scholarly journals Therapeutic Positive Airway Pressure Level Predicts Response to Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

2019 ◽  
Vol 15 (08) ◽  
pp. 1165-1172 ◽  
Author(s):  
Clara H. Lee ◽  
Everett G. Seay ◽  
Benjamin K. Walters ◽  
Nicholas J. Scalzitti ◽  
Raj C. Dedhia
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Airway Pressure ◽  
Hypoglossal Nerve ◽  
Positive Airway Pressure ◽  
Pressure Level ◽  
Hypoglossal Nerve Stimulation ◽  
Obstructive Sleep

scholarly journals 0551 Therapeutic Positive Airway Pressure Level Predicts Response to Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A220-A220
Author(s):  
Clara H Lee ◽  
Everett G Seay ◽  
Benjamin K Walters ◽  
Nicholas J Scalzitti ◽  
Raj C Dedhia
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Airway Pressure ◽  
Hypoglossal Nerve ◽  
Positive Airway Pressure ◽  
Pressure Level ◽  
Hypoglossal Nerve Stimulation ◽  
Obstructive Sleep

Obstructive Sleep Apnea: Diagnosis and Management

2020 ◽  
Author(s):  
Diane C Lim ◽  
Richard J Schwab
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Airway Pressure ◽  
Hypoglossal Nerve ◽  
Positive Airway Pressure ◽  
Oral Appliances ◽  
Craniofacial Abnormalities ◽  
Obstructive Sleep ◽  
Line Of Therapy

As part 2 of three chapters on sleep disordered breathing, this chapter reviews obstructive sleep apnea (OSA) diagnosis and management. OSA should be considered in all patients who have loud habitual snoring, excessive daytime sleepiness, and witnessed apneas. On physical examination, craniofacial abnormalities that can lead to sleep apnea include retrognathia, micrognathia, a narrow hard palate, nasal obstruction, an overjet, and an overbite. Enlargement of the upper airway soft tissue structures (the tongue, soft palate, lateral walls, and parapharyngeal fat pads) also increases the risk of OSA. The gold standard for making the diagnosis of OSA is overnight polysomnography, but home sleep apnea tests (HSAT) are rapidly gaining acceptance, especially in patients with a high probability of OSA. The first line of therapy for OSA remains positive airway pressure (PAP), with the second line of therapy being oral appliances. Another alternative to PAP therapy is hypoglossal nerve stimulation, which has been shown to decrease the Apnea-Hypopnea index by 67.4%. This review contains 6 figures, 3 tables, and 52 references. Key Words: craniofacial abnormalities, Epworth Sleepiness Scale, home sleep apnea test, hypoglossal nerve stimulation, obstructive sleep apnea, oral appliances, oral pharyngeal crowding, polysomnography, positive airway pressure, STOP-BANG

Tongue-Based Procedures in Treating Refractory Obstructive Sleep Apnea in Down Syndrome Patients: A Systematic Review and Meta-Analysis

FACE ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 65-70
Author(s):  
Paul B. Lee ◽  
Michael T. Chung ◽  
Jared Johnson ◽  
Jordyn Lucas ◽  
Caitlin R. Priest ◽  
...  
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Hypoglossal Nerve ◽  
Meta Analysis ◽  
Apnea Hypopnea Index ◽  
Hypoglossal Nerve Stimulation ◽  
Obstructive Sleep

Objective: There is a high prevalence of obstructive sleep apnea (OSA) in pediatric and adult Down Syndrome (DS) patients that is refractory to adenotonsillectomy and continuous positive airway pressure. Newer treatment modalities have emerged with improved outcomes. The objective is to provide an updated systematic review and meta-analysis to analyze the clinical outcomes of OSA in pediatric and adult DS patients with hypoglossal nerve stimulation using Inspire, midline posterior glossectomy plus lingual tonsillectomy (MPG + LT), and combined genioglossus advancement plus radiofrequency (GGS + RF). Methods: A comprehensive literature search of PubMed and Google Scholar was performed followed by a meta-analysis. Studies with preoperative and post-operative Apnea Hypopnea Index (AHI) values were included with patients serving as their own control. Results: Across 5 studies, 56 patients were analyzed. The mean reduction in AHI was statistically significant before vs. after procedure ( P < .001 for hypoglossal nerve stimulation using Inspire with a paired 2-tailed t-test and P = .031 for MPG + LT). Although individual patient AHI values were unavailable in the GGS + RF study, the standard difference in mean AHI was also significant for GGS + RF with P = .001. Device malfunction was the most common complication for Inspire while postoperative bleeding was observed for MPG + LT and nasopharyngeal obstruction and retropalatal collapse were observed for GGS + RF. Conclusion: This review reveals significant improvement in AHI with Inspire, MPG + LT, and GGS + RF for DS patients with refractory OSA. Further investigation is needed for comparison between these 3 therapies.

Hypoglossal Nerve Stimulation in Veterans with Obstructive Sleep Apnea

2019 ◽  
Vol 130 (9) ◽  
pp. 2275-2280 ◽  
Author(s):  
Kathleen M. Sarber ◽  
Katherine W. Chang ◽  
Madison V. Epperson ◽  
Meredith E. Tabangin ◽  
Mekibib Altaye ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nerve Stimulation ◽  
Hypoglossal Nerve ◽  
Hypoglossal Nerve Stimulation ◽  
Obstructive Sleep
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