Nerve stimulation for the treatment of obstructive sleep apnea
This review will trace the elements of neurostimulation for obstructive sleep apnea and details on its implementation, efficacy and safety, immediate clinical outcomes, and future prospects. The literature on upper airway neurostimulation was surveyed from July 2013 to July 2019, with a focus on the...
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| Veröffentlicht in: | Sleep and biological rhythms 2020, Vol.18 (2), p.77-87 |
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| creator | Yamauchi, Motoo Satoh, Makoto Kitahara, Tadashi Ota, Ichiro Strohl, Kingman |
| description | This review will trace the elements of neurostimulation for obstructive sleep apnea and details on its implementation, efficacy and safety, immediate clinical outcomes, and future prospects. The literature on upper airway neurostimulation was surveyed from July 2013 to July 2019, with a focus on the components of devices, evidence for clinical utility, and adverse events. Current technology is focused on the hypoglossal nerve stimulation (HNS). The most long-term experience is with the Inspire Medical System (Maple Grove, MN USA) which has both FDA and European regulatory approval. Given the inclusion criteria- BMI |
| doi_str_mv | 10.1007/s41105-020-00252-2 |
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The literature on upper airway neurostimulation was surveyed from July 2013 to July 2019, with a focus on the components of devices, evidence for clinical utility, and adverse events. Current technology is focused on the hypoglossal nerve stimulation (HNS). The most long-term experience is with the Inspire Medical System (Maple Grove, MN USA) which has both FDA and European regulatory approval. Given the inclusion criteria- BMI < 35 (ideally < 32), AHI 15–65/h, and a favorable anterior–posterior velopharyngeal collapse pattern on DISE, across many centers ~ 65% of patients who are intolerant to primary therapy achieve clinical success (AHI < 20/h with a reduction of < 50% in AHI), and more have symptomatic relief. Adverse events are generally mild, often self-limited, with occasional need for uncomplicated surgical adjustments or replacement of the implantable generator. Three other devices are in various phases of development, each with differences in nerve electrodes, implantable components, power sources, proprietary programming, and activation patterns. Hypoglossal nerve stimulation (HNS) is not considered a first-line treatment option. 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Adverse events are generally mild, often self-limited, with occasional need for uncomplicated surgical adjustments or replacement of the implantable generator. Three other devices are in various phases of development, each with differences in nerve electrodes, implantable components, power sources, proprietary programming, and activation patterns. Hypoglossal nerve stimulation (HNS) is not considered a first-line treatment option. 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Given the inclusion criteria- BMI < 35 (ideally < 32), AHI 15–65/h, and a favorable anterior–posterior velopharyngeal collapse pattern on DISE, across many centers ~ 65% of patients who are intolerant to primary therapy achieve clinical success (AHI < 20/h with a reduction of < 50% in AHI), and more have symptomatic relief. Adverse events are generally mild, often self-limited, with occasional need for uncomplicated surgical adjustments or replacement of the implantable generator. Three other devices are in various phases of development, each with differences in nerve electrodes, implantable components, power sources, proprietary programming, and activation patterns. Hypoglossal nerve stimulation (HNS) is not considered a first-line treatment option. 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| subjects | Biomedical and Life Sciences Biomedicine Health Psychology Human Physiology Internal Medicine Neurology Neurosciences Psychiatry Review Article |
| title | Nerve stimulation for the treatment of obstructive sleep apnea |
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