Electric stimulation and transcranial magnetic stimulation for obstructive sleep apnea

Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep disorder that significantly compromises human health. While continuous positive airway pressure (CPAP) remains the gold standard for treatment, its clinical effectiveness is often limited by poor patient adherence, underscoring the need for alternative therapies. Emerging evidence suggests that physical stimulation therapies may offer a promising non-invasive approach by activating upper airway dilator muscles to maintain airway patency, thereby reducing the severity of OSAS and alleviating related symptoms. This review summarizes recent advances in physical stimulation-based interventions for OSAS, with a comprehensive analysis of clinical trials involving hypoglossal nerve stimulation (HGNS), transcutaneous electrical stimulation (TES), intraoral neuromuscular stimulation, and transcranial magnetic stimulation (TMS). These studies primarily focus on improving upper airway collapsibility, mitigating excessive daytime sleepiness, and enhancing patients' quality of life. Notably, physical stimulation therapies have demonstrated therapeutic potential by significantly reducing the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI), indicating symptom relief and improved sleep architecture in OSAS patients. This review aims to elucidate the underlying mechanisms of physical stimulation approaches and to reinforce their role as viable alternatives to CPAP therapy, thereby advancing clinical strategies for OSAS management.