Electrical Stimulation: A New Horizon in Treating Sleep Apnoea

Sleep Apnoea affects nearly 1 billion individuals globally, with a significant number in the UK. It’s marked by repeated breathing interruptions during sleep, leading to pronounced daytime fatigue, compromised concentration, and frequent headaches. These disturbances heighten the risk of road traffic accidents and cardiovascular complications.

Deeper Insights into Sleep Apnoea

While often associated with snoring, the impact of Sleep Apnoea is far more profound. Sufferers experience numerous breathing lapses at night, jeopardizing their oxygen intake. This can lead to heightened daytime drowsiness and reduced attention span. Due to the associated risks, diagnosed individuals are strongly advised against driving when feeling extremely fatigued.

Traditional Treatment Approaches

The Continuous Positive Airway Pressure (CPAP) machine remains the primary treatment for sleep apnoea. It works by channeling air into a mask worn over the mouth or nose, ensuring an open airway during sleep. However, patient adherence to CPAP therapy is challenging; with adherence rates dropping from 75% after 3 months to about 25% after five years. Other treatments include mandibular advancement devices (MAD) and surgery in severe cases.

The Pioneering TESLA Trial

Established by Professor Joerg Steier from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, the TESLA home trial explored the efficacy of transcutaneous electrical stimulation for sleep apnoea patients. This method involves stimulating the upper airway and the genioglossus muscle, using patches under the chin. The trial showcased the potential of electrical stimulation, with a TENS machine being instrumental in current delivery.

Key Findings from the TESLA Trial

The trial engaged 56 subjects known for their non-compliance to CPAP therapy. Participants were divided into two groups: one utilized the nightly TENS treatment, while the other continued with CPAP. The TENS group showed significant improvement in nighttime breathing and reduced daytime fatigue after three months. Given the results, a broader multi-center trial is being planned.

Further Insights from the TESLA Trial

Despite pandemic-related challenges, the trial confirmed that TESLA can be safely and effectively applied in OSA patients non-compliant to CPAP. The treatment showed positive impacts on sleepiness and fragmentation. This method offers an affordable treatment alternative in clinical practice. However the lead researchers also advised caution when considering the study finding, publishing a statement on the charity webpage hope2sleep.co.uk. Addressing the potential of TENS for OSA, Dr. Deeban Ratneswaran, the first author of the reported trial, commented:: 

“While the results are promising, it is essential to highlight the specific conditions of our study. The success of the method depends heavily on the selection of responders, education of the patient, and the meticulous management of the therapeutic settings. Our study sheds light on the potential and the acceptability of using TESLA in a home setting, and a broader multi-centre trial will be required to further validate its applicability. We strongly advise patients to consult their healthcare providers before considering new treatment modalities, and to continue with their current established treatment for the meantime.”

[Full statement available here]

In Summary

The TESLA trial has illuminated the potential of TENS as an affordable and non-invasive treatment for sleep apnoea. As research progresses, the hope is to uncover more innovative solutions for those plagued by this sleep disorder.