The Experts below are selected from a list of 38343 Experts worldwide ranked by ideXlab platform
Wilfried De Backer - One of the best experts on this subject based on the ideXlab platform.
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electrical stimulation of the hypoglossal nerve in the treatment of Obstructive Sleep Apnea
Sleep Medicine Reviews, 2010Co-Authors: Eric J Kezirian, Alan R Schwartz, Philip L. Smith, An Boudewyns, Paul Van De Heyning, David W Eisele, Wilfried De BackerAbstract:Upper airway occlusion in Obstructive Sleep Apnea has been attributed to a decline in pharyngeal neuromuscular activity occurring in a structurally narrowed airway. Surgical treatment focuses on the correction of anatomic abnormalities, but there is a potential role for activation of the upper airway musculature, especially with stimulation of the hypoglossal nerve and genioglossus muscle. We present evidence from research on upper airway neuromuscular electrical stimulation in animals and humans. We also present results from eight Obstructive Sleep Apnea patients with a fully implanted system for hypoglossal nerve stimulation, demonstrating an improvement in upper airway collapsibility and Obstructive Sleep Apnea severity. Future research, including optimization of device features and stimulation parameters as well as patient selection, is necessary to make hypoglossal nerve stimulation a viable alternative to positive airway pressure therapy and upper airway surgical procedures.
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therapeutic electrical stimulation of the hypoglossal nerve in Obstructive Sleep Apnea
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Marc Bennett, Alan R Schwartz, Philip L. Smith, An Boudewyns, Jan Hedner, Wilfried De Backer, Paul Van De HeyningAbstract:Background Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on Obstructive Sleep Apnea is not known. Objective To determine the response in Obstructive Sleep Apnea to electrical stimulation of the hypoglossal nerve. Methods Eight patients with Obstructive Sleep Apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results Unilateral hypoglossal nerve stimulation decreased the severity of Obstructive Sleep Apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean Apnea-hypopnea indices in non–rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P P Conclusion The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in Obstructive Sleep Apnea.
Eric J Kezirian - One of the best experts on this subject based on the ideXlab platform.
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previous surgery and hypoglossal nerve stimulation for Obstructive Sleep Apnea
Otolaryngology-Head and Neck Surgery, 2019Co-Authors: Eric J Kezirian, Joachim T Maurer, Clemens Heiser, A Steffen, Maurits Boon, Benedikt Hofauer, Karl Doghramji, Ulrich J Sommer, Ryan J Soose, Richard SchwabAbstract:ObjectiveTo examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of Obstructive Sleep Apnea with hypoglossal nerve stimulation.Study DesignCohort (ret...
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electrical stimulation of the hypoglossal nerve in the treatment of Obstructive Sleep Apnea
Sleep Medicine Reviews, 2010Co-Authors: Eric J Kezirian, Alan R Schwartz, Philip L. Smith, An Boudewyns, Paul Van De Heyning, David W Eisele, Wilfried De BackerAbstract:Upper airway occlusion in Obstructive Sleep Apnea has been attributed to a decline in pharyngeal neuromuscular activity occurring in a structurally narrowed airway. Surgical treatment focuses on the correction of anatomic abnormalities, but there is a potential role for activation of the upper airway musculature, especially with stimulation of the hypoglossal nerve and genioglossus muscle. We present evidence from research on upper airway neuromuscular electrical stimulation in animals and humans. We also present results from eight Obstructive Sleep Apnea patients with a fully implanted system for hypoglossal nerve stimulation, demonstrating an improvement in upper airway collapsibility and Obstructive Sleep Apnea severity. Future research, including optimization of device features and stimulation parameters as well as patient selection, is necessary to make hypoglossal nerve stimulation a viable alternative to positive airway pressure therapy and upper airway surgical procedures.
Alan R Schwartz - One of the best experts on this subject based on the ideXlab platform.
