Transvenous phrenic nerve stimulation for treating central sleep apnea may regulate sleep microstructure
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Transvenous phrenic nerve stimulation for treating central sleep apnea may regulate sleep microstructure. / Hartmann, Simon; Immanuel, Sarah; McKane, Scott; Linz, Dominik; Parrino, Liborio; Baumert, Mathias.
In: Sleep Medicine, Vol. 113, 01.2024, p. 70-75.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Transvenous phrenic nerve stimulation for treating central sleep apnea may regulate sleep microstructure
AU - Hartmann, Simon
AU - Immanuel, Sarah
AU - McKane, Scott
AU - Linz, Dominik
AU - Parrino, Liborio
AU - Baumert, Mathias
N1 - Publisher Copyright: © 2023 The Authors
PY - 2024/1
Y1 - 2024/1
N2 - 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 remedē 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.
AB - 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 remedē 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.
KW - Central sleep apnea
KW - Cyclic alternating pattern
KW - Transvenous phrenic nerve stimulation
UR - http://www.scopus.com/inward/record.url?scp=85177030637&partnerID=8YFLogxK
U2 - 10.1016/j.sleep.2023.11.005
DO - 10.1016/j.sleep.2023.11.005
M3 - Journal article
C2 - 37988861
AN - SCOPUS:85177030637
VL - 113
SP - 70
EP - 75
JO - Sleep Medicine
JF - Sleep Medicine
SN - 1389-9457
ER -
ID: 378826698