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Chest Implant Might Help With Hard-to-Treat Sleep Apnea

Study found device may provide alternative to air mask therapy

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The surgery is minimally invasive, and patients typically were back to regular activity within a day or two, said study co-author Dr. Ryan Soose, director of the division of sleep surgery at UPMC.

"It's a unique and promising new treatment," Soose said.

As the patient breathes in and out, the pacemaker sends electrical impulses to the nerve, which causes the person's tongue to move slightly forward and their upper airway to contract open. Both movements keep the airway from collapsing.

Patients only used the pacemaker during sleep, turning it on and off by waving a magnet over the implant.

"We found there was a very robust effect on sleep apnea," Strollo said. Patients experienced much fewer episodes of sleep apnea and received much more oxygen in their blood as a result.

The researchers also found that sleep apnea returned when patients were taken off the pacemaker treatment.

The technology also appears safe. It did no permanent damage to the patient's tongues, Strollo said, although two of five patients did report some discomfort associated with the electrical stimulation.

In an accompanying journal editorial, Dr. Atul Malhotra at the University of California, San Diego, noted that while the pacemaker appeared to reduce sleep apnea, it didn't eliminate it. He pointed out that the study lacked a comparison group, and that the results could have been due to other factors such as participants' diet or exercise.

An FDA panel will review findings from the clinical trial in February, Strollo said.

A number of teams have been researching this technology, said Dr. William Kohler, medical director of the Florida Sleep Institute. He was not involved with the new study.

Kohler sees the pacemaker technology as an alternative to CPAP, rather than something that will supplant the air mask.

"This needs to be investigated as a treatment not in the first line, but if other treatments fail," Kohler said. "The more therapies we have out there, the better. But we need more experience with it to really see where it's going to fit as far as the overall treatment for sleep apnea goes."

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