Evidence map›Paper›PMID 30187368›Full record

ArticleSleep & breathing = Schlaf & Atmung2018

Evaluation of body position in upper airway stimulation for obstructive sleep apnea-is continuous voltage sufficient enough?

Armin Steffen, Julia T Hartmann, Inke R König, Madeline J L Ravesloot, Benedikt Hofauer, Clemens Heiser

Abstract read
PubMed Publisher
In one paragraph

Article in Sleep & breathing = Schlaf & Atmung, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Referral of adults with obstructive sleep apnea for surgical consultation: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021
    Pooled it
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  3. Trial
  4. Trial
  5. Impact of Postoperative Weight Changes on Hypoglossal Nerve Stimulation Success for Obstructive Sleep Apnea.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Armin SteffenDepartment of Otorhinolaryngology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. armin.steffen@uksh.de.ORCID http://orcid.org/0000-0002-1044-492X
Julia T HartmannDepartment of Otorhinolaryngology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Inke R KönigInstitute of Medical Biometry and Statistics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Madeline J L RaveslootDepartment of Otorhinolaryngology, OLVG, Amsterdam, The Netherlands.
Benedikt HofauerDepartment of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany.
Clemens HeiserDepartment of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe definition of positional obstructive sleep apnea (POSA) is widely accepted as a difference of 50% or more in AHI between supine and non-supine position. Upper airway stimulation (UAS) is an effective treatment for OSA but the implant delivers a single voltage over sleep period without consideration of body position. Clinical practice suggests different outcomes for OSA in supine position under UAS treatment.

methodsOutcomes of 44 patients were analyzed 12 months after implantation in a two-center, prospective consecutive trial in a university hospital setting. Total night and supine AHI were evaluated and the ratio of time spent in supine was considered. Correlation between the classic and the modified definition of POSA and treatment response were evaluated.

resultsThe time ratio spent in supine position did not differ before implantation and after 12 months. Total and supine AHI were reduced with the use of UAS therapy (p < 0.001) but both the baseline and final supine AHI were higher than total night AHI. Considering POSA definition as a ratio of supine to non-supine AHI, there was no clear cutoff for defining responders neither with nor without the additional component of time in supine position.

conclusionsThe OSA reduction is strong for the total AHI and supine AHI. Nonetheless, here, there is no cutoff for defining POSA as critical for UAS therapy response. Therefore, there is no evidence for excluding POSA patients from UAS in general. Future technology improvement should take body position and adaptive voltage into account.

Indexed as

Implantable NeurostimulatorsElectric Stimulation TherapyFemaleHumansMaleMiddle AgedPatient Reported Outcome MeasuresPolysomnographySeverity of Illness IndexSleep Apnea, ObstructiveSnoringSupine PositionTreatment OutcomeHypoglossal nerve stimulationPAP failurePAP intolerancePositional sleep apneaSleep apneaUpper airway stimulation

Identifiers

PMID30187368

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.