Experimental device for obstructive sleep apnea

Obstructive sleep apnea, a dangerous sleep disorder that affects millions of Americans may have found a cure. The disease commonly manifested as snoring but leading to tremendous sleep deprivation can be severely debilitating. Sleep deprivation may lead to car crashes, accidents, high blood pressure, heart attack, stroke, and diabetes.

Now researchers are starting to test a device designed to stop apnea by zapping the tongue during sleep. In obstructive sleep apnea the tongue and throat muscles relax during sleep falling back and choking the person awake from sleep. For people with apnea this can happen for 30 seconds or so, causing them to jerk awake and gasp – a cycle that repeats itself 30 or more times an hour. This device will stop the tongue and throat muscles from relaxing so much that they collapse and block breathing. It would stun the hypoglossal nerve.

Minneapolis-based Inspire Medical Systems by end of next month would begin enrolling 100 apnea patients in a study to see if so-called hypoglossal nerve stimulation really works. Other companies are also coming up with similar devices: San Diego-based ImThera Medical and Apnex Medical of St. Paul, Minn.

Dr. Meir Kryger, a sleep medicine specialist at Gaylord Hospital in Connecticut, who would be leading the clinical trial said, “In this kind of research, we’re not looking for little changes… What we’re looking for is actually cure.” At present the best treatment for apnea is continuous positive airway pressure (CPAP), which employs a mask that gently blows air through the nose to keep airways open during sleep. But nearly 30% of the apnea patients refuse to or are unable to use CPAP. There are also surgeries available for obstructive sleep apnea where part of the roof of the mouth or other soft tissue may be removed. But these are difficult surgeries and tried only in severe cases.

This new system would mean an implant of a small generator near the collarbone and snake a wire up under the jaw to that tongue-controlling nerve. A sensor at the diaphragm detects when a patient inhales, signalling the implant to zap the nerve. The power would be so adjusted to keep the tongue from falling backward during sleep. Dr. Amy Atkeson of Columbia University Medical Center in New York however warns that it is still a long way to go and patients should consult their physicians before embarking on any experiments.

By Dr Ananya Mandal, MD

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