Therapeutic electrical stimulation of the hypoglossal nerve in obstructivesleep apnea

Schwartz, AR Bennett, ML Smith, PL De Backer, W Hedner, J Boudewyns, A Van de Heyning, P Ejnell, H Hochban, W Knaack, L Podszus, T Penzel, T Peter, JH Goding, GS Erickson, DJ Testerman, R Ottenhoff, F Eisele, DW

Ar. Schwartz et al., Therapeutic electrical stimulation of the hypoglossal nerve in obstructivesleep apnea, ARCH OTOLAR, 127(10), 2001, pp. 1216-1223

40

INGLESE

Article

Otolaryngology,"da verificare

ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY

0886-4470 → ACNP

127

10

2001

1216 - 1223

ISI

0886-4470(200110)127:10<1216:TESOTH>2.0.ZU;2-A

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.