Office-Based Multilevel Radiofrequency Ablation for Mild-to-Moderate Obstructive Sleep Apnea

Abstract

Objective: Investigate multilevel radiofrequency ablation (RFA) as an alternative therapy for patients with mild-to-moderate obstructive sleep apnea (OSA). Study Design: Prospective, open-label, single-arm, nonrandomized clinical trial. Setting: Multicenter academic and private clinics. Methods: Patients with mild-to-moderate OSA (apnea-hypopnea index [AHI] 10-30; body mass index ≤ 32) were treated with 3 sessions of office-based RFA to the soft palate and tongue base. The primary outcome was a change in the AHI and oxygen desaturation index (ODI 4%). Secondary outcomes included subjective sleepiness level; snoring level; and sleep-related quality of life. Results: Fifty-six patients were enrolled, with 43 (77%) completing the study protocol. Following 3 sessions of office-based RFA to the palate and base of the tongue, the mean AHI decreased from 19.7 to 9.9 (p =.001), while the mean ODI (4%) decreased from 12.8 to 8.4 (p =.005). Mean Epworth Sleepiness Scale scores declined from 11.2 (±5.4) to 6.0 (±3.5) (p =.001), while Functional Outcomes of Sleep Questionnaire scores improved from a mean of 14.9 at baseline to 17.4 (p =.001). The mean visual analog scale snoring scale was reduced from 5.3 (±1.4) at baseline to 3.4 (±1.6) at 6 months posttherapy (p =.001). Conclusion: Office-based, multilevel RFA of the soft palate and base of the tongue is a safe and effective treatment option with minimal morbidity for properly selected patients with mild-to-moderate OSA who are intolerant or refuse continuous positive airway pressure therapy.