Did you know that sleep apnea is one of the most common sleep disorders? In fact, a bit more than a quarter of the American population suffers from sleep apnea. This condition is characterized by long breathing interruptions during sleep and if left untreated it can lead to other even more serious health issues.
What’s more, there are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea. The first type is more common and occurs when the airway collapse at the back of the throat due to a lack of stimulus to the throat muscles. The second type is less common and occurs as a result of absent nerve signals from the brain responsible for breathing for longer periods of time.
That said, to treat sleep apnea, doctors usually recommend the use of special sleep equipment. However, some people cannot tolerate this therapy which is why there’s even a greater need of finding alternative treatments for relieving sleep apnea symptoms, one of which is pacemaker therapy.
Pacemaker Therapy for Sleep Apnea
One of the newest and most advanced alternative treatments for sleep apnea is pacemaker therapy. Although people usually consider pacemakers to be the solution to some heart issues, they can actually alleviate sleep apnea too. Therefore, we need a brief physiology explanation to be able to understand how pacemakers can help in treating this sleep disorder.
When breathing, air flows from the mouth and nose, through the back of the tongue, the trachea, and down into the lungs. This is a result of signals from the brain that stimulate the diaphragm to produce inspiration which also activates the throat muscles to contract and prevent airway blockage. And, when something impedes this process during sleep, it leads to sleep apnea.
The Research around Pacemaker Therapy
According to research, people suffering from moderate to severe obstructive sleep apnea (OSA) can alleviate their condition by the pacing of the hypoglossal nerve which is located in the neck. To be more precise, the occurrence of breathing interruptions in people who had a hypoglossal pacemaker inserted reduced by a whopping 50% in just a year. Plus, they’ve also experienced an improvement regarding their oxygen levels at night, daytime sleepiness, and life quality.
So, how does this therapy help in treating this condition?
The pacemaker consists of three main elements including the stimulation electrode, the sensing electrode, and the electrical generator. The stimulation electrode is inserted on one of the hypoglossal nerves (either left or right) and is in charge of activating the nerve to stiffen the tongue muscles and prevent airway collapse and apnea. The sensing electrode which identifies when inhaling begins is inserted in the chest. And, the electrical generator supplies power for the entire pacemaker to function.
Though it seems like a great alternative for those who cannot tolerate or simply find using sleep equipment inconvenient, the hypoglossal pacemaker isn’t commonly used due to two main reasons. First, it is quite expensive – around $30,000. Second, there isn’t enough data proving the effectiveness in severely obese OSA patients. The second reason is quite important since about 65% of patients suffering from obstructive sleep apnea are either overweight or obese.
Finally, those who suffer from central sleep apnea can also consider pacemaker therapy for treating their condition. In these patients, a pacemaker can be inserted through a vein to detect the absence of effort to breathe and stimulate the phrenic nerve responsible for activating diaphragm contraction. Once they get the pacemaker inserted, central sleep apnea patients can enjoy a better quality of sleep and reduce central apneas.