Comparative efficacy of electrical stimulation therapies for obstructive sleep apnea: A network meta-analysis of randomized controlled trials

SMES, TENS, and HNS are effective treatments for OSA. SMES is physiologically superior for reducing AHI and improving oxygenation, owing to its ability to stimulate multiple upper-airway muscles and induce long-term neuromuscular adaptation. TENS improves LSAT by enhancing respiratory muscle performance, and HNS effectively reduces daytime sleepiness. These therapies offer modality-specific benefits that may support personalized OSA management.