TY - JOUR T1 - Improvement in obstructive sleep apnoea features under targeted hypoglossal neurostimulation is independent from body mass index and collar size JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p4955 AU - Daniel Rodenstein AU - Benny Mwenge AU - Myriam Dury AU - Benoit Lengele AU - Philippe Rombaux Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p4955.abstract N2 - Background: The treatment of moderate to severe obstructive sleep apnoea (OSA) is continuous positive pressure (CPAP) applied during sleep. Although its health effects are beyond doubt, many patients refuse or stop CPAP because of intolerance or local side effects. Alternative therapies are needed.Aim: We used targeted hypoglossal neurostimulation (THN) to treat 11 patients (1 female) non compliant with CPAP therapy with the aim of improving both breathing and sleep.Methods: One hypoglossal nerve was stimulated through a multicontact cuffed electrode positioned around the main trunk of the nerve and connected to a stimulator implanted in a subcutaneous pocket on the anterior chest wall. Stimulation was applied continuously during sleep.Results: The BMI of the group was 30.7+3.5 kg/m2; on diagnostic polysomnography the average apnoea-hypopnoea index (AHI) was 47.5+16.6, the 4% oxygen desaturation index (ODI) 28.6+21.5 and the microarousal index (MAI) 35.5+13.8, all per hour of sleep. After 3 months therapy the BMI was unchanged whereas the AHI was 21.5+12.2, the ODI 13.9+14.7 and the MAI 24.8+15.1, all p<0.05. There was a significant correlation between initial AHI and ODI and BMI (p<0.05) and there was a tendency for initial AHI to correlate to collar size (p<0.1). The final ODI correlated to BMI (p<0.05). By contrast, there was no significant correlation between changes in AHI, or changes in ODI with THN and BMI or collar size.Conclusions: THN may improve breathing and sleep irrespective of body size and of collar size, two well known determinants of OSA severity. ER -