A case of hypoglossal nerve stimulator ‐resistant obstructive sleep apnea cured with the addition of a chin strap

We describe the case of nonresponder whose obstructive sleep apnea (OSA) resolved with the addition of chin strap. After initial placement and titration of HGNS implant, follow‐up sleep study demonstrated persistent moderate OSA. Drug‐induced sleep endoscopy demonstrated supraglottic collapse with activate neurostimulation. With mouth closure and change of stimulation settings to unipolar from bipolar, the airway collapse and desaturations improved. The follow‐up polysomnogram with (HGNS) therapy and chin strap demonstrated resolution of sleep apnea. Laryngoscope, 2017
Source: The Laryngoscope - Category: ENT & OMF Authors: Tags: Sleep Medicine Source Type: research

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CONCLUSION: Despite good interrater variability and convenient usage of the suggested X‑ray assessment system, this approach did not enable the identification of any associations by which a TM and, therefore, a possible straightforward or complicated treatment pathway could be predicted. Attention should possibly be paid to a rotation of the cuff during implantation with a lateral position of the stimulation lead. PMID: 31598770 [PubMed - as supplied by publisher]
Source: HNO - Category: ENT & OMF Tags: HNO Source Type: research
CONCLUSION: Despite good interrater variability and convenient usage of the suggested X‑ray assessment system, this approach did not enable the identification of any associations, by which a TM and therefore a possible straightforward or complicated treatment pathway could be predicted. Attention should possibly be paid to a rotation of the cuff during implantation with a lateral position of the stimulation lead. PMID: 31414154 [PubMed - as supplied by publisher]
Source: Nuklearmedizin - Category: Radiology Authors: Tags: HNO Source Type: research
ConclusionsThese three cases lend support to the hypothesis that chronic insomnia and obstructive sleep apnea share a pathophysiology of chronic stress. Among patients with obstructive sleep apnea, the stress response is directed at inspiratory airflow limitation during sleep (hypopnea, snoring, and inaudible fluttering of the throat). Therefore, when chronic insomnia and obstructive sleep apnea occur in one individual, aggressive treatment of obstructive sleep apnea may lead to a reduction in chronic stress that causes the patient ’s chronic insomnia to remit.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
The worldwide prevalence of sleep disorders is ~ 50% with even higher occurrence in psychiatric population. Bipolar disorder (BD) is a severe mental illness characterized by shifts in mood and activity. The BD syndrome also involves heterogeneous symptomatology including cognitive dysfunctions and impairments of autonomic nervous system. Sleep abnormalities are frequently associated with BD and are often a good predictor of a mood swing. Preservation of stable sleep–wake cycles is therefore a key to the maintenance of stability in BD indicating also the crucial role of circadian rhythms in this syndrome. The symptom ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
ConclusionsThis study shows that male BD patients are associated with an increased risk of OSA, which has direct implications for the development of targeted prevention interventions or the implementation of a screening algorithm for OSA to reduce its negative health impact.This article is protected by copyright. All rights reserved.
Source: Psychiatry and Clinical Neurosciences - Category: Neuroscience Authors: Tags: Regular Article Source Type: research
Worldwide, approximately 1% to 4% of people suffer from bipolar disorder (BD). BD is a severe mental disorder ranking as the fourth most important contributor to the global disease burden among psychiatric, neurological and substance-use disorders (Collins et al., 2011; Merikangas et al., 2007). Whereas BD has traditionally been defined by recurrences of manic and depressive episodes, it is now recognized that BD patients also present with persistent abnormalities between mood episodes (such as cognitive deficits, cardio-vascular diseases, altered sleep homeostasis and circadian dysregulation), leading to conceptualization...
Source: Journal of Affective Disorders - Category: Neurology Authors: Tags: Research paper Source Type: research
Authors: Fehr BS, Katz WF, Van Enkevort EA, Khawaja IS Abstract Objective: To examine the correlations between obstructive sleep apnea (OSA) and psychiatric disorders such as major depressive disorder (MDD), posttraumatic stress disorder (PTSD), or bipolar disorder (BD) and whether comorbid psychiatric diagnosis increases the risk of OSA. Methods: This retrospective chart review study included all patients (N = 413) seen within a randomly selected 4-month period (August 2014 to November 2014) in a Veterans Administration outpatient psychiatry clinic. Patients were screened for symptoms of OSA with the STOP-BANG...
Source: The Primary Care Companion for CNS Disorders - Category: Primary Care Tags: Prim Care Companion CNS Disord Source Type: research
ConclusionObstructive sleep apnea is a common disorder that causes significant reduction in quality of life and is an independent risk factor for multiple comorbidities. Electroconvulsive therapy is an established treatment for medication-refractory depression with minimal risk in most patient populations. This is the first report in the literature of a patient undergoing ECT for bipolar depression with recent activation of Inspire hypoglossal nerve stimulator who had no disruption in the function of his implanted device.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
Authors: Moonga SS, Mischoulon D, Winkelman JW, Stern TA PMID: 29195035 [PubMed - in process]
Source: The Primary Care Companion for CNS Disorders - Category: Primary Care Tags: Prim Care Companion CNS Disord Source Type: research
Introduction: Uvulopalatopharyngoplasty (UPPP) and its combination with bipolar radiofrequency surgery of the tongue base (UPPP + RFBT) are the most common surgical treatment modalities of obstructive sleep apnea syndrome (OSAS). These procedures should improve the results of polygraphy, decrease the daytime sleepiness and influence also the incidence of cardiovascular disorders and snoring. In this project, we concentrate on the comparison of apnea – hypopnea index (AHI) change with subjective results and satisfaction of patients.
Source: Sleep Medicine - Category: Sleep Medicine Authors: Tags: Other Source Type: research
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