The usefulness of an intra-oral tongue stimulation device

<bold>Background and aim:</bold> The tone of the tongue and pharyngeal muscles is of particularly important in the development of obstructive sleep apnea (OSA). The training of those muscles is feasible, and may lead to improvements in OSA severity. The usefulness of intra-oral tongue stimulators which were used during the daytime for the tongue muscle training in patients with mild OSA has already been reported. However, little is known whether they are also usefulness in the wide spectrum of OSA patients, including moderate to severe range, and whether they are also useful in Japanese OSA patients. The aim of this pilot study is to confirm the possibility of intra-oral tongue stimulation device in the wide spectrum of OSA patients in Japan. <bold>Materials and Methods:</bold> Patients diagnosed as OSA between June 2022 and February 2024 by polysomnography were targeted. Inclusion criteria are 1) patients refused to use continuous positive airway pressure (CPAP), oral appliance and surgical intervention; and 2) want to use an intra-oral tongue stimulation device. Patients were asked to use the device for 20 minutes once daily for a 6-week period. Then, evaluation of OSA severity was performed. <bold>Results:</bold> We enrolled 7 patients (85.7% men, mean age, 50.6±13.6 years, and body mass index, 24.8±1.7 kg/m2). The mean apnea-hypopnea index (AHI) was 18.9±13.0 events/h before using the device and reduced to 11.7±8.3 event/h (38.1% reduction, p<0.001). There were no adverse side effects observed. <bold>Conclusions:</bold> In this pilot study, it was suggested that intra-oral tongue stimulation device can provide a safe and novel approach to reduce AHI even in the wide spectrum of OSA patients in Japan. This therapy may be a promising treatment option for OSA.