Phrenic nerve stimulation for treatment of central sleep apnea

The prevalence of central sleep apnea (CSA) is rare in general population. However, CSA is prevalent in those with cardiovascular and cerebrovascular disorders. CSA may persist or even worsen with positive airway pressure therapy in some patients and phrenic nerve stimulation (PNS) offers an alternative treatment for patients with CSA. The device is implanted similar to a cardiac pacemaker and typically followed in the sleep clinic. Multiple studies have described the efficacy and safety of PNS. Improvements were seen in apnea hypopnea events, central events, arousals, and daytime sleepiness and maintained through 5 years. Safety demonstrated a 91% freedom from serious adverse events through 1 year. The physiologic approach and improvement in sleep metrics and quality of life with a strong safety profile make this therapy a good option for many patients with central sleep apnea.