Transoral Neuromuscular Electrical Stimulation Therapy Adherence and Intensity Levels in Veterans with Mild OSA

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ID: 317245
2026
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Abstract
Abstract Study Objectives To describe the use of transoral neuromuscular stimulation therapy in Veterans with mild obstructive sleep apnea (OSA) by looking at session-level data for both adherence and stimulation intensity. Methods A retrospective review of session-level data of the 82 patients prescribed the eXciteOSA device at the VA San Diego Healthcare System (VASDHS) was analyzed. The device is prescribed for use over two phases: (1) Phase 1: one daily 20-minute session daily for 42 days, and (2) Phase 2: one daily 20-minute session on two days per week. Results Forty-one out of 76 patients (54%) completed Phase 1 (42 sessions) within the first 60 days of using eXciteOSA therapy. Three (4%) completed Phase 1 after the first 60 days, and 32 (42%) patients never completed Phase 1. Initial Phase 1 graduates had a cumulative usage of 866 minutes, while those that did not complete Phase 1 had 578 minutes. Average stimulation intensity levels in the initial Phase 1 graduates increased from week 1 to week 6 (from 3.2 to 11.2). Conclusions Based on the prescription-based adherence definition, adherence is modest but is contingent on how adherence is defined. Notably however, median positive airway pressure adherence is 40% for those with a recent prescription within our facility for comparison. Future research should focus on interventions to help improve both adherence and stimulation intensity levels of this novel daytime OSA therapy.
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Authors Carl Stepnowsky, Tania Zamora, Yzabel Velazquez, Christopher N. Schmickl, Cesar Cervantes-Gameros, Robert L Owens, Brian S. Wojeck, Peter Colvonen, Brandon Nokes
Journal SLEEP Advances
Year 2026
DOI
10.1093/sleepadvances/zpag061
URL
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