Hypoglossal nerve stimulation therapy on peripheral arterial tonometry in obstructive sleep apnea: a pilot study

Purpose Hypoglossal nerve stimulation (HGNS) is being increasingly utilized in the setting of moderate-severe obstructive sleep apnea (OSA). While moderate-severe OSA confers excess cardiovascular risk, the impact of HGNS on cardiovascular requires further investigation. With the advent of periphera...

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Bibliographic Details
Published in:Sleep & breathing 2019-03, Vol.23 (1), p.153-160
Main Authors: Ikeda, Allison K., Li, Qiao, Quyuumi, Arshed A., Dedhia, Raj C.
Format: Article
Language:English
Subjects:
Aged
Apnea
Arousal
Autonomic nervous system
Autonomic Nervous System - physiology
Cardiovascular diseases
Dentistry
Electric Stimulation Therapy - methods
Female
Humans
Hypoglossal Nerve
Internal Medicine
Male
Manometry - methods
Medicine
Medicine & Public Health
Middle Aged
Neurology
Otorhinolaryngology
Pediatrics
Pilot Projects
Pneumology/Respiratory System
Polysomnography - instrumentation
Sleep
Sleep apnea
Sleep Apnea, Obstructive - therapy
Sleep Breathing Physiology and Disorders • Original Article
Sleep disorders
Titration
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Summary:Purpose Hypoglossal nerve stimulation (HGNS) is being increasingly utilized in the setting of moderate-severe obstructive sleep apnea (OSA). While moderate-severe OSA confers excess cardiovascular risk, the impact of HGNS on cardiovascular requires further investigation. With the advent of peripheral arterial tonometry (PAT), one can non-invasively study real-time changes to the autonomic nervous system. This study evaluates the effect of HGNS therapy on autonomic output, using PAT-integrated polysomnography. Methods Subjects included adult patients undergoing 2-month post-operative HGNS titration studies with PAT-integrated polysomnography. Apneic and hypopneic events with arousal during stage 2 sleep were identified at increasing levels of stimulation. With each event, PAT signal attenuations were recorded, processed, and analyzed. Results Nine subjects were enrolled, and eight met inclusion criteria (mean age 67.8 ± 12.4 years; 50% female). The PAT signal did not significantly change before and during stimulation (mean pre-stimulation 43.4 ± 1.7, mean intra-stimulation 41.1 ± 22.5, p  = 0.53) in any patient. The ratio of the PAT signal maximum and minimum amplitudes during sleep breathing events largely demonstrated very weak correlation ( R 2  = 
ISSN:1520-9512
1522-1709
DOI:10.1007/s11325-018-1676-9