The potential for neurostimulation in obstructive sleep apnea.
Obstructive sleep apnea affects millions of individuals. It usually is due to pharyngeal collapse during sleep, resulting in daytime somnolence. This can have grave consequences on everyday life and in the long term can lead to pulmonary and systemic hypertension, myocardial disease, and stroke. Non-structural obstructive sleep apnea can be relieved by tracheostomy and continuous positive airway pressure, two methods that bypass the overly compliant pharyngeal musculature during inspiration. It may well be desirable to exchange a dynamic and more physiologic approach to obstructive sleep apnea for these purely static solutions. This approach should restore disturbed cyclical stiffening of the upper airway by electronically stimulating the appropriate muscles, timed by information originating during the inspiratory effort. The open-loop systems proposed here are based upon principles pioneered by us for the rehabilitation of the paralyzed larynx that are now well within practical reach of current technologies.
Broniatowski
M
M
Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Ohio.
D004558:Electric Stimulation; D006801:Humans; D010609:Pharyngeal Muscles / Q000503:physiopathology; D010614:Pharynx / Q000503:physiopathology*; D011175:Positive-Pressure Respiration; D019736:Prostheses and Implants; D012891:Sleep Apnea Syndromes / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D014139:Tracheostomy