Hypoglossal nerve stimulation on sleep and level of alertness in OSA
Neurology. 2018-07-18; 91(7): e615-e619
DOI: 10.1212/WNL.0000000000006001
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1. Neurology. 2018 Aug 14;91(7):e615-e619. doi: 10.1212/WNL.0000000000006001. Epub
2018 Jul 18.
Hypoglossal nerve stimulation on sleep and level of alertness in OSA: A
preliminary study.
Philip P(1), Heiser C(2), Bioulac S(2), Altena E(2), Penchet G(2), Cuny E(2),
Hofauer B(2), Monteyrol PJ(2), Micoulaud-Franchi JA(2).
Author information:
(1)From the Université de Bordeaux (P.P., S.B., E.A., J.-A.M.-F.), SANPSY, USR
3413, Bordeaux; CNRS-SANPSY (P.P., S.B., E.A., J.-A.M.-F.), USR 3413, Bordeaux;
Clinique du Sommeil (P.P., S.B., P.-J.M., J.-A.M.-F.), CHU Pellegrin, Place
Amélie-Raba-Léon, Bordeaux, France; Service de Neuro-chirurgie (E.A., E.C.), CHU
de Bordeaux, Place Amélie Raba-Léon, Bordeaux, France; and Department of
Otolaryngology, Head and Neck Surgery (C.H., B.H.), Technical University of
Munich, Klinikum Rechts der Isar, Hals-Nasen-Ohren-Klinik, Munich, Germany.
.
(2)From the Université de Bordeaux (P.P., S.B., E.A., J.-A.M.-F.), SANPSY, USR
3413, Bordeaux; CNRS-SANPSY (P.P., S.B., E.A., J.-A.M.-F.), USR 3413, Bordeaux;
Clinique du Sommeil (P.P., S.B., P.-J.M., J.-A.M.-F.), CHU Pellegrin, Place
Amélie-Raba-Léon, Bordeaux, France; Service de Neuro-chirurgie (E.A., E.C.), CHU
de Bordeaux, Place Amélie Raba-Léon, Bordeaux, France; and Department of
Otolaryngology, Head and Neck Surgery (C.H., B.H.), Technical University of
Munich, Klinikum Rechts der Isar, Hals-Nasen-Ohren-Klinik, Munich, Germany.
OBJECTIVES: To quantify the effect of hypoglossal nerve stimulation (HNS), a
novel therapy for patients with obstructive sleep apnea, on objective level of
alertness (measured with Maintenance of Wakefulness Test [MWT] values) and
nocturnal sleep architecture.
METHODS: Ten male patients (mean age 52.0 ± 9.4 years; mean body mass index 28.8
± 3.3 kg/m2) noncompliant to continuous positive airway pressure received HNS
(Inspire therapy) and were prospectively evaluated at baseline and 6 months after
HNS therapy. Polysomnographic parameters (sleep breathing and sleep architecture)
and objective level of alertness (MWT) were measured.
RESULTS: The mean preimplantation apnea-hypopnea index of 46.7/h ± 12.2/h was
reduced to 14.5/h ± 8.9/h at 6 months postimplantation (p < 0.001). The mean MWT
latency improved from 25.0 ± 12.8 minutes at baseline to 36.8 ± 7.0 minutes after
6 months of treatment (p = 0.004). A reduction of N1% (11.8 ± 10.6 vs 4.2 ± 1.9,
p = 0.04) was observed. The reduction in the duration of wake after sleep onset
(WASO) was 71.4 ± 32.4 minutes vs 53.4 ± 13.5 minutes (p = 0.06) but was not
significant. MWT latencies at 6 months were negatively correlated with the
intensity of stimulation (r = -0.63, p = 0.05). Intensity of stimulation was
positively correlated with WASO (r = 0.76, p = 0.01).
CONCLUSION: HNS improved the objective level of alertness and changed nocturnal
sleep architecture. The level of neural stimulation determines the amount of
nocturnal WASO and the level of objective level of alertness.
© 2018 American Academy of Neurology.
DOI: 10.1212/WNL.0000000000006001
PMID: 30021916