Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Sleep and Breathing
Published in: Sleep and Breathing 4/2017

01-12-2017 | Sleep Breathing Physiology and Disorders • Original Article

Effects of upper-airway stimulation on sleep architecture in patients with obstructive sleep apnea

Authors: Benedikt Hofauer, Pierre Philip, Markus Wirth, Andreas Knopf, Clemens Heiser

Published in: Sleep and Breathing | Issue 4/2017

Login to get access

Abstract

Purpose

Selective upper-airway stimulation (UAS) is a novel therapy for patients with obstructive sleep apnea (OSA). The aim of this study was to compare changes in sleep architecture during the diagnostic polysomnography and the post-implantation polysomnography in UAS in patients with OSA.

Methods

Twenty-six patients who received a UAS device (Inspire Medical Systems) were included. Treatment outcome was evaluated 2 and 3 months after surgery. Data collection included demographics, body mass index (BMI), apnea hypopnea index (AHI), oxygen saturation and desaturation index (ODI), Epworth sleepiness score (ESS), arousal parameter, and sleep patterns.

Results

The mean age was 60.2 years, 25 patients were male, 1 patient was female. Mean BMI was 29.0 kg/m2. The mean pre-implantation AHI of 33.9/h could be reduced to 9.1/h at 2 months post-implantation (p < 0.001). The amount of time spent in N1-sleep could be reduced from 23.2% at baseline to 16.0% at month 3 post-implantation. The amount of time spent in N2- and N3-sleep did not change during the observation period. A significant increase of the amount of REM sleep at month 2 (15.7%) compared to baseline (9.5%; p = 0.010) could be observed. A reduction of the number of arousals and the arousal index could be observed.

Conclusion

In conclusion, significant changes in sleep architecture of patients with OSA and sufficient treatment with UAS could be observed. A reduction of the amount of time spent in N1-sleep could be caused by treatment with UAS and the rebound of REM sleep, observed for the first time in a study on UAS, is also a potential marker of the efficacy of UAS on sleep architecture.

