Increasing off-time improves sleep-disordered breathing induced by vagal nerve stimulation

Vagal nerve stimulation (VNS) has been reported to adversely impact breathing in sleep. While continuous positive airway pressure is often employed to treat these patients, little data exist on the effects of adjusting various settings on VNS-induced sleep-disordered breathing. We describe a patient in whom increasing off-time caused resolution of VNSinduced arterial oxygen desaturations in sleep, which we believe is a novel observation.