Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea

Alan R Schwartz; Marc L. Bennett; Philip L Smith; Wilfried De Backer; Jan Hedner; An Boudewyns; Paul Van De Heyning; Hasse Ejnell; Walter Hochban; Lennart Knaack; Thomas Podszus; Thomas Penzel; J. Hermann Peter; George S. Goding; Donald J. Erickson; Roy Testerman; Frans Ottenhoff; David W. Eisele

doi:10.1001/archotol.127.10.1216

Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea

Alan R Schwartz, Marc L. Bennett, Philip L Smith, Wilfried De Backer, Jan Hedner, An Boudewyns, Paul Van De Heyning, Hasse Ejnell, Walter Hochban, Lennart Knaack, Thomas Podszus, Thomas Penzel, J. Hermann Peter, George S. Goding, Donald J. Erickson, Roy Testerman, Frans Ottenhoff, David W. Eisele

School of Medicine

Research output: Contribution to journal › Article › peer-review

200 Scopus citations

Abstract

Background: Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective: To determine the response in obstructive sleep apnea to electrical stimulation of the hypoglossal nerve. Methods: Eight patients with obstructive sleep apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results: Unilateral hypoglossal nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non-rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P<.001) and rapid eye movement (48.2±30.5 and 16.6±17.1, respectively; P<.001) sleep and reduced the severity of oxyhemoglobin desaturations. With improvement in sleep apnea, a trend toward deeper stages of non-rapid eye movement sleep was observed. Moreover, all patients tolerated long-term stimulation at night and did not experience any adverse effects from stimulation. Even after completing the study protocol, the 3 patients who remained free from stimulator malfunction continued to use this device as primary treatment. Conclusion: The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in obstructive sleep apnea.

Original language	English (US)
Pages (from-to)	1216-1223
Number of pages	8
Journal	Archives of Otolaryngology--Head and Neck Surgery
Volume	127
Issue number	10
DOIs	https://doi.org/10.1001/archotol.127.10.1216
State	Published - 2001

ASJC Scopus subject areas

Surgery
Otorhinolaryngology

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10.1001/archotol.127.10.1216

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Schwartz, A. R., Bennett, M. L., Smith, P. L., De Backer, W., Hedner, J., Boudewyns, A., Van De Heyning, P., Ejnell, H., Hochban, W., Knaack, L., Podszus, T., Penzel, T., Peter, J. H., Goding, G. S., Erickson, D. J., Testerman, R., Ottenhoff, F., & Eisele, D. W. (2001). Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea. Archives of Otolaryngology--Head and Neck Surgery, 127(10), 1216-1223. https://doi.org/10.1001/archotol.127.10.1216

Schwartz, AR, Bennett, ML, Smith, PL, De Backer, W, Hedner, J, Boudewyns, A, Van De Heyning, P, Ejnell, H, Hochban, W, Knaack, L, Podszus, T, Penzel, T, Peter, JH, Goding, GS, Erickson, DJ, Testerman, R, Ottenhoff, F & Eisele, DW 2001, 'Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea', Archives of Otolaryngology--Head and Neck Surgery, vol. 127, no. 10, pp. 1216-1223. https://doi.org/10.1001/archotol.127.10.1216

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title = "Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea",

abstract = "Background: Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective: To determine the response in obstructive sleep apnea to electrical stimulation of the hypoglossal nerve. Methods: Eight patients with obstructive sleep apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results: Unilateral hypoglossal nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non-rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P<.001) and rapid eye movement (48.2±30.5 and 16.6±17.1, respectively; P<.001) sleep and reduced the severity of oxyhemoglobin desaturations. With improvement in sleep apnea, a trend toward deeper stages of non-rapid eye movement sleep was observed. Moreover, all patients tolerated long-term stimulation at night and did not experience any adverse effects from stimulation. Even after completing the study protocol, the 3 patients who remained free from stimulator malfunction continued to use this device as primary treatment. Conclusion: The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in obstructive sleep apnea.",

author = "Schwartz, {Alan R} and Bennett, {Marc L.} and Smith, {Philip L} and {De Backer}, Wilfried and Jan Hedner and An Boudewyns and {Van De Heyning}, Paul and Hasse Ejnell and Walter Hochban and Lennart Knaack and Thomas Podszus and Thomas Penzel and Peter, {J. Hermann} and Goding, {George S.} and Erickson, {Donald J.} and Roy Testerman and Frans Ottenhoff and Eisele, {David W.}",

year = "2001",

doi = "10.1001/archotol.127.10.1216",

language = "English (US)",

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T1 - Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea

AU - Schwartz, Alan R

AU - Bennett, Marc L.

AU - Smith, Philip L

AU - De Backer, Wilfried

AU - Hedner, Jan

AU - Boudewyns, An

AU - Van De Heyning, Paul

AU - Ejnell, Hasse

AU - Hochban, Walter

AU - Knaack, Lennart

AU - Podszus, Thomas

AU - Penzel, Thomas

AU - Peter, J. Hermann

AU - Goding, George S.

AU - Erickson, Donald J.

AU - Testerman, Roy

AU - Ottenhoff, Frans

AU - Eisele, David W.

PY - 2001

Y1 - 2001

N2 - Background: Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective: To determine the response in obstructive sleep apnea to electrical stimulation of the hypoglossal nerve. Methods: Eight patients with obstructive sleep apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results: Unilateral hypoglossal nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non-rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P<.001) and rapid eye movement (48.2±30.5 and 16.6±17.1, respectively; P<.001) sleep and reduced the severity of oxyhemoglobin desaturations. With improvement in sleep apnea, a trend toward deeper stages of non-rapid eye movement sleep was observed. Moreover, all patients tolerated long-term stimulation at night and did not experience any adverse effects from stimulation. Even after completing the study protocol, the 3 patients who remained free from stimulator malfunction continued to use this device as primary treatment. Conclusion: The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in obstructive sleep apnea.

AB - Background: Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on obstructive sleep apnea is not known. Objective: To determine the response in obstructive sleep apnea to electrical stimulation of the hypoglossal nerve. Methods: Eight patients with obstructive sleep apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results: Unilateral hypoglossal nerve stimulation decreased the severity of obstructive sleep apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean apnea-hypopnea indices in non-rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P<.001) and rapid eye movement (48.2±30.5 and 16.6±17.1, respectively; P<.001) sleep and reduced the severity of oxyhemoglobin desaturations. With improvement in sleep apnea, a trend toward deeper stages of non-rapid eye movement sleep was observed. Moreover, all patients tolerated long-term stimulation at night and did not experience any adverse effects from stimulation. Even after completing the study protocol, the 3 patients who remained free from stimulator malfunction continued to use this device as primary treatment. Conclusion: The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in obstructive sleep apnea.

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Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea

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