New implant to treat dangerous sleep disorder
Some people wake up every morning without ever realising that they have spent much of the night in restless sleep, struggling to breathe.
But if you are someone who needs to nap during the day and struggles with circulatory problems and headaches, then it could be that you too are suffering from what is known as obstructive sleep apnoea (OSA).
The condition is associated with considerable health risks, including an increased chance of suffering a stroke or heart attack. OSA is brought about by the muscle tone of the body relaxing during sleep, causing the patient’s tongue to block the airway at the throat.
As well as weight loss, the most common treatment for OSA is Continuous Positive Airway Pressure (CPAP), which uses a mask to maintain a continuous level of positive airway pressure.
However, there could now be an alternative for some OSA sufferers, thanks to the development of upper airway stimulation (UAS), which is a fully implanted system that is turned on before going to sleep and prevents the tongue muscles from relaxing.
Joachim Maurer from the ENT university clinic at Mannheim in western Germany has been testing the technology on patients for years now, but says the treatment is only suitable for 1 to 2 per cent of OSA sufferers.
His research on specially selected patients found that UAS reduced pauses in breathing (apnoeas) by 68 per cent and curtailed the reduction in blood oxygen saturation by as much as 70 per cent.
Patients also suffered less daytime drowsiness and noticed a marked improvement in their quality of life.
“Nearly half of all patients either receive inadequate or no treatment,” Maurer says.
This is because the most popular CPAP treatment requires patients to wear a mask at night. Although CPAP is a proven and effective treatment for OSA, many patients find wearing a mask so uncomfortable that the equipment often eventually ends up stored away unused in a bedroom wardrobe.
A total of 124 patients from across the globe were involved in the international study using UAS.
“For 70 per cent of the sample, the treatment produced equal results to using a breathing mask, while 20 per cent noticed an improvement, which could be further optimised,” explains Maurer.
“The treatment failed to work for just 10 per cent of patients.”
However, some OSA sufferers remain sceptical about the benefits of UAS over traditional treatments, not least because of costs in the region of US$27,000 dollars (Bt877,000).
“It’s a severely invasive procedure for the body and is also extremely expensive,” notes Hartmut Rentmeister, chairman of Germany’s 4,000-member-strong Association for Chronic Sleep Disorders (AVSD).
“It also must be noted that it can only be used on a certain type of patient.”
Maurer accepts that only a small percentage of OSA sufferers can avail of the new treatment, but points out that OSA is one of the most prevalent sleeping disorders and the therapy is only considered for patients for whom breathing masks and jaw guards are not suitable.
Patients can also be excluded due to large tonsils, small jawbones, heart conditions and obesity. Central sleep apnoea, in which the effort to breathe is diminished or absent, cannot be treated in this way.
The study’s positive results are thanks in part to a strenuous patient selection process, but Maurer remains confident that further research will lead to a reduction in costs and more OSA sufferers being deemed suitable for treatment using UAS.
Source: The Nation
Published: 08 July 2014
Category: Features, Technology & Devices
