA, UK; clee128{at}

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Upper airway stimulation for obstructive sleep apnoea

In this multicentre, prospective cohort study (N Engl J Med 2014;370:139–49), the clinical safety and efficacy of upper airway stimulation in 126 patients with moderate to severe obstructive sleep apnoea who had difficulty adhering to CPAP were evaluated. Upper airway pacing of the hypoglossal nerve, coordinated with ventilatory effort, led to significant improvement in subjective and objective measures of the severity of obstructive sleep apnoea. Median apnoea-hypopnoea index at 12 months reduced 68%, from 29.3 events/h to 9.0 events/h (p<0.001). Oxygen desaturation index decreased 70%, from 25.4 events/h to 7.4 events/h (p<0.001). A reduction of sleep apnoea symptoms and improved quality of life were reported by patients. There is a possible role for this treatment in the future, although it is unlikely to replace CPAP as first line therapy.

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.