Upper airway hypoglossal nerve stimulation is safe and effective in adolescents with Down syndrome and severe persistent obstructive sleep apnea (OSA) occurring after adenotonsillectomy, and who couldn't tolerate positive airway pressure, early research suggests.
In a phase I study, 42 adolescents received a surgically implanted device that moves the tongue forward during sleep. Results at 1-year follow-up showed 66% "responded well" to treatment and showed a drop in apnea-hypopnea index (AHI) of at least 50%.
"Parents came back to us and said not only is the sleep better but my child seems to be doing better during the day," lead investigator Christopher Hartnick, MD, director of the Division of Pediatric Otolaryngology and the Pediatric Airway, Voice, and Swallowing Center at Massachusetts Eye and Ear, Boston, told Medscape Medical News.
The findings were published online April 21 in JAMA Otolaryngology–Head and Neck Surgery.
Limited Options
Upper airway simulation has been shown previously to be effective for adults with OSA, but up until now, the process has not been evaluated in children.
The device used in the current study "stimulates the hypoglossal nerve to protrude the tongue and open the airway on inspiration during sleep," the investigators note.
"Hypoglossal nerve stimulation may be a particularly suitable therapy for patients with Down syndrome because it can augment neuromuscular airway tone and reduce anatomical obstruction at the base of the tongue, a common site of residual obstruction in children with Down syndrome," they add.
