Sleep Care

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“Pacemaker” Device Could Improve Sleep Apnea

Many individuals suffering from sleep apnea find their symptoms effectively treated by one of several different routes:  Continuous Positive Airway Pressure (CPAP), wearing a dental appliance to tilt the jaw forward and keep the airway open at night, weight loss, or surgery to remove tissue that can block the airway.  These methods tend to be most effective for obstructive sleep apnea, which is the most common form of sleep apnea.  In obstructive sleep apnea, the upper airway becomes blocked as tissue relaxes and closes it off, preventing air from moving through.

Heart x-rayFor those diagnosed with central sleep apnea, however, breathing is stopped for a  different reason:  the signal from the brain to take a breath fails to get to the muscles in the chest and abdomen responsible for doing the work of breathing.  In this situation, the treatments mentioned above tend to be less effective than they are for obstructive sleep apnea.  Part of the complication is that patients with central sleep apnea often have other significant health conditions—such as brain or heart problems—that complicate treating the apnea.  A new device similar to a pacemaker used to treat irregular heart rhythms may provide a good solution.

 

Stimulating breathing

Made by the medical device company Respicardia, the implant is put in under the collarbone, with a wire run through a vein to a place near either of the phrenic nerves.  These nerves are responsible for carrying signals from the brain to the body’s muscles that control breathing.  The device can be programmed to send an electric signal to stimulate the nerves and produce breathing at a regular, controlled rate, effectively reversing the condition of central sleep apnea.

Recently, a six month pilot study was done involving 47 patients.  After allowing one month for the patient to heal following surgery to implant the device, the devices were turned on and adjusted to the patient’s sleeping patterns.

The results of the study were promising:  There was an overall 90 percent reduction in central sleep apnea, and 76 percent of patients reported at least a mild improvement in their overall quality of life (with some reporting greater degrees of improvement).  With these results, the researchers are hoping to move forward with a larger randomized, controlled clinical trial involving 150 patients.

While the device works similar to a pacemaker, it also carries some of the same risks.  For example, if the wire moves from its position or becomes infected, surgery may be needed to reposition or remove it.  Overall, however, the researchers found that benefits to the device for effectively improving central sleep apnea outweighed the potential risks.  This may be good news for those suffering from central sleep apnea who have been unable to find an effective treatment.

 

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