Kinesthetic stimulation for obstructive sleep apnea syndrome: An \u201con-off\u201d proof of concept trial

Alfredo I Hernández,Nadège Limousin,Renaud Tamisier,Philippe Mabo,Jean-Louis Pépin,Yves Dauvilliers,Corinne Loiodice,Lotfi Senhadji,Amel Amblard,Gustavo Guerrero,Laurence Graindorge,Diego Pérez,Arnaud Prigent,Delphine Feuerstein,Frédéric Gagnadoux

doi:10.1038/s41598-018-21430-w

Abstract

Obstructive sleep apnea (OSA) occurs when the upper airway narrows or collapses due to the loss of upper airway muscle activation at sleep onset. This study investigated the effectiveness of triggered kinesthetic stimulation in patients with OSA. This proof-of-concept, open-label, multicenter prospective study was conducted on 24 patients with severe OSA. During a one night evaluation, kinesthetic stimulation was intermittently delivered in 30 minute periods. The duration of apneas and hypopneas during Stimon and Stimoff periods were compared. Five hospital-based university centers in France participated. Sleep studies were evaluated by a single scorer at a core laboratory (CHU Grenoble). Results show that during the Stimon phases, statistically significant decreases in durations of apneas and hypopneas were observed in 56% and 46% of patients, respectively. Overall, 75% of patients showed an improvement in apneas or hypopneas durations. The mean reduction in durations for patients with a significant decrease was 4.86 seconds for apneas and 6.00 seconds for hypopneas. This proof of concept study is the first to identify kinesthetic stimulation as a potentially effective therapy for OSA. These data justify evaluation in a controlled study.

Highlights

Obstructive sleep apnea (OSA) occurs when the upper airway narrows or collapses due to the loss of upper airway muscle activation at sleep onset
continuous positive airway pressure (CPAP), the first line therapy for the management of moderate to severe OSA, is associated with excellent results in symptomatic patients, there is a 15% initial refusal rate and long term adherence is difficult to achieve in minimally symptomatic patients[5]
The study population is typical of patients with severe OSA, predominantly middle-age, male, obese with frequent co-morbidities

Summary

Introduction

Obstructive sleep apnea (OSA) occurs when the upper airway narrows or collapses due to the loss of upper airway muscle activation at sleep onset. This study investigated the effectiveness of triggered kinesthetic stimulation in patients with OSA. The mean reduction in durations for patients with a significant decrease was 4.86 seconds for apneas and 6.00 seconds for hypopneas. This proof of concept study is the first to identify kinesthetic stimulation as a potentially effective therapy for OSA. These data justify evaluation in a controlled study. In addition to CPAP, MAD and surgery to enlarge the upper airway, stimulation therapies have gained interest in the treatment of OSA8. To upper airway dilator muscles (e.g., hypoglossal nerve stimulation9) or direct electrical stimulation of submental transcutaneous muscles are currently under evaluation[10]

Methods

Results

Conclusion