Navigation Links
Hypoglossal nerve stimulation increases airflow during sleep in obstructive sleep apnea
Date:11/24/2011

Hypoglossal nerve stimulation (HGNS) produced marked dose-related increases in airflow in obstructive sleep apnea (OSA) patients without arousing them from sleep, according to a new study from the Johns Hopkins Sleep Disorders Center. The study suggests the potential therapeutic efficacy of HGNS across a broad range of sleep apnea severity and offers an alternative to continuous positive airway pressure (CPAP), the current mainstay of treatment for moderate to severe OSA. The effectiveness of CPAP is often limited by poor patient adherence.

"With HGNS, airflow increased in all of our patients, and increased progressively with stimulus amplitude," according to Alan R. Schwartz, MD, medical director of the Sleep Center at Johns Hopkins Bayview Medical Center. "The increases in airflow we observed were of sufficient magnitude to eliminate inspiratory airflow limitation (IFL) in the majority of patients."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

The study, which was supported by device manufacturer Apnex Medical, Inc., enrolled 30 middle-aged patients with moderate and severe obstructive sleep apnea who were implanted with a novel HGNS system. The pacemaker-like device monitors breathing patterns and is activated during sleep to stimulate the hypoglossal nerve, which controls muscles in the upper airway.

During the study, current was increased stepwise during non-REM sleep. Frequency and pulse width were fixed. At each current level, stimulation was applied on alternating breaths so that responses in inspiratory airflow could be compared to adjacent unstimulated breaths, and maximal inspiratory airflow (VImax) and IFL were measured.

HGNS produced linear increases in VImax with increasing current. Mean VImax increased significantly from 21521ml/s off stimulation to 50937mL/s on stimulation. VImax increased in all patients, and IFL was abolished entirely in 17 (57%). Normal or near-normal levels of flow were achieved in all 30 patients.

"In our study, acute unilateral stimulation of the hypoglossal nerve during sleep in patients with obstructive sleep apnea resulted in progressive increases in inspiratory airflow with increasing stimulation intensity, and inspiratory flow limitation was completely eliminated in the majority of patients," said Dr. Schwartz. "Of note, inspiratory airflow returned to baseline levels on alternating unstimulated breaths, suggesting that HGNS has a direct effect on lingual muscles and airway patency without arousing patients from sleep."

The study had a few limitations. Esophageal manometry was not used to monitor inspiratory effort, and flow response was not measured in all body positions and sleep stages. In addition, the effects of chronic use of HGNS therapy were not assessed.

"Our findings extend previous findings on the effects of HGNS on airflow in obstructive sleep apnea by characterizing flow responses over a range of stimulus amplitudes and demonstrating greater increases in airflow," concluded Dr. Schwartz. "The magnitude of the increases in airflow we observed indicate that HGNS can provide substantial relief of upper airway obstruction during sleep in these patients across a wide range of disease severity."


'/>"/>

Contact: Nathaniel Dunford
ndunford@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

Related biology news :

1. Researchers get $7.5M grant to combat nerve agents
2. Noninvasive current stimulation improves sight in patients with optic nerve damage
3. Simple nerve cells regulate swimming depth of marine plankton
4. UC San Diego biologists discover genes that repair nerves after injury
5. Team creates genetic GPS system to comprehensively locate and track inhibitory nerve cells
6. Scripps Research scientists solve mystery of nerve disease genes
7. Syracuse University scientists discover new hitch to link nerve cell motors to their cargo
8. WSU study expands time window for facial nerve rehabilitation
9. Johns Hopkins scientists reveal nerve cells navigation system
10. Experimental Alzheimers disease drugs might help patients with nerve injuries
11. OSU chemist developing solution to nerve agent exposure
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/14/2017)... , Feb. 14, 2017  Wake Forest Baptist ... as its new chief executive officer (CEO). Freischlag joins ... John D. McConnell , M.D., who last year ... at the Medical Center, after leading it since 2008. ... full scope of Wake Forest Baptist,s academic health system, ...
(Date:2/10/2017)... Research and Markets has announced ... - Scientific and Commercial Aspects" to their offering. ... Biomarkers ... with therapy for selection of treatment as well for monitoring ... of disease in modern medicine. Biochip/microarray technologies and next generation ...
(Date:2/8/2017)... -- Aware, Inc. (NASDAQ: AWRE ), a leading supplier ... its quarter and year ended December 31, 2016. ... million compared to $6.9 million in the same quarter last ... $0.6 million compared to $2.6 million in the fourth quarter ... was $0.5 million, or $0.02 per diluted share, which compares ...
Breaking Biology News(10 mins):
(Date:2/24/2017)... -- Aethlon Medical, Inc. (Nasdaq: AEMD ), today ... CEO, Jim Joyce . In a ... Bill Gates warned world leaders that a ... weapons. Mr. Gates expressed his concern, which is also ... terrorists have access to the necessary tools to design ...
(Date:2/24/2017)... , Feb. 24, 2017  Driven by ... biotechnology are now the fastest growing categories, finds ... Specialty Actives in Personal Care: Multi-regional Market Analysis ... and management consulting firm Kline. "Biotechnology ... that make them more effective for skin and ...
(Date:2/24/2017)... , ... February 24, 2017 , ... FireflySci, Inc is ... in late 2014, FireflySci had the goal of bringing their powerful cuvette ... to shape the path that FireflySci is going on as they add yet another ...
(Date:2/24/2017)... Corporation (NASDAQ: VWR), the leading global independent provider of product ... its financial results for the fourth quarter and full year ... 4Q16 record quarterly net sales of $1.13 billion, up ... 4Q16 EMEA-APAC segment net sales increased ... net sales increased 2.5%, or down 0.9% on an organic ...
Breaking Biology Technology: