P26 Qualitative analysis of patient feedback of domiciliary transcutaneous electrical stimulation in patients with obstructive sleep apnoea

Introduction

Obstructive Sleep Apnoea (OSA) is commonly treated with Continuous Positive Airway Pressure (CPAP) therapy. Over the last decade, hypoglossal nerve stimulation in OSA has been tested in randomised controlled trials (RCT) to maintain the neuromuscular tone of the genioglossus muscle and treat OSA. We sought to analyse the qualitative feedback of patients who were included in an RCT using transcutaneous electrical stimulation (TESLA-home) for three months.

Method & Patients

We analysed the feedback of patients included in the TESLA-home trial (NCT03160456, 2018–2023) undertaken at Guy’s & St Thomas’ Hospital, London following patients for 3 months. The intervention arm received domiciliary TESLA, while the control arm received usual care (CPAP). Patients with OSA (apnoea-hypopnoea index 5–35/hour) who failed effective CPAP usage (<4 hours/night) were included. This is an interim analysis on 46/56 patients.

Results

The trial randomised 56 randomised patients, 29 patients into the intervention arm (TESLA), while 27 patients were assigned to usual care (CPAP). In total, this interim analysis included exit interview feedback from 46 patients. 89% (41) of patients reported no skin discomfort, the rest had mild skin discomfort; some patients experienced improved headaches, while one patient discontinued the intervention (TESLA) due to mild headaches. Out of the entire group, 59% (27) of patients reported dryness of the mouth (both trial arms). 67% (31) of the patients reported limited sleep quality as well as not feeling refreshed (both trial arms), caused by either being non-responders to TESLA or non-adherence to CPAP.

Discussion

TESLA is well tolerated but may cause mild skin sensation and mild headaches in some patients. Other related issues (dry mouth, sleep quality) match the problems experienced with usual care (CPAP).