PT - JOURNAL ARTICLE AU - Olivier M. Vanderveken AU - Faiza Safiruddin AU - Johan Verbraecken AU - Kent Lee AU - Joachim Maurer AU - Paul Van de Heyning AU - Nico de Vries TI - Upper airway stimulation in OSA patients increases airway size in a dose-response manner DP - 2013 Sep 01 TA - European Respiratory Journal PG - 4616 VI - 42 IP - Suppl 57 4099 - http://erj.ersjournals.com/content/42/Suppl_57/4616.short 4100 - http://erj.ersjournals.com/content/42/Suppl_57/4616.full SO - Eur Respir J2013 Sep 01; 42 AB - Introduction: Upper airway stimulation (UAS) is a potential therapy for CPAP-refractory OSA by hypoglossal stimulation using an implantable, programmable neurostimulator. We tested whether increasing stimulation amplitude would increase palatal and tongue-base airway size during wakefulness and sedation.Methods: Fifteen OSA patients had awake and drug-induced sleep endoscopy (DISE) at least 3 months after UAS system implantation (Inspire Medical Systems, Minneapolis, MN). Stimulation was applied at four increasing amplitudes: first sensation, tongue movement, PSG-titrated therapeutic, and sub-discomfort. Palatal and tongue-base cross-sectional area were measured and compared between periods with and without stimulation. Asterisk indicates p<0.05 vs. sensation amplitude.