{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:13:15Z","timestamp":1789002795498,"version":"build-2803163510"},"reference-count":58,"publisher":"European Respiratory Society (ERS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Institute for Health and Care Research (NIHR) Biomedical Research Centre based at Guy\u2019s and St Thomas\u2019 NHS Foundation Trust and King\u2019s College London, United Kingdom","award":["IS-BRC-1215-20006"],"award-info":[{"award-number":["IS-BRC-1215-20006"]}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2025,11,3]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term adherence to continuous positive airway pressure (CPAP), the standard treatment for obstructive sleep apnoea (OSA), is often poor. Electrical stimulation of upper airway dilator muscles through hypoglossal nerve stimulation (HNS) has emerged as an effective non-CPAP alternative. However, evidence regarding its effect on the cardiovascular system remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A meta-analysis investigating the effect of HNS and transcutaneous electrical nerve stimulation (TENS) on blood pressure was conducted (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"www.crd.york.ac.uk\/PROSPERO\">www.crd.york.ac.uk\/PROSPERO<\/jats:ext-link>\n                      identifier CRD42023429546). MEDLINE\/PubMed and Web of Science Core Collection databases were searched up to 25 January 2024. Quality assessment was performed using the Cochrane Risk of Bias for Randomised Trials tool and Newcastle\u2013Ottawa Scale for nonrandomised studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 6260 eligible studies identified, eight underwent full-text screening. Four did not measure change in blood pressure and were excluded. Data from the remaining four studies (n=304) were pooled (three HNS studies (n=291) and one TENS study (n=13)). Patients were middle-aged (mean\u00b1\n                      <jats:sc>sd<\/jats:sc>\n                      age 59.3\u00b113.1 years), overweight (mean\u00b1\n                      <jats:sc>sd<\/jats:sc>\n                      body mass index 28.7\u00b13.8 kg\u00b7m\n                      <jats:sup>\u22122<\/jats:sup>\n                      ), and had moderate-to-severe OSA (mean\u00b1\n                      <jats:sc>sd<\/jats:sc>\n                      apnoea\u2013hypopnoea index 34.8\u00b17.1 events\u00b7h\n                      <jats:sup>\u22121<\/jats:sup>\n                      ). Electrical stimulation was associated with a trend towards reduction in systolic (\u22123.44, 95% CI \u22127.98\u20131.10 mmHg), diastolic (\u22123.41, 95% CI \u22128.10\u20131.27 mmHg), and mean arterial blood pressure (\u22125.69, 95% CI \u221213.66\u20132.28 mmHg).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A trend between electrical stimulation of upper airway dilator muscles and reduction in blood pressure was demonstrated. Further studies on normal subjects and patients with OSA are required to compare the effects on blood pressure to CPAP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.01076-2025","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T13:15:27Z","timestamp":1773321327000},"page":"01076-2025","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The effect of electrical stimulation of the upper airway dilator muscles on blood pressure in healthy volunteers and patients with obstructive sleep apnoea: a systematic review and meta-analysis"],"prefix":"10.1183","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1124-3887","authenticated-orcid":false,"given":"Zakaa S.","family":"Khaled","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3407-5364","authenticated-orcid":false,"given":"Abdullatif","family":"Alhuzaim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1587-3109","authenticated-orcid":false,"given":"Joerg","family":"Steier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"2026070608550557000_12.3.01076-2025.1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"2026070608550557000_12.3.01076-2025.2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/22.5.667"},{"key":"2026070608550557000_12.3.01076-2025.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2010.01.012"},{"key":"2026070608550557000_12.3.01076-2025.4","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00587.2005"},{"key":"2026070608550557000_12.3.01076-2025.5","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-0136"},{"key":"2026070608550557000_12.3.01076-2025.6","first-page":"e775","article-title":"Correction to: obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association","volume":"145","year":"2022","journal-title":"Circulation"},{"key":"2026070608550557000_12.3.01076-2025.7","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000988"},{"key":"2026070608550557000_12.3.01076-2025.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.14.1906"},{"key":"2026070608550557000_12.3.01076-2025.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2013.04.026"},{"key":"2026070608550557000_12.3.01076-2025.10","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1164\/ajrccm.156.6.9610026","article-title":"Sleep-disordered breathing and neuropsychological deficits. 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