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:2/28/2017)... Germany , February 28, 2017 News ... ... Amsterdam from 14 to 16 March, Materna ... destination, and show how seamless travel is a real benefit for ... has added biometrics to their passenger touch point solutions to take ...
(Date:2/22/2017)... 2017 With the biometrics market to ... four technologies that innovative and agile startups must ... in the changing competitive landscape: multifactor authentication (MFA), ... "Companies can no longer afford to ... Dimitrios Pavlakis , Industry Analyst at ABI ...
(Date:2/13/2017)... , Feb. 13, 2017  RSA Conference -- ... platform that is designed to enhance fraud detection ... release in the RSA Fraud & Risk Intelligence ... organizations to leverage additional insights from internal and ... to better protect their customers from targeted cybercrime ...
Breaking Biology News(10 mins):
(Date:3/24/2017)... and ROCKVILLE, Md. , March ... of Maxwell Biotech Venture Fund (MBVF), today announced positive ... added to the standard drug therapy regimen in patients ... small molecule drug discovered by scientists at Sequella, Inc. ... Institutes of Health. A total of ...
(Date:3/24/2017)... 2017 Agenus Inc. (NASDAQ: AGEN), an immuno-oncology ... cancer vaccines, today announced participation at the following conferences: ... Blair and Maidstone Life Sciences conference "Cancer Immunotherapy Conference" ... New York, NY . Agenus will participate ... 9:40 am: Robert B. Stein , M.D., Ph.D., ...
(Date:3/23/2017)... 23, 2017  SeraCare Life Sciences, Inc., a ... vitro diagnostics manufacturers and clinical laboratories, is ... multiplexed Inherited Cancer reference material ... next-generation sequencing (NGS). The Seraseqâ„¢ Inherited Cancer DNA ... from industry experts to validate the ability ...
(Date:3/23/2017)... YORK , March 23, 2017 ... ... of death, putting significant strain on health care systems, in ... cancer diagnoses rises, so too does the development of innovative ... minimum side effects. Among the many types of cancer treatments, ...
Breaking Biology Technology: