Phrenic nerve stimulation for central sleep apnea: a single institution experience.

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI:10.1007/s11325-024-03125-x
Julie Mease, Ralph Augostini, Scott McKane, Meena Khan
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Abstract

Purpose: Phrenic nerve stimulation (PNS) was approved by the Food and Drug Administration (FDA) to treat moderate to severe central sleep apnea. We report here, results of a retrospective study regarding our institutional outcomes at one year. In this study we evaluated the change in the apnea hypopnea index, epworth sleepiness score, and functional outcomes of sleep score at one year post implant.

Methods: This is a retrospective analysis of patients ≥ 18 years of age who had PNS implanted for moderate to severe CSA at the Ohio State University Wexner Medical Center apnea between Feb 1, 2018 to July 1, 2021. Sleep disordered breathing parameters and objective sleepiness as measured by the Epworth Sleepiness Scale (ESS) scores, and Functional Outcomes of Sleep Questionnaire (FOSQ) scores were assessed at baseline and one-year post-implant.

Results: Twenty-two patients were implanted with PNS at OSU between February 1, 2018 and May, 31, 2022. The AHI showed a statistically significant decrease from a median of 40 events/hour at baseline to 18 at follow-up (p-value = 0.003). The CAI decreased from 16 events/hour to 2 events/hour (p-value of 0.001). The obstructive apnea index, mixed apnea index, and hypopnea index did not significantly change. The ESS scores had a statistically significant improvement from a median score of 12 to 9 (p-value = 0.028). While the FOSQ showed a trend to improvement from 15.0 to 17.8, it was not statistically significant (p-value of 0.086).

Conclusion: Our study found that PNS therapy for moderate to severe CSA improves overall AHI and CAI. Objective sleepiness as measured by the ESS also improved at one-year post implant.

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膈神经刺激治疗中枢性睡眠呼吸暂停:一家医疗机构的经验。
目的:美国食品和药物管理局(FDA)已批准膈神经刺激术(PNS)用于治疗中度至重度中枢性睡眠呼吸暂停。我们在此报告一项回顾性研究的结果,该研究涉及本机构一年来的治疗效果。在这项研究中,我们评估了植入一年后呼吸暂停低通气指数、埃普沃斯嗜睡评分和睡眠功能评分的变化:这是一项回顾性分析,对象是 2018 年 2 月 1 日至 2021 年 7 月 1 日期间在俄亥俄州立大学韦克斯纳医疗中心因中度至重度 CSA 而植入 PNS 的年龄≥ 18 岁的呼吸暂停患者。在基线和植入后一年对睡眠呼吸紊乱参数和客观嗜睡进行评估,客观嗜睡由埃普沃斯嗜睡量表(ESS)评分和睡眠功能结果问卷(FOSQ)评分来衡量:22名患者于2018年2月1日至2022年5月31日期间在OSU植入了PNS。AHI从基线时的中位数40次/小时下降到随访时的18次/小时(P值=0.003),差异有统计学意义。CAI 从每小时 16 次下降到每小时 2 次(P 值为 0.001)。阻塞性呼吸暂停指数、混合性呼吸暂停指数和低通气指数没有明显变化。ESS评分的中位数从12分降至9分(P值=0.028),有统计学意义。虽然 FOSQ 有从 15.0 分提高到 17.8 分的趋势,但没有统计学意义(p 值为 0.086):我们的研究发现,针对中重度 CSA 的 PNS 治疗可改善总体 AHI 和 CAI。结论:我们的研究发现,PNS 治疗中度至重度 CSA 可改善总体 AHI 和 CAI,植入一年后,通过 ESS 测量的客观嗜睡情况也有所改善。
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来源期刊
Sleep and Breathing
Sleep and Breathing 医学-呼吸系统
CiteScore
5.20
自引率
4.00%
发文量
222
审稿时长
3-8 weeks
期刊介绍: The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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