Therapeutic electrical stimulation of the hypoglossal nerve in obstructivesleep apnea

Citation
Ar. Schwartz et al., Therapeutic electrical stimulation of the hypoglossal nerve in obstructivesleep apnea, ARCH OTOLAR, 127(10), 2001, pp. 1216-1223
Citations number
40
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Otolaryngology,"da verificare
Journal title
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY
ISSN journal
0886-4470 → ACNP
Volume
127
Issue
10
Year of publication
2001
Pages
1216 - 1223
Database
ISI
SICI code
0886-4470(200110)127:10<1216:TESOTH>2.0.ZU;2-A
Abstract
Background: Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective: To determine the response in obstructive sleep apnea to electric al stimulation of the hypoglossal nerve. Methods: Eight patients with obstructive sleep apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiratio n. Sleep and breathing patterns were examined at baseline before implantati on and after implantation at 1, 3, and 6 months and last follow-up. Results: Unilateral hypoglossal nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non-ra pid eye movement (mean +/- SD episodes per hour, 52.0 +/- 20.4 for baseline nights and 22.6 +/- 12.1 for stimulation nights; P<.001) and rapid eye mov ement (48.2 +/- 30.5 and 16.6 +/- 17.1, respectively; P<.001) sleep and red uced the severity of oxyhemoglobin desaturations. With improvement in sleep apnea, a trend toward deeper stages of non-rapid eye movement sleep was ob served. Moreover, all patients tolerated long-term stimulation at night and did not experience any adverse effects from stimulation. Even after comple ting the study protocol, the 3 patients who remained free from stimulator m alfunction continued to use this device as primary treatment. Conclusion: The findings demonstrate the feasibility and therapeutic potent ial for hypoglossal nerve stimulation in obstructive sleep apnea.