Oral Appliance Therapy and Hypoglossal Nerve Stimulation as Non-PAP Treatment Alternatives for Obstructive Sleep Apnea: A Narrative Expert Review

Abstract

This perspective on alternatives to Positive Airway Pressure therapy for the treatment of obstructive sleep apnea summarizes the proceedings of a focus group that was conducted by the Sleep Research Society Foundation. This perspective is from a multi-disciplinary panel of experts from sleep medicine, dental sleep medicine, and otolaryngology that aims to identify the current role of Oral Appliance Therapy and hypoglossal nerve stimulation for the treatment of obstructive sleep apnea with emphasis on the U.S. practice arena. A secondary aim is to identify – from an implementation science standpoint -- the various barriers and facilitators for adoption of non-PAP treatment that includes access to care, multi-disciplinary expertise, reimbursement, regulatory aspects, current treatment guidelines, health policies and other factors related to delivery of care. The panel has contextualized the review with recent events – such as a large-scale PAP device recall compounded by supply chain woes of the pandemic -- and emerging science in the field of obstructive sleep apnea and offers solutions for multi-disciplinary approaches while identifying knowledge gaps and future research opportunities.