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electrical stimulation of the hypoglossal nerve in the treatment of Obstructive Sleep Apnea
Sleep Medicine Reviews, 2010Co-Authors: Eric J Kezirian, Alan R Schwartz, Philip L. Smith, An Boudewyns, Paul Van De Heyning, David W Eisele, Wilfried De BackerAbstract:Upper airway occlusion in Obstructive Sleep Apnea has been attributed to a decline in pharyngeal neuromuscular activity occurring in a structurally narrowed airway. Surgical treatment focuses on the correction of anatomic abnormalities, but there is a potential role for activation of the upper airway musculature, especially with stimulation of the hypoglossal nerve and genioglossus muscle. We present evidence from research on upper airway neuromuscular electrical stimulation in animals and humans. We also present results from eight Obstructive Sleep Apnea patients with a fully implanted system for hypoglossal nerve stimulation, demonstrating an improvement in upper airway collapsibility and Obstructive Sleep Apnea severity. Future research, including optimization of device features and stimulation parameters as well as patient selection, is necessary to make hypoglossal nerve stimulation a viable alternative to positive airway pressure therapy and upper airway surgical procedures.
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therapeutic electrical stimulation of the hypoglossal nerve in Obstructive Sleep Apnea
Archives of Otolaryngology-head & Neck Surgery, 2001Co-Authors: Marc Bennett, Alan R Schwartz, Philip L. Smith, An Boudewyns, Jan Hedner, Wilfried De Backer, Paul Van De HeyningAbstract:Background Hypoglossal nerve stimulation has been demonstrated to relieve upper airway obstruction acutely, but its effect on Obstructive Sleep Apnea is not known. Objective To determine the response in Obstructive Sleep Apnea to electrical stimulation of the hypoglossal nerve. Methods Eight patients with Obstructive Sleep Apnea were implanted with a device that stimulated the hypoglossal nerve unilaterally during inspiration. Sleep and breathing patterns were examined at baseline before implantation and after implantation at 1, 3, and 6 months and last follow-up. Results Unilateral hypoglossal nerve stimulation decreased the severity of Obstructive Sleep Apnea throughout the entire study period. Specifically, stimulation significantly reduced the mean Apnea-hypopnea indices in non–rapid eye movement (mean ± SD episodes per hour, 52.0 ± 20.4 for baseline nights and 22.6 ± 12.1 for stimulation nights; P P Conclusion The findings demonstrate the feasibility and therapeutic potential for hypoglossal nerve stimulation in Obstructive Sleep Apnea.
Daniel J Gottlieb - One of the best experts on this subject based on the ideXlab platform.
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Obstructive Sleep Apnea during rem Sleep and cardiovascular disease
American Journal of Respiratory and Critical Care Medicine, 2017Co-Authors: Nisha R Aurora, Daniel J Gottlieb, Ciprian M Crainiceanu, Ji Soo Kim, Naresh M PunjabiAbstract:Rationale: Obstructive Sleep Apnea (OSA) during REM Sleep is a common disorder. Data on whether OSA that occurs predominantly during REM Sleep is associated with health outcomes are limited.Objecti...
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cpap versus oxygen in Obstructive Sleep Apnea
The New England Journal of Medicine, 2014Co-Authors: Sanjay R. Patel, Reena Mehra, Daniel J Gottlieb, Naresh M Punjabi, Stuart F Quan, Denise C Babineau, Russell P TracyAbstract:Background Obstructive Sleep Apnea is associated with hypertension, inflammation, and in creased cardiovascular risk. Continuous positive airway pressure (CPAP) reduces blood pressure, but adherence is often suboptimal, and the benefit beyond manage ment of conventional risk factors is uncertain. Since intermittent hypoxemia may underlie cardiovascular sequelae of Sleep Apnea, we evaluated the effects of noctur nal supplemental oxygen and CPAP on markers of cardiovascular risk. Methods We conducted a randomized, controlled trial in which patients with cardiovascular disease or multiple cardiovascular risk factors were recruited from cardiology prac tices. Patients were screened for Obstructive Sleep Apnea with the use of the Berlin questionnaire, and home Sleep testing was used to establish the diagnosis. Participants with an Apnea–hypopnea index of 15 to 50 events per hour were randomly assigned to receive education on Sleep hygiene and healthy lifestyle alone (the control group) or, in addition to education, either CPAP or nocturnal supplemental oxygen. Cardio vascular risk was assessed at baseline and after 12 weeks of the study treatment. The primary outcome was 24hour mean arterial pressure.
