Upper-Airway Stimulation for Obstructive Sleep Apnea

• Published in: The New England journal of medicine Vol. 370; no. 2; pp. 139 - 149
• Main Authors: Strollo, Patrick J, Soose, Ryan J, Maurer, Joachim T, de Vries, Nico, Cornelius, Jason, Froymovich, Oleg, Hanson, Ronald D, Padhya, Tapan A, Steward, David L, Gillespie, M. Boyd, Woodson, B. Tucker, Van de Heyning, Paul H, Goetting, Mark G, Vanderveken, Oliver M, Feldman, Neil, Knaack, Lennart, Strohl, Kingman P
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 09-01-2014
• Subjects: Adult; Aged; Apnea; Biological and medical sciences; Continuous positive airway pressure; Electric Stimulation Therapy - adverse effects; Female; General aspects; Heart attacks; Humans; Hypertension; Hypoglossal Nerve; Lung; Male; Medical sciences; Middle Aged; Oxygen - blood; Pharyngeal Muscles - innervation; Pharyngeal Muscles - physiopathology; Pneumology; Polysomnography; Prospective Studies; Quality of life; Respiratory system : syndromes and miscellaneous diseases; Respiratory tract; Sleep; Sleep and wakefulness; Sleep apnea; Sleep Apnea, Obstructive - therapy; Sleep disorders; Medicine; Stimulation; Nervous system diseases; Sleep apnea syndrome; Upper respiratory tract; Respiratory disease
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1308659

In this single-cohort study of patients with obstructive sleep apnea who could not adhere to treatment with continuous positive airway pressure, stimulation of the upper-airway muscles in synchrony with ventilatory efforts improved sleep quality.
Obstructive sleep apnea is a common disorder, characterized by recurrent narrowing and closure of the upper airway accompanied by intermittent oxyhemoglobin desaturation and sympathetic activation.
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Sequelae include excessive sleepiness and impaired quality of life. Moderate-to-severe obstructive sleep apnea, defined as an apnea–hypopnea index (AHI) score of 15 or more apnea or hypopnea events per hour, is an independent risk factor for insulin resistance, dyslipidemia, vascular disease, and death.
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Treatment with continuous positive airway pressure (CPAP) with the use of a mask favorably modifies these adverse health consequences.
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However, the general effectiveness of CPAP therapy is dependent on patient acceptance . . .