对阻塞性睡眠呼吸暂停和并发性神经肌肉疾病的低光神经刺激
Alison Y Choi1, Thomas M Kaffenberger2,3, Ryan J Soose2
1University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
The Laryngoscope
|February 15, 2025
概括
低分泌神经刺激 (HGNS) 在5名神经肌肉疾病 (NMD) 患者中有效治疗阻塞性睡眠呼吸暂停 (OSA). 该疗法改善了睡眠呼吸暂停的严重程度和白天的嗜睡,对这个患者群体显示出有前途.
科学领域:
- 神经学 神经学
- 睡眠医学 睡眠医学
- 手术创新 在外科创新.
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 对由于呼吸肌肉衰弱而导致神经肌肉疾病 (NMD) 的患者构成重大风险.
- 持续正气道压力 (CPAP) 往往不能被NMD患者容忍,需要替代治疗.
- 低分泌神经刺激 (HGNS) 为OSA管理提供了一个外科选择.
研究的目的:
- 评估HGNS在患有OSA和并发性NMD的患者中的安全性和有效性.
- 评估HGNS对睡眠呼吸暂停严重程度,坚持和患者报告结果的影响.
主要方法:
- 一个由五名患有各种NMD (肌痛性肌痛症,肌肉发育不良,Charcot-Marie-Tooth,多发性硬化症) 和接受HGNS治疗的OSA患者组成的病例系列.
- 术前和术后评估呼吸暂停-呼吸暂停指数 (AHI),爱普沃思睡眠度量表 (ESS) 评分,以及氧气和.
- 在植入后3个月和12个月评估设备粘附性.
主要成果:
- 从34.9到8.5 (p=0.03) 的平均AHI显著改善,5/6的患者在术后达到AHI<5.
- 在ESS分数显著下降,从13.1到8.5 (p=0.03),表明白天嗜睡性下降.
- 平均设备坚持是相当大的,记录在8小时/晚上在3个月和7.2小时/晚上在12个月.
结论:
- 在这小群患有NMD的患者中,HGNS证明了作为OSA治疗的安全性和有效性.
- 对于那些不能耐受CPAP的OSA患有NMD的患者来说,HGNS可能是一个可行的治疗选择.
- 需要进行更大规模的前性研究,以在更广泛的NMD人群中证实这些发现.
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