New implant to ease sleep apnea

Washington: Researchers have developed a new implant device – a pacemaker with a tiny generator and a sensing lead – which instead of using electrical pulses to control abnormal heart rate, uses two wires to stimulate the tongue to help cut sleep apnea.

A new device implanted in the chest called hypoglossal nerve stimulation (HGNS) offers promise for patients with moderate to severe obstructive sleep apnea (OSA) who cannot tolerate continuous positive airway pressure (CPAP).

Patients use a remote control to turn on the device before going to sleep and turn it off upon waking up. A delay allows the user to fall asleep before the pulse generator begins stimulation, researchers from University of Pennsylvania in
the US said.

After detecting the user’s breathing pattern, the machine stimulates the hypoglossal nerve (the nerve that controls tongue motion) which enlarges the upper airway. Researchers completed 20 implants between January 2015 and
March 2016.

All patients had information from a baseline polysomnography (PSG) recording prior to HGNS implant, as well as a post PSG approximately two months after HGNS, to assess the severity of their apnea and any change after treatment.

Those who received the implant were typically overweight, middle aged, and had severe OSA. Total apnea-hypopnea index (AHI) – which measures severity
of sleep apnea by counting the number of pauses in breathing during sleep – for all patients significantly decreased an average of 35 events per hour after the device was planted, which corresponds to an average reduction of 84 per cent,researchers said.

Additionally, the lowest oxygen level measured in the blood during the night significantly increased by 11 per cent, from 79 per cent to 90 per cent, they said. The device is a pacemaker with a tiny generator and a sensing lead, but instead of using electrical pulses to control abnormal heart rate, it uses two wires to stimulate the tongue.

“Considering that sleep apnea can lead to high blood pressure, heart attack, stroke, and other serious health problems, it is critically important that we study devices that may serve as another option instead of CPAP to treat patients with sleep apnea,” said Richard Schwab from University of Pennsylvania.

“There is no perfect treatment option for obstructive sleep apnea, but our preliminary data suggest that hypoglossal nerve stimulation can effectively treat patients with sleep apnea who are unable to tolerate CPAP,” said Schwab.