Trial registration

NCT02293746.
Literature
1.
Pengo MF, Steier J (2015) Emerging technology: electrical stimulation in obstructive sleep apnoea. J Thorac Dis 7:1286–1297PubMedPubMedCentral
2.
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235CrossRefPubMed
3.
Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177:1006–1014CrossRefPubMedPubMedCentral
4.
Steier J, Martin A, Harris J, Jarrold I, Pugh D, Williams A (2014) Predicted relative prevalence estimates for obstructive sleep apnoea and the associated healthcare provision across the UK. Thorax 69:390–392CrossRefPubMed
5.
6.
Philip P, Stoohs R, Guilleminault C (1994) Sleep fragmentation in normals: a model for sleepiness associated with upper airway resistance syndrome. Sleep 17:242–247PubMed
7.
Strollo PJ, Soose RJ, Maurer JT, de Vries N, Cornelius J et al (2014) Upper-airway stimulation for obstructive sleep apnea. N Engl J Med 370:139–149CrossRefPubMed
8.
McArdle N, Douglas NJ (2001) Effect of continuous positive airway pressure on sleep architecture in the sleep apnea-hypopnea syndrome: a randomized controlled trial. Am J Respir Crit Care Med 164:1459–1463CrossRefPubMed
9.
Narkiewicz K, Somers VK (1999) Obstructive sleep apnea as a cause of neurogenic hypertension. Curr Hypertens Rep 1:268–273CrossRefPubMed
10.
Martinez D, Klein C, Rahmeier L, da Silva RP, Fiori CZ et al (2012) Sleep apnea is a stronger predictor for coronary heart disease than traditional risk factors. Sleep Breath 16:695–701CrossRefPubMed
11.
Palomäki H, Partinen M, Juvela S, Kaste M (1989) Snoring as a risk factor for sleep-related brain infarction. Stroke 20:1311–1315CrossRefPubMed
12.
Bradley TD, Rutherford R, Grossman RF, Lue F, Zamel N et al (1985) Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome. Am Rev Respir Dis 131:835–839PubMed
13.
Lévy P, Bonsignore MR, Eckel J (2009) Sleep, sleep-disordered breathing and metabolic consequences. Eur Respir J 34:243–260CrossRefPubMed
14.
Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL (2002) Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 165:677–682CrossRefPubMed
15.
Gottlieb DJ, Yenokyan G, Newman AB, O’Connor GT, Punjabi NM et al (2010) Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 122:352–360CrossRefPubMedPubMedCentral
16.
Giles TL, Lasserson TJ, Smith BH, White J, Wright J, Cates CJ (2006) Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev CD001106
17.
Somiah M, Taxin Z, Keating J, Mooney AM, Norman RG et al (2012) Sleep quality, short-term and long-term CPAP adherence. J Clin Sleep Med 8:489–500PubMedPubMedCentral
18.
Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, Richards KC, Weaver TE (2011) A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev 15:343–356CrossRefPubMedPubMedCentral
19.
Lévy P, Kohler M, McNicholas WT, Barbé F, McEvoy RD et al (2015) Obstructive sleep apnoea syndrome. Nat Rev Dis Prim 1:15015CrossRefPubMed
20.
Kent DT, Lee JJ, Strollo PJ, Soose RJ (2016) Upper airway stimulation for OSA: early adherence and outcome results of one center. Otolaryngol Head Neck Surg
21.
Soose RJ, Woodson BT, Gillespie MB, Maurer JT, de Vries N et al (2016) Upper airway stimulation for obstructive sleep apnea: self-reported outcomes at 24 months. J Clin Sleep Med 12:43–48CrossRefPubMedPubMedCentral
22.
Strollo PJ, Gillespie MB, Soose RJ, Maurer JT, de Vries N et al (2015) Upper airway stimulation for obstructive sleep apnea: durability of the treatment effect at 18 months. Sleep 38:1593–1598CrossRefPubMedPubMedCentral
23.
Heiser C, Knopf A, Bas M, Gahleitner C, Hofauer B (2016) Selective upper-airway stimulation for obstructive sleep apnea—a single center clinical experience. Eur Arch Otorhinolaryngol
24.
Kezirian EJ, Hohenhorst W, de Vries N (2011) Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol 268:1233–1236CrossRefPubMed
25.
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRefPubMed
26.
Heiser C, Thaler E, Boon M, Soose RJ, Woodson BT (2016) Updates of operative techniques for upper airway stimulation. Laryngoscope
27.
Heiser C, Hofauer B, Lozier L, Woodson BT, Stark T (2016) Nerve monitoring guided selective hypoglossal nerve stimulation in obstructive sleep apnea. Laryngoscope
28.
Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C et al (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8:597–619PubMedPubMedCentral
29.
Sher AE, Schechtman KB, Piccirillo JF (1996) The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 19:156–177CrossRefPubMed
30.
Woodson BT, Soose RJ, Gillespie MB, Strohl KP, Maurer JT et al (2016) Three-year outcomes of cranial nerve stimulation for obstructive sleep apnea: the STAR trial. Otolaryngol Head Neck Surg 154:181–188CrossRefPubMed
31.
Woodson BT, Gillespie MB, Soose RJ, Maurer JT, de Vries N et al (2014) Randomized controlled withdrawal study of upper airway stimulation on OSA: short- and long-term effect. Otolaryngol Head Neck Surg 151:880–887CrossRefPubMed
32.
Van de Heyning PH, Badr MS, Baskin JZ, Cramer Bornemann MA, De Backer WA et al (2012) Implanted upper airway stimulation device for obstructive sleep apnea. Laryngoscope 122:1626–1633CrossRefPubMed
33.
Verma A, Radtke RA, Van Landingham KE, King JH, Husain AM (2001) Slow wave sleep rebound and REM rebound following the first night of treatment with CPAP for sleep apnea: correlation with subjective improvement in sleep quality. Sleep Med 2:215–223CrossRefPubMed
34.
Redline S, Kirchner HL, Quan SF, Gottlieb DJ, Kapur V, Newman A (2004) The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture. Arch Intern Med 164:406–418CrossRefPubMed
35.
Sagaspe P, Taillard J, Chaumet G, Moore N, Bioulac B, Philip P (2007) Aging and nocturnal driving: better with coffee or a nap? A randomized study. Sleep 30:1808–1813CrossRefPubMedPubMedCentral
36.
37.
Aldrich M, Eiser A, Lee M, Shipley JE (1989) Effects of continuous positive airway pressure on phasic events of REM sleep in patients with obstructive sleep apnea. Sleep 12:413–419CrossRefPubMed
38.
Grimaldi D, Beccuti G, Touma C, Van Cauter E, Mokhlesi B (2014) Association of obstructive sleep apnea in rapid eye movement sleep with reduced glycemic control in type 2 diabetes: therapeutic implications. Diabetes Care 37:355–363CrossRefPubMedPubMedCentral
39.
Mokhlesi B, Finn LA, Hagen EW, Young T, Hla KM et al (2014) Obstructive sleep apnea during REM sleep and hypertension. Results of the Wisconsin sleep cohort. Am J Respir Crit Care Med 190:1158–1167CrossRefPubMedPubMedCentral
40.
Fietze I, Quispe-Bravo S, Hänsch T, Röttig J, Baumann G, Witt C (1997) Arousals and sleep stages in patients with obstructive sleep apnoea syndrome: changes under nCPAP treatment. J Sleep res 6:128–133CrossRefPubMed
Metadata
Title
Effects of upper-airway stimulation on sleep architecture in patients with obstructive sleep apnea
Authors
Benedikt Hofauer
Pierre Philip
Markus Wirth
Andreas Knopf
Clemens Heiser
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 4/2017
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-017-1519-0

Other articles of this Issue 4/2017

Sleep and Breathing 4/2017 Go to the issue

Sleep Breathing Physiology and Disorders • Original Article

Psoriasis is associated with risk of obstructive sleep apnea independently from metabolic parameters and other comorbidities: a large hospital-based case-control study

Sleep Breathing Physiology and Disorders • Original Article

Severity of desaturation events differs between hypopnea and obstructive apnea events and is modulated by their duration in obstructive sleep apnea

Sleep Breathing Physiology and Disorders • Original Article

Sex-specific association between serum uric acid and self-reported snoring in rural China: a cross-sectional study

Neurology • Original Article

Clinical and polysomnographic characteristics of excessive daytime sleepiness in children

Sleep Breathing Physiology and Disorders • Original Article

Using the STOPBANG questionnaire and other pre-test probability tools to predict OSA in younger, thinner patients referred to a sleep medicine clinic

Sleep Breathing Physiology and Disorders • Original Article

Effects of CPAP in patients with obstructive apnoea: is the presence of allergic rhinitis relevant?

ACC 2024 Congress Coverage

Cardiology Video

Highlights from the ACC 2024 Congress

Watch now

Watch official videos from the ACC congress summarizing key highlights from the last year in heart failure, cardiomyopathies, valvular disease, pulmonary vascular disease, and pediatric cardiology.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits