Neurostimulation for Treatment of Obstructive Sleep Apnea (Podcast)

While there are comprehensive treatment options for obstructive sleep apnea (OSA), the disorder is underrecognized and underdiagnosed, says Jessica Vensel Rundo, MD, MS, Director of the Sleep Neuromodulation Program in Cleveland Clinic’s Sleep Disorders Center.

“About 25% to 50% of males and 10% to 25% of females have some degree of obstructive sleep apnea,” says Dr. Vensel Rundo. “That translates to many millions of Americans.”

In 2014, a new category of surgical therapy became available to help this population when the FDA approved the first neurostimulation device to treat OSA. In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Vensel Rundo discusses OSA and hypoglossal nerve stimulation, providing insight on the following:

• Positive airway pressure (PAP) therapy as the first line of treatment for OSA
• Screening criteria and ideal candidates for airway neurostimulation
• Implantation and function of the transcutaneous electrical stimulator
• Patient outcomes following neurostimulation
• Potential future devices, including a bilateral hypoglossal nerve stimulator and a continuous negative expiratory pressure device

Click the podcast player above to listen to the episode now, or read on for a short edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

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Excerpt from the episode

Podcast host Glen Stevens, DO, PhD: Would you recommend that anybody who is thinking about airway neurostimulation see a sleep specialist, or can they go to their general neurologist for this?

Dr. Vensel Rundo: I think it usually is most helpful if they can be referred to a sleep specialist, just to discuss in more detail what their issues are with PAP therapy and what other potential options there might be in addition to hypoglossal nerve stimulation.

Also, we see a number of patients who are intolerant to PAP therapy or just struggle with whatever their treatment option is for sleep apnea. Other patients may also struggle because they have additional sleep disorders like insomnia, restless legs syndrome or circadian rhythm disorders. In these cases, a sleep specialist is best equipped to assess why these patients may have difficulties adhering to their current treatment option and to determine whether other sleep disorders may be contributing to these difficulties.