September 24, 2013
Implanted Device Cuts Central Sleep Apnea Episodes Significantly
[ Watch the Video: Small Implant Makes Big Difference In Sleep Apnea ]
Michael Harper for redOrbit.com - Your Universe Online
Unlike obstructive sleep apnea, central sleep apnea can be both difficult to diagnose and potentially more dangerous.
According to sleep medicine experts from Ohio State University Wexner Medical Center, more than one-third of heart failure patients are affected by central sleep apnea, making their cardiovascular condition even worse. These doctors now say they’ve tested an intravenous device to alleviate the condition in heart patients.
After trials, doctors saw a 56 percent reduction in overall apnea events per hour and a more than 80 percent reduction in central sleep apnea events. This device could prove beneficial to many as recent studies have shown prolonged bouts of sleep apnea can lead to a myriad of other health conditions.
“One of the concerning features of central sleep apnea is that these patients don’t fit the usual profile of obstructive sleep apnea,” explained Dr. Rami Khayat, one of the sleep medicine experts working on this study at Ohio State. “They generally don’t snore, so they’re tougher to diagnose, and the symptoms of sleepiness and fatigue overlap with symptoms associated with heart failure.”
As the name suggests, obstructive sleep apnea occurs when the airway is obstructed during sleep. Patients with either type of sleep apnea often stop breathing for longer than ten seconds at a time during sleep. Central sleep apnea, on the other hand, occurs when signals to the brain are interrupted. In these cases, a patient’s brain is not being told to breathe for longer than ten seconds at a time.
The device is implanted just below the collar bone with a stimulation lead running intravenously along a phrenic nerve. The device also uses a pulse generator and a sensing lead to detect respiration. Similar to a pacemaker, the device detects when a person stops breathing and can electronically signal the diaphragm to breathe again.
The Ohio State University doctors implanted this device in 47 test patients and gave them one month to completely heal. Once healed, the patients returned to the hospital to have the doctors turn on their devices and have them programmed to their sleep habits.
“The device normalized breathing during sleep, it reduced apnea episodes and, in association with that, we saw improvements in sleepiness symptoms and patients’ quality of life,” said Dr. Abraham, a consultant for Respicardia.
“We also noted a reduction in blood pressure in patients with hypertension,” he added.
The doctors will now set out to compare these results with current methods for treating central and obstructive sleep apnea in larger and controlled clinical trials. Participants for these trials will be separated into two groups. The first group will have their devices turned on shortly after surgery, while the second group will have their devices turned on six months after the operation.
“If these initial findings bear out in the larger studies, an implantable device could be a good option for central sleep apnea patients who cannot tolerate positive airway pressure therapy,” said Dr. Khayat in a statement.
Such a device could prove beneficial to many patients and prevent many other health issues. A June study found that even moderate cases of obstructive sleep apnea can significantly increase the risk of sudden cardiac death while asleep.