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Polysomnographic features of hypoglossal nerve stimulation efficacy: Looking deeper than the apnea-hypopnea index.
Laryngoscope Investig Otolaryngol
February 2025
Objectives: Hypoglossal nerve stimulation (HGNS) is a promising surgical option for patients with obstructive sleep apnea (OSA) who are intolerant of continuous positive airway pressure therapy (CPAP). Efficacy studies for HGNS stimulation largely focus on the apnea-hypopnea index and/or oxygen desaturation index. This study's objective was to show the physiological effects of HGNS stimulation on upper airway patency, airflow, and treatment effect during polysomnography (PSG) testing.
View Article and Find Full Text PDFNight to night variability in obstructive sleep apnea severity, the physiological endotypes and the frequency of flow limitation.
Sleep
December 2024
Monash Lung, Sleep, Allergy and Immunology, Monash Health, Victoria, Australia.
Article Synopsis
- The study investigates night-to-night variability (NtNV) in obstructive sleep apnea (OSA) severity and looks for predictors of this variability.
- 71 OSA patients underwent two sleep studies to analyze their apnea-hypopnea index (AHI), endotypes, and airflow limitations.
- Results revealed significant variability in AHI, but no strong correlations were found between AHI variability and changes in OSA endotypes, suggesting the complexity of predicting OSA severity.
Multilevel-Single Stage-Functional Rhinoplasty & BRP (Barb Reposition Palatoplasty) in Surgical Management of Primary Snorers, UARS and Mild OSA.
Indian J Otolaryngol Head Neck Surg
December 2024
Inamdar Multispecialty Hosp Pune, Ghaisas Ent Hospital, Pune, India.
Obstructive sleep apnoea syndrome (OSA) is a multi-factorial disorder, with quite complex endotypes, consisting of anatomical and non-anatomical pathophysiological factors. Continuous positive airway pressure (CPAP) is recognized as the first-line standard treatment for OSA, whereas upper airway (UA) surgery is often recommended for treating mild OSA patients who have refused or cannot tolerate CPAP, mild and primary snorers. The main results achievable by the surgery are UA expansion, and/or stabilization, and/or removal of the obstructive tissue to different UA levels.
View Article and Find Full Text PDFAnsa cervicalis stimulation effects on upper airway patency: a structure-based analysis.
Eur Respir J
January 2025
Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
Article Synopsis
- Ansa cervicalis stimulation (ACS) is being explored as a therapy for obstructive sleep apnea (OSA) by stabilizing the pharynx and addressing collapse of various flow-limiting structures in the airway.
- A study involving 41 OSA participants measured the effects of ACS on airflow and identified the specific structures causing airflow limitations during sleep.
- Results indicated that ACS significantly reduced the collapsibility of all tested airway structures, with the most marked effects observed on the palatal and oropharyngeal walls, while factors like lower apnea-hypopnea index were linked to greater improvements in airway pressure.
Differential neuromotor control of the vertical and longitudinal genioglossus muscle fibers: An overlooked tongue retractor.
Respir Physiol Neurobiol
January 2025
Rappaport School of Medicine, Technion Institute of Technology, Haifa, Israel; Respiratory Unit, Bnai-Zion Medical Center, Haifa, Israel. Electronic address:
Article Synopsis
- The study investigates the role of the genioglossus (GG) muscle in tongue movement during breathing, specifically focusing on the anterior fibers and their EMG activity during wakefulness and sleep.
- Results showed that electrical stimulation of the anterior GG fibers caused tongue retraction, while the longitudinal fibers were responsible for protrusion.
- The findings reveal distinct control mechanisms for the anterior GG compared to the protrusive fibers, suggesting that treatments for obstructive sleep apnea should avoid stimulating the retractor fibers of the GG.
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