Treating obstructive sleep apnea with hypoglossal nerve stimulation

Background: Reduced upper airway muscle activity during sleep is fundamental to obstructive sleep apnea (OSA) pathogenesis. Hypoglossal nerve stimulation (HGNS) counteracts this problem, with potential to reduce OSA severity. Study Objectives: To examine safety and efficacy of a novel HGNS system (H...

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Main Authors: Eastwood, Peter, Barnes, M., Walsh, J., Maddison, K., Hee, G., Schwartz, A., Smith, P., Malhotra, A., McEvoy, R., Wheatley, J., O'Donoghue, F., Rochford, P., Churchward, T., Campbell, M., Palme, C., Robinson, S., Goding, G., Eckert, D., Jordan, A., Catcheside, P., Tyler, L., Antic, N., Worsnop, C., Kezirian, E., Hillman, D.
Format: Journal Article
Published: 2011
Online Access:http://hdl.handle.net/20.500.11937/12633
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author Eastwood, Peter
Barnes, M.
Walsh, J.
Maddison, K.
Hee, G.
Schwartz, A.
Smith, P.
Malhotra, A.
McEvoy, R.
Wheatley, J.
O'Donoghue, F.
Rochford, P.
Churchward, T.
Campbell, M.
Palme, C.
Robinson, S.
Goding, G.
Eckert, D.
Jordan, A.
Catcheside, P.
Tyler, L.
Antic, N.
Worsnop, C.
Kezirian, E.
Hillman, D.
author_facet Eastwood, Peter
Barnes, M.
Walsh, J.
Maddison, K.
Hee, G.
Schwartz, A.
Smith, P.
Malhotra, A.
McEvoy, R.
Wheatley, J.
O'Donoghue, F.
Rochford, P.
Churchward, T.
Campbell, M.
Palme, C.
Robinson, S.
Goding, G.
Eckert, D.
Jordan, A.
Catcheside, P.
Tyler, L.
Antic, N.
Worsnop, C.
Kezirian, E.
Hillman, D.
author_sort Eastwood, Peter
building Curtin Institutional Repository
collection Online Access
description Background: Reduced upper airway muscle activity during sleep is fundamental to obstructive sleep apnea (OSA) pathogenesis. Hypoglossal nerve stimulation (HGNS) counteracts this problem, with potential to reduce OSA severity. Study Objectives: To examine safety and efficacy of a novel HGNS system (HGNS, Apnex Medical, Inc.) in treating OSA. Participants: Twenty-one patients, 67% male, age (mean ± SD) 53.6 ± 9.2 years, with moderate to severe OSA and unable to tolerate continuous positive airway pressure (CPAP). Design: Each participant underwent surgical implantation of the HGNS system in a prospective single-arm interventional trial. OSA severity was defined by apnea-hypopnea index (AHI) during in-laboratory polysomnography (PSG) at baseline and 3 and 6 months post-implant. Therapy compliance was assessed by nightly hours of use. Symptoms were assessed using the Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Calgary Sleep Apnea Quality of Life Index (SAQLI), and the Beck Depression Inventory (BDI). Results: HGNS was used on 89% ± 15% of nights (n = 21). On these nights, it was used for 5.8 ± 1.6 h per night. Nineteen of 21 participants had baseline and 6-month PSGs. There was a significant improvement (all P &lt; 0.05) from baseline to 6 months in: AHI (43.1 ± 17.5 to 19.5 ± 16.7), ESS (12.1 ± 4.7 to 8.1 ± 4.4), FOSQ (14.4 ± 2.0 to 16.7 ± 2.2), SAQLI (3.2 ± 1.0 to 4.9 ± 1.3), and BDI (15.8 ± 9.0 to 9.7 ± 7.6). Two serious device-related adverse events occurred: an infection requiring device removal and a stimulation lead cuff dislodgement requiring replacement. Conclusions: HGNS demonstrated favorable safety, efficacy, and compliance. Participants experienced a significant decrease in OSA severity and OSA-associated symptoms. Clinical Trial Information: Name: Australian Clinical Study of the Apnex Medical HGNS System to Treat Obstructive Sleep Apnea. Registration Number: NCT01186926. URL: <a href="http://clinicaltrials.gov/ct2/show/NCT01186926">http://clinicaltrials.gov/ct2/show/NCT01186926</a>.
