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

Area of Science:

• Sleep Medicine
• Neurology
• Medical Devices

Background:

• Central sleep apnea (CSA) is a serious condition affecting breathing during sleep.
• Phrenic nerve stimulation (PNS) is an FDA-approved therapy for moderate to severe CSA.
• Understanding long-term outcomes of PNS is crucial for patient management.

Purpose of the Study:

• To evaluate the one-year outcomes of phrenic nerve stimulation (PNS) in patients with moderate to severe central sleep apnea (CSA).
• To assess changes in apnea hypopnea index (AHI), central apnea index (CAI), Epworth Sleepiness Scale (ESS), and Functional Outcomes of Sleep Questionnaire (FOSQ) scores post-PNS implantation.

Main Methods:

• Retrospective analysis of 22 patients (≥18 years) with moderate to severe CSA who received PNS implantation.
• Data collected at baseline and one-year post-implant included AHI, CAI, ESS, and FOSQ scores.
• Statistical analysis was performed to determine significant changes in measured parameters.

Main Results:

• Phrenic nerve stimulation (PNS) significantly reduced the apnea hypopnea index (AHI) from 40 to 18 events/hour (p=0.003) and the central apnea index (CAI) from 16 to 2 events/hour (p=0.001).
• Epworth Sleepiness Scale (ESS) scores significantly improved, decreasing from a median of 12 to 9 (p=0.028).
• The Functional Outcomes of Sleep Questionnaire (FOSQ) showed a trend towards improvement, but it was not statistically significant (p=0.086).

Conclusions:

• Phrenic nerve stimulation (PNS) therapy is effective in improving key sleep-disordered breathing parameters, specifically AHI and CAI, in patients with moderate to severe CSA.
• PNS therapy also leads to significant improvements in objective sleepiness as measured by ESS scores at one year post-implantation.
• These findings support the use of PNS as a valuable treatment option for managing moderate to severe CSA.