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epidemiology of Obstructive Sleep Apnea a population health perspective
American Journal of Respiratory and Critical Care Medicine, 2002Co-Authors: Terry Young, Paul E Peppard, Daniel J GottliebAbstract:Population-based epidemiologic studies have uncovered the high prevalence and wide severity spectrum of undiagnosed Obstructive Sleep Apnea, and have consistently found that even mild Obstructive Sleep Apnea is associated with significant morbidity. Evidence from methodologically strong cohort studies indicates that undiagnosed Obstructive Sleep Apnea, with or without symptoms, is independently associated with increased likelihood of hypertension, cardiovascular disease, stroke, daytime Sleepiness, motor vehicle accidents, and diminished quality of life. Strategies to decrease the high prevalence and associated morbidity of Obstructive Sleep Apnea are critically needed. The reduction or elimination of risk factors through public health initiatives with clinical support holds promise. Potentially modifiable risk factors considered in this review include overweight and obesity, alcohol, smoking, nasal congestion, and estrogen depletion in menopause. Data suggest that Obstructive Sleep Apnea is associated with all these factors, but at present the only intervention strategy supported with adequate evidence is weight loss. A focus on weight control is especially important given the expanding epidemic of overweight and obesity in the United States. Primary care providers will be central to clinical approaches for addressing the burden and the development of cost-effective case-finding strategies and feasible treatment for mild Obstructive Sleep Apnea warrants high priority.
Joachim T Maurer - One of the best experts on this subject based on the ideXlab platform.
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previous surgery and hypoglossal nerve stimulation for Obstructive Sleep Apnea
Otolaryngology-Head and Neck Surgery, 2019Co-Authors: Eric J Kezirian, Joachim T Maurer, Clemens Heiser, A Steffen, Maurits Boon, Benedikt Hofauer, Karl Doghramji, Ulrich J Sommer, Ryan J Soose, Richard SchwabAbstract:ObjectiveTo examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of Obstructive Sleep Apnea with hypoglossal nerve stimulation.Study DesignCohort (ret...
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upper airway stimulation for Obstructive Sleep Apnea
The New England Journal of Medicine, 2014Co-Authors: Nico De Vries, Joachim T MaurerAbstract:BACKGROUND Obstructive Sleep Apnea is associated with considerable health risks. Although continuous positive airway pressure (CPAP) can mitigate these risks, effectiveness can be reduced by inadequate adherence to treatment. We evaluated the clinical safety and effectiveness of upper-airway stimulation at 12 months for the treatment of moderate-to-severe Obstructive Sleep Apnea. METHODS Using a multicenter, prospective, single-group, cohort design, we surgically implanted an upper-airway stimulation device in patients with Obstructive Sleep Apnea who had difficulty either accepting or adhering to CPAP therapy. The primary outcome measures were the Apnea–hypopnea index (AHI; the number of Apnea or hypopnea events per hour, with a score of ≥15 indicating moderate-to-severe Apnea) and the oxygen desaturation index (ODI; the number of times per hour of Sleep that the blood oxygen level drops by ≥4 percentage points from baseline). Secondary outcome measures were the Epworth Sleepiness Scale, the Functional Outcomes of Sleep Questionnaire (FOSQ), and the percentage of Sleep time with the oxygen saturation less than 90%. Consecutive participants with a response were included in a randomized, controlled therapy-withdrawal trial. RESULTS The study included 126 participants; 83% were men. The mean age was 54.5 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 28.4. The median AHI score at 12 months decreased 68%, from 29.3 events per hour to 9.0 events per hour (P<0.001); the ODI score decreased 70%, from 25.4 events per hour to 7.4 events per hour (P<0.001). Secondary outcome measures showed a reduction in the effects of Sleep Apnea and improved quality of life. In the randomized phase, the mean AHI score did not differ significantly from the 12-month score in the nonrandomized phase among the 23 participants in the therapy-maintenance group (8.9 and 7.2 events per hour, respectively); the AHI score was significantly higher (indicating more severe Apnea) among the 23 participants in the therapy-withdrawal group (25.8 vs. 7.6 events per hour, P<0.001). The ODI results followed a similar pattern. The rate of procedure-related serious adverse events was less than 2%. CONCLUSIONS In this uncontrolled cohort study, upper-airway stimulation led to significant improvements in objective and subjective measurements of the severity of Obstructive Sleep Apnea. (Funded by Inspire Medical Systems; STAR ClinicalTrials.gov number, NCT01161420.)
