0513 Effects of Hypoglossal Nerve Stimulation on Sleep Architecture and Objective Level of Alertness measured by MWT in OSA Patients. (27th April 2018)

• Record Type: Journal Article
• Authors: Philip, P; Heiser, C; Bioulac, S; Altena, E; Penchet, G; Cuny, E; Hofauer, B; Monteyrol, P; Micoulaud-Franchi, J
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A192
• Page End: A193
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy061.512
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Hypoglossal nerve stimulation (HNS) is a novel therapy for patients suffering from obstructive sleep apnea (OSA) that has proven its efficacy in reducing the apnea-hypopnea index (AHI). This study evaluated the impact of HNS on sleep architecture and objective level of alertness. Methods: Ten patients who received HNS were included. Treatment outcome was evaluated 6 months after surgery. Data collection included demographics, body mass index (BMI), polysomnographic parameters (sleep breathing and sleep architecture parameters) and objective level of alertness (Maintenance of Wakefulness Test, MWT). Results: The mean age was 52.0 years±9.4 and all patients were male. Mean BMI was 28.8 kg/m2 ± 3.3. The mean pre-implantation AHI of 46.7/h ±12.2 was reduced to 14.5/h±8.9 at 6 months post-implantation (p < 0.001). The mean MWT latency improved significantly from 25.0 ± 12.8 minutes at baseline to 36.8 ± 7.0 minutes after 6 months of treatment (p=0.004). A significant reduction in WASO (71.4min±32.4 vs 53.4min±13.5, p=0.06) and of N1% (9.7 ± 8.8 vs 3.7 ± 1.8, p=0.04) was observed. MWT latencies at 6 months were significantly correlated with the intensity of stimulation (r=-0.63, p=0.05). Intensity of stimulation was positively correlated with WASO (r=0.76, p=0.01). Conclusion: Significant changes in sleep architecture were observed six months post-treatment by HNS. To optimize daytime alertness and sleep quality, HNS should be calibrated not only on AHI but also on sleep structure and WASO. Because of the intrinsic properties of HNS, we strongly recommend titration of these therapeutic devices on both breathing events and sleep structure patterns. Support (If Any): NA.