Navigation Links
Hypoglossal nerve stimulation increases airflow during sleep in obstructive sleep apnea

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
American Thoracic Society

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:
(Date:6/1/2016)... June 1, 2016 Favorable Government ... Administration and Criminal Identification to Boost Global Biometrics System ... released TechSci Research report, " Global Biometrics Market ... Forecast and Opportunities, 2011 - 2021", the global biometrics ... 2021, on account of growing security concerns across various ...
(Date:5/16/2016)... May 16, 2016   EyeLock LLC , a ... the opening of an IoT Center of Excellence in ... expand the development of embedded iris biometric applications. ... of convenience and security with unmatched biometric accuracy, making ... aside from DNA. EyeLock,s platform uses video technology to ...
(Date:5/3/2016)... Lithuania , May 3, 2016  Neurotechnology, ... released the MegaMatcher Automated Biometric Identification System ... of large-scale multi-biometric projects. MegaMatcher ABIS can process ... accuracy using any combination of fingerprint, face or ... MegaMatcher SDK and MegaMatcher Accelerator ...
Breaking Biology News(10 mins):
(Date:6/23/2016)... , ... June 23, 2016 , ... STACS DNA Inc., ... Leader at the Arkansas State Crime Laboratory, has joined STACS DNA as a Field ... DNA team,” said Jocelyn Tremblay, President and COO of STACS DNA. “In further expanding ...
(Date:6/23/2016)... 2016  Blueprint Bio, a company dedicated to identifying, ... community, has closed its Series A funding round, according ... "We have received a commitment from Forentis Fund ... to meet our current goals," stated Matthew Nunez ... to complete validation on the current projects in our ...
(Date:6/23/2016)... Francisco, CA (PRWEB) , ... June 23, 2016 ... ... (EDC) software, is exhibiting at the Pennsylvania Convention Center and will showcase its ... Annual conference. ClinCapture will also be presenting a scientific poster on Disrupting Clinical ...
(Date:6/23/2016)... 22, 2016  Amgen (NASDAQ: AMGN ) ... QB3@953 life sciences incubator to accelerate the development ... laboratory space at QB3@953 was created to help high-potential ... for many early stage organizations - access to laboratory ... Amgen launched two "Amgen Golden Ticket" awards, providing each ...
Breaking Biology Technology: