The hypoglossal nerve stimulator (HNS) is approved for the treatment of obstructive sleep apnea (OSA) in patients who cannot tolerate positive airway pressure (PAP) therapy. Indications for implantation include an apnea-hypopnea index (AHI) of 15 to 65 events/h with central apneas constituting fewer than 25% of the AHI because it is assumed that HNS therapy will have no effect on central events. We present a patient whose OSA was inadequately controlled with PAP who underwent HNS as a salvage procedure despite not meeting these indications. After HNS implantation, the patient’s obstructive component was successfully treated but treatment-emergent central sleep apnea (CSA) was complicated by new-onset Cheyne-Stokes breathing (CSB). Ethical approval was obtained from the Cincinnati Veterans Affairs Medical Center.
Sarber KM, Ishman SL, Patil RD. Emergence of Cheyne-Stokes Breathing After Hypoglossal Nerve Stimulator Implant in a Patient With Mixed Sleep Apnea. JAMA Otolaryngol Head Neck Surg. 2019;145(4):389–390. doi:10.1001/jamaoto.2018.4077
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: