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.