Transvenous phrenic nerve stimulation for treating central sleep apnea may regulate sleep microstructure

Simon Hartmann, Sarah Immanuel, Scott McKane, Dominik Linz, Liborio Parrino, Mathias Baumert*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

STUDY OBJECTIVES: To assess the impact of transvenous phrenic nerve stimulation (TPNS) on non-rapid eye movement sleep microstructure quantified by cyclic alternating pattern (CAP) in individuals with central sleep apnea (CSA). METHODS: We analyzed baseline and 6-month follow-up overnight polysomnograms (PSG) in 134 CSA patients enrolled in the remede System Pivotal Trial implanted with TPNS randomized (1:1) to neurostimulation (treatment group) or no stimulation (control group). Differences in CAP rate, A1 index, and A2+A3 index between study arms at follow-up were assessed using Analysis of Covariance adjusted for baseline values. RESULTS: On follow-up PSG, the treatment group showed a decrease in the frequency of A2+A3 phases compared to controls (-5.86 ± 11.82 vs. 0.67 ± 15.25, p = 0.006), while the frequency of A1 phases increased more in the treatment group (2.57 ± 11.67 vs. -2.47 ± 10.60, p = 0.011). The change in CAP rate at follow-up was comparable between study arms. CONCLUSIONS: TPNS treatment for central sleep apnea may affect sleep microstructure. Brief phases of rapid cortical activity appear to be replaced by short phases of slower cortical activity, which may promote sleep continuity. Further investigations are warranted to elucidate the mechanisms underlying the effect of TPNS on CAP.
Original languageEnglish
Pages (from-to)70-75
Number of pages6
JournalSleep Medicine
Volume113
Issue number1
Early online date19 Nov 2023
DOIs
Publication statusPublished - Jan 2024

Keywords

  • Central sleep apnea
  • Cyclic alternating pattern
  • Transvenous phrenic nerve stimulation

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