Sleep Apnea And Pacemaker

Is surgery the only option for treating sleep apnea or snoring

I do predominantly the line share of sleep apnea surgery in our department. I collaborate closely with the pulmonologists, who are the sleep medicine s. Those are the s that help diagnose and treat sleep apnea, as well. If those patients fail their, their medical or their conservative therapy, that's typically when they get sent to see me for surgical considerations to, to look at potential cures for their apnea. It's not uncommon for me to see a lot of patients for, who come in for snoring complaints and, you know, are wondering whether or not they have sleep apnea. So sleep apnea is condition where you actually stop breathing at night.

Snoring is somewhere on that spectrum, towards the more mild, you know, milder end of that spectrum. But, you know, really the only way to determine if you have sleep apnea, the gold standard of testing, is really getting a sleep study. And that's an overnight, monitored study where patients, you know, sleep in a room that's similar to a hotel room but they're being monitored and they're hooked up, you know, for sound so to speak with different monitors and cables on them. And that's really our best test to diagnose sleep apnea. The treatment for sleep apnea is typically a nonsurgical therapy; something called CPAP,

which stands for Continuous Positive Airway Pressure. And it's the patients that don't tolerate their CPAP who end up seeing me for surgical considerations. And there's a number of reasons why patients may not tolerate their CPAP. But there are some surgeries that can be helpful in patients who are not tolerant of their medical therapy. And I offer a variety of surgeries including nasal surgery, a variety of palatal surgeries for the kind of tonsil and soft pallet region and then also a variety of tonguebased procedures, as well. But we typically see a patient back after their procedure in about three weeks to recheck everything, make sure that they're healing okay.

After that, I normally recheck a sleep study in about three months after their surgery, just to give everything a chance to heal and to scar. And we, you know, make further recommendations based on the result of their followup sleep study after their surgery. We're exploring the, a new technology now which is actually a nerve stimulator for sleep apnea. It's an implantable device, very similar to a pacemaker that goes into the patient's chest. And there's an electrode that will actually stimulate the nerve that goes to the tongue to provide the tongue with a little bit of more tone when they're sleeping at night, and thereby eliminating their sleep apnea.

First Ever Pacemaker for Dangerous Sleep Apneamp4

gt;gt;Narrator: One of the first things his sdid after diagnosing Darrell Felty with heart problems, was check him for sleep problems,too. A sleep apnea test, like this one, confirmed that Darrell has central sleep apnea, a dangerousform of the disorder that can cause patients to hyperventilate during the night. gt;gt;William Abraham: And when they do that,it affects the oxygen and carbon dioxide levels in the blood in a way that signals their brainto stop breathing. gt;gt;Narrator: Normally patients with sleep apneaare treated by wearing a mask like this one. But, like many, Felty found it bulky and uncomfortable.

gt;gt;Darrell Felty: Once I wore it that night,in my heart of hearts I thought; ‘Well, I'll never wear this mask', you know.I just took an instant dislike to it. gt;gt;Narrator: Even if he did wear the mask,there is no evidence it helps in caseS like his. So William Abraham at Ohio StateUniversity Medical Center took a new approach. Felty is the first US patient to get this an implant designed to help those with central sleep apnea. During the night, theimplant monitors a patient's breathing, and if there's a problem, sends a smallelectric pulse through a wire to the patient's diaphragm.

gt;gt;William Abraham: And thus, stimulating thediaphragm, the main breathing muscle in the body, to break the pattern of central sleepapnea in heart failure patients. gt;gt;Narrator: The device is calibrated and activatedby this wand. And once in place, may do more than help heart patients sleep better. gt;gt;William Abraham: While our primary goalhere is to simply treat the sleep apnea, we have high hopes that in the long run, in doingso, we may actually improve the heart failure including survival in these patients. gt;gt;Darrell Felty: I feel kind of honored, andI hope this thing works out successfully,

that I'll help other people, you know, they'llfollow in my footsteps. gt;gt;Narrator: At Ohio State University MedicalCenter this is Clark Powell reporting.

Small Implant Makes Big Difference In Sleep Apnea

CLARK POWELL: There was a time when Leslie McGuire woulddread going to bed. Because of his sleep apnea, Leslie felt exhausted most of the day. And,at night, it didn't get much better. LESLIE MCGUIRE: Before I was diagnosed, I would wake up probablyfive or six times a night sitting on the side of the bed gasping for air. POWELL: For many, wearinga breathing mask at night can help, especially for those with obstructive sleep apnea, inwhich the airways tend to close. But the mask didn't work for Leslie. He has central sleepapnea, and when it came to finding a treatment for him, time was of the essence.

DR. WILLIAM ABRAHAM: This formof sleep apnea is particularly dangerous because it's associated with patients just stoppingbreathing periodically. POWELL: William Abraham is a cardiologist at the Ohio State UniversityWexner Medical Center. He says while we're sleeping, the brain continues to tell thebody to breathe. But, in central sleep apnea, that signal is faulty. So, to help those patients,s at Ohio State are implanting a pacemakerlike device just under the collarbone and runninga wire to the patient's diaphragm. At night, that wire signals the diaphragm, promptingpatients to breathe.

DR. ABRAHAM: What we saw were remarkable results. More than a 50% reduction in thenumber of events occurring per hour and more than a 90% reduction specifically in thoseevents related to central sleep apnea. It POWELL: It worked for Leslie, who says he now sleepsthrough the night and has more energy to spend his days with his wife. MCGUIRE: Besides her, thisis the best thing that's ever happened to me. Everything is changed. Everything is somuch better. POWELL: At Ohio State's Wexner Medical Center, this is Clark Powell reporting.

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