0848 Two Are Better Than One: Treatment of Complex Sleep Apnea with Two Distinct Sleep Neurostimulators

Abstract

Abstract Introduction Complex sleep apnea refers to the emergence of central apnea when obstructive apneas have been adequately treated. While a combination of medications and noninvasive positive airway pressure ventilation is frequently used in patients with this syndrome, the optimal treatment has not yet been fully elucidated. With the advent of nerve stimulation therapy, it is now possible to target specific physiologic mechanisms and provide precise and adjustable therapy. We present a case in which two distinct nerve stimulators were used to successfully treat a patient with complex sleep apnea. Report of Cases: We present a case in which a ptient with complex slepe apnea was successfully treated by implantation of two distinct nerve stimulators: hypoglossal nerve stimulation therapy for obstructive sleep apnea and phrenic nerve stimulation therapy for concomitant central sleep apnea. Conclusion Complex sleep apnea was successfully treated in this patient with the combination of hypoglossal and phrenic nerve stimulation therapy as evidenced by a reduction in both the obstructive and central apnea hypopnea indices. This patient also had significant clinical improvement with decreased excessive daytime sleepiness and improved daytime functioning as evidenced by decreased Epworth Sleepiness Score, improved patient reported daytime activity, decreased apnea hypopnea index, and increased total sleep time. This case provides evidence for the efficacy and safety of the simultaneous use of hypoglossal and phrenic nerve stimulation for the treatment of complex sleep apnea. Is also highlights the importance of obtaining a laboratory polysomnographic evaluation in all patients prior to any sleep device implantation. Further study is needed, however, to establish the long-term efficacy of this approach to treatment. Support (If Any) I am seeking financial support and assistance for meeting attendance and travel for the June sleep meeting from Inspire Sleep Apnea and other travel assistance funds.