SynthesisSleep & breathing = Schlaf & Atmung2026
Comparison of upper airway stimulation, tongue base surgeries, and continuous positive airway pressure for moderate-to-severe obstructive sleep apnea: a systematic review and network meta-analysis.
Synthesis in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
3 authors.
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Abstract
purposeTo compare treatment outcomes of tongue base-targeting interventions-transoral robotic surgery (TORS), plasma ablation tongue base reduction (PATBR), implantable upper airway stimulation (UAS)-and continuous positive airway pressure (CPAP) in moderate-to-severe obstructive sleep apnea (OSA) patients.
methodsThe PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases were systematically searched through January 2026. A network meta-analysis was conducted to compare tongue-directed surgical procedures (TORS and PATBR), UAS, and CPAP. Outcomes included changes in the apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), lowest oxygen saturation, postoperative hospital stay, success rate (postoperative AHI < 20 with > 50% reduction), and cure rate (postoperative AHI < 5).
resultsTen studies comprising 758 patients were included. UAS demonstrated significantly greater AHI reduction than TORS (standardized mean difference [SMD] = 1.36 [0.27-2.46]) and significantly improved lowest oxygen saturation (SMD = 1.46 [0.30-2.62]). CPAP showed greater, though not statistically significant, AHI improvement compared with TORS (SMD = 1.17 [- 0.32-2.66]). ESS improvement did not differ significantly among treatments. Both PATBR (SMD = - 1.30 [- 1.80--0.79]) and UAS (SMD = - 5.49 [- 6.65--4.33]) were associated with significantly shorter hospital stays than TORS. Success rates were higher with CPAP (odds ratio [OR] = 3.73 [1.38-10.13]) and UAS (OR = 5.58 [1.97-15.84]) compared to TORS, whereas cure rates were significantly higher with UAS (OR = 12.13 [1.98-74.50]). Ranking analysis indicated overall superiority of UAS across objective outcomes.
conclusionsUAS provides superior objective outcomes with shorter hospitalization and comparable subjective improvement, supporting its role as an effective treatment option for moderate-to-severe OSA.
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