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spelling curtin-20.500.11937-126332017-09-13T14:58:46Z Treating obstructive sleep apnea with hypoglossal nerve stimulation Eastwood, Peter Barnes, M. Walsh, J. Maddison, K. Hee, G. Schwartz, A. Smith, P. Malhotra, A. McEvoy, R. Wheatley, J. O'Donoghue, F. Rochford, P. Churchward, T. Campbell, M. Palme, C. Robinson, S. Goding, G. Eckert, D. Jordan, A. Catcheside, P. Tyler, L. Antic, N. Worsnop, C. Kezirian, E. Hillman, D. Background: Reduced upper airway muscle activity during sleep is fundamental to obstructive sleep apnea (OSA) pathogenesis. Hypoglossal nerve stimulation (HGNS) counteracts this problem, with potential to reduce OSA severity. Study Objectives: To examine safety and efficacy of a novel HGNS system (HGNS, Apnex Medical, Inc.) in treating OSA. Participants: Twenty-one patients, 67% male, age (mean ± SD) 53.6 ± 9.2 years, with moderate to severe OSA and unable to tolerate continuous positive airway pressure (CPAP). Design: Each participant underwent surgical implantation of the HGNS system in a prospective single-arm interventional trial. OSA severity was defined by apnea-hypopnea index (AHI) during in-laboratory polysomnography (PSG) at baseline and 3 and 6 months post-implant. Therapy compliance was assessed by nightly hours of use. Symptoms were assessed using the Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Calgary Sleep Apnea Quality of Life Index (SAQLI), and the Beck Depression Inventory (BDI). Results: HGNS was used on 89% ± 15% of nights (n = 21). On these nights, it was used for 5.8 ± 1.6 h per night. Nineteen of 21 participants had baseline and 6-month PSGs. There was a significant improvement (all P &lt; 0.05) from baseline to 6 months in: AHI (43.1 ± 17.5 to 19.5 ± 16.7), ESS (12.1 ± 4.7 to 8.1 ± 4.4), FOSQ (14.4 ± 2.0 to 16.7 ± 2.2), SAQLI (3.2 ± 1.0 to 4.9 ± 1.3), and BDI (15.8 ± 9.0 to 9.7 ± 7.6). Two serious device-related adverse events occurred: an infection requiring device removal and a stimulation lead cuff dislodgement requiring replacement. Conclusions: HGNS demonstrated favorable safety, efficacy, and compliance. Participants experienced a significant decrease in OSA severity and OSA-associated symptoms. Clinical Trial Information: Name: Australian Clinical Study of the Apnex Medical HGNS System to Treat Obstructive Sleep Apnea. Registration Number: NCT01186926. URL: <a href="http://clinicaltrials.gov/ct2/show/NCT01186926">http://clinicaltrials.gov/ct2/show/NCT01186926</a>. 2011 Journal Article http://hdl.handle.net/20.500.11937/12633 10.5665/sleep.1380 unknown
spellingShingle Eastwood, Peter
Barnes, M.
Walsh, J.
Maddison, K.
Hee, G.
Schwartz, A.
Smith, P.
Malhotra, A.
McEvoy, R.
Wheatley, J.
O'Donoghue, F.
Rochford, P.
Churchward, T.
Campbell, M.
Palme, C.
Robinson, S.
Goding, G.
Eckert, D.
Jordan, A.
Catcheside, P.
Tyler, L.
Antic, N.
Worsnop, C.
Kezirian, E.
Hillman, D.
Treating obstructive sleep apnea with hypoglossal nerve stimulation
title Treating obstructive sleep apnea with hypoglossal nerve stimulation
title_full Treating obstructive sleep apnea with hypoglossal nerve stimulation
title_fullStr Treating obstructive sleep apnea with hypoglossal nerve stimulation
title_full_unstemmed Treating obstructive sleep apnea with hypoglossal nerve stimulation
title_short Treating obstructive sleep apnea with hypoglossal nerve stimulation
title_sort treating obstructive sleep apnea with hypoglossal nerve stimulation
url http://hdl.handle.net/20.500.11937/12633