The Effectiveness of Nasal Airway Stent Therapy for the Treatment of Mild-to-Moderate Obstructive Sleep Apnea Syndrome

Respiration. 2021;100(3):193-200. doi: 10.1159/000512319. Epub 2020 Dec 28.


Background: Patients with obstructive sleep apnea syndrome (OSAS) experience excessive daytime sleepiness and insomnia and they are at risk of developing cardiovascular disease and stroke. Continuous positive airway pressure therapy could improve symptoms and decrease these risks; however, adherence is problematic. Although the oral appliance is another therapeutic option, patient satisfaction is limited and the effect of the nasal airway stent - a new device - remains unclear.

Objectives: The aim of this study was to evaluate the effect of NAS therapy in patients with mild-to-moderate OSAS in a prospective, single-arm, interventional pilot study.

Method: Patients with mild/moderate sleep apnea (n = 71; Apnea-Hypopnea Index [AHI], 5-20 events/h on polysomnography) were recruited. Sleep-associated events were measured using a portable device (WatchPAT200) pre- and immediately post-treatment and at 1 month follow-up. AHI (including supine and non-supine AHI), Oxygen Desaturation Index (ODI), Respiratory Disturbance Index (RDI), percutaneous oxygen saturation, heart rate, and snore volume were evaluated. Symptoms were assessed using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale.

Results: NAS use significantly improved AHI, supine AHI, RD, ODI, and snore volume compared to pre-intervention (r = 0.44, 0.48, 0.3, 0.42, and 0.34; p < 0.001, p < 0.001, p = 0.011, p < 0.001, and p = 0.048, respectively). Additionally, 25 and 10% of patients showed complete and partial response for AHI, respectively; these improvements remained significant 1 month later. Pittsburgh Sleep Quality Index scores improved from 6.0 to 5.3 (r = 0.46, p = 0.022).

Conclusions: NAS therapy reduced severity and snoring in patients with mild-to-moderate OSAS. Approximately 30% of patients did not tolerate NAS due to side effects.

Keywords: Alternative therapy; Apnea-Hypopnea Index; Nasal airway stent; Obstructive sleep apnea syndrome; Snoring.

MeSH terms

  • Airway Management* / adverse effects
  • Airway Management* / instrumentation
  • Airway Management* / methods
  • Disorders of Excessive Somnolence / diagnosis
  • Disorders of Excessive Somnolence / etiology
  • Disorders of Excessive Somnolence / therapy
  • Female
  • Heart Rate Determination / methods
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Oxygen Consumption
  • Pilot Projects
  • Polysomnography / methods
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / physiopathology
  • Sleep Apnea, Obstructive* / therapy
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / etiology
  • Sleep Initiation and Maintenance Disorders / therapy
  • Sleep Quality
  • Snoring* / diagnosis
  • Snoring* / etiology
  • Snoring* / therapy
  • Stents*
  • Treatment Outcome