Cluster analysis of upper airway stimulation adherence patterns and implications on clinical care.

Study Objectives: Upper airway stimulation (UAS) therapy is effective for a subset of obstructive sleep apnea (OSA) patients with continuous positive airway pressure (CPAP) intolerance. While overall adherence is high, some patients have suboptimal adherence, which limits efficacy. Our goal was to identify therapy usage patterns during the first 3 months of therapy to enable targeted strategies for improved adherence.

Post-implant care pathway: lessons learned and recommendations after 5 years of clinical implementation of hypoglossal nerve stimulation therapy.

Hypoglossal nerve stimulation (HNS) therapy is now an established and widely-available obstructive sleep apnea (OSA) treatment alternative for continuous positive airway pressure (CPAP)-intolerant patients. Additionally, the HNS body of literature is robust with strong data on safety, efficacy, and durability-from the 5-year STAR Trial outcomes, to post-approval studies of independent institutions, to the multicenter ADHERE registry which recently reported outcomes on over 1,000 patients and is poised to enroll 5,000 HNS patients total. Nevertheless, now with thousands of implanted patients across hundreds of certified centers, and that number growing rapidly, the post-implant management of the HNS patient represents the next critical frontier.

Reversible sleep-related stridor during vagus nerve stimulation.

A 23-year-old woman without history of antecedent vocal, respiratory, or sleep disorders received vagus nerve stimulation (VNS) therapy for refractory partial epilepsy and developed sleep-related stridor during the course of parameter titration. Reduction of VNS current during polysomnography completely eliminated stridor. We conclude that VNS may cause sleep-related stridor in rare cases, expanding the spectrum of known sleep-disordered breathing disorders associated with VNS therapy.

Hallucinating the past: a case of spontaneous and involuntary recall of long-term memories: perspectives on the hemispheric organization of visual memory.

This paper presents the unique case of a patient who developed palinopsias and formed visual hallucinations, representing spontaneous recall of memories from a discrete 10-year time period. The visual phenomena began shortly after the initiation of prophylactic whole-brain radiation therapy, following the removal of a metastatic adenocarcinoma in the region of the right cuneus. The most striking feature of this patient's hallucinations is the composition: memories from a discrete 10-year time period from about 30 years ago.