Therapeutic Electrical Stimulation of the Hypoglossal Nerve in Obstructive Sleep Apnea

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Abstract
OBSTRUCTIVE sleep apnea affects 2% to 4% of the adult population1 and is most commonly seen in middle-aged, overweight men.2 It is caused by recurrent episodes of upper airway obstruction during sleep that lead to periodic oxyhemoglobin desaturations and arousals from sleep.3,4 Disturbances in sleep and oxygenation are believed to be responsible for the major clinical manifestations of this disorder, which include daytime hypersomnolence, arterial and pulmonary hypertension, and cardiopulmonary failure. The primary goal of therapy is to avert or alleviate the clinical sequelae of this disorder by relieving upper airway obstruction during sleep.5 Various methods have been used to relieve upper airway obstruction in apneic patients, including nasal continuous positive airway pressure,6-9 weight reduction,10,11 positional maneuvers,12 pharmacologic interventions,13-15 dental appliances,16,17 and upper airway reconstructive or bypass surgery,18-22 all with varying degrees of success. Thus, no single treatment is certain to provide complete relief of upper airway obstruction in all patients during sleep.