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Short-Term Outcome of Unilateral Inspiration-Coupled Hypoglossal Nerve Stimulation in Patients with Obstructive Sleep Apnea

Author

Listed:
  • Johannes Pordzik

    (Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany)

  • Christopher Seifen

    (Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany)

  • Katharina Ludwig

    (Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany)

  • Tilman Huppertz

    (Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany)

  • Katharina Bahr

    (Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany)

  • Christoph Matthias

    (Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany)

  • Haralampos Gouveris

    (Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany)

Abstract

Hypoglossal nerve stimulation (HGNS) is a therapeutic option for patients with obstructive sleep apnea (OSA) and intolerance of positive airway pressure (PAP) therapy. Most reported data are based on multicentre pivotal trials with selected baseline core clinical features. Our aim was to investigate polysomnography (PSG)-based outcomes of HGNS-therapy in a patient cohort with higher average AHI and BMI than previously reported. Data of 29 consecutive patients (nine female; mean age: 55.52 ± 8.6 years, mean BMI 30.13 ± 3.93 kg/m 2 ) were retrospectively evaluated. Numerical values of PSG- based metrics were compared before and after intervention using Wilcoxon’s rank-sum test. AHI (38.57/h ± 12.71, 24.43/h ± 13.3, p < 0.001), hypopnea index (24.05/h ± 9.4, 15.27/h ± 8.23, p < 0.001), apnea index (14.5/h ± 12.05, 9.17/h ± 10.86, p < 0.01), snoring index (262.68/h ± 170.35, 143.48/h ± 162.79, p < 0.001), cortical arousal index (20.8/h ± 10.34 vs. 14.9/h ± 8.36, p < 0.01) and cumulative duration of apnea and hypopnea during sleep (79.79 min ± 40.32 vs. 48.62 min ± 30.56, p < 0.001) were significantly lower after HGNS. HGNS provides an effective therapy option for selected patients not tolerating PAP-therapy with higher average AHI and BMI than usually reported. HGNS-therapy appears to suppress central nervous system arousal circuits while not eliciting peripheral autonomous sympathetic activation. Such metrics as the snoring index and the cumulative duration of respiratory events during sleep may be considered in future HGNS studies.

Suggested Citation

  • Johannes Pordzik & Christopher Seifen & Katharina Ludwig & Tilman Huppertz & Katharina Bahr & Christoph Matthias & Haralampos Gouveris, 2022. "Short-Term Outcome of Unilateral Inspiration-Coupled Hypoglossal Nerve Stimulation in Patients with Obstructive Sleep Apnea," IJERPH, MDPI, vol. 19(24), pages 1-9, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:24:p:16443-:d:996832
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    References listed on IDEAS

    as
    1. Naijin Zhang & Yintao Chen & Shuang Chen & Pengyu Jia & Xiaofan Guo & Guozhe Sun & Yingxian Sun, 2017. "Self-Reported Snoring Is Associated with Dyslipidemia, High Total Cholesterol, and High Low-Density Lipoprotein Cholesterol in Obesity: A Cross-Sectional Study from a Rural Area of China," IJERPH, MDPI, vol. 14(1), pages 1-10, January.
    2. Saif Mashaqi & Salma Imran Patel & Daniel Combs & Lauren Estep & Sonia Helmick & Joan Machamer & Sairam Parthasarathy, 2021. "The Hypoglossal Nerve Stimulation as a Novel Therapy for Treating Obstructive Sleep Apnea—A Literature Review," IJERPH, MDPI, vol. 18(4), pages 1-24, February.
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