Who will desire upper airway stimulation as a treatment of obstructive sleep apnea in the Japanese patient population?

Excerpt

Obstructive sleep apnea (OSA) is a common chronic condition [1], observed in 10–20% of the general population [2]. Current population-based studies, including data from Japan, suggested that in addition to men, a substantial proportion of women, especially post-menopausal women, have OSA [2]. Continuous positive airway pressure (CPAP) therapy has been an established treatment option and generally considered as a first-line treatment for moderate to severe OSA. Nowadays, more than 400,000 patients in Japan with OSA are using CPAP. However, several patients with OSA underuse or even discontinue CPAP therapy, and reportedly, 29–83% were poorly adherent [3]. Although a recent big data analysis in the US found increasing adherence over time (up to 87% adherent), characteristics, the severity of OSA, and presence or absence of sleepiness are considered as important factors for CPAP adherence [3]. Another option for the treatment of OSA includes use of a mandibular advancement device (MAD). However, the efficacy of MAD on the suppression of OSA varies [4]. Although adherence to MAD use is generally considered better than that to CPAP therapy [5], adherence to MAD use is also highly variable ranging from 32 to 82% at 1 year [5]. Therefore, effective alternatives that can successfully suppress OSA and maintain adherence are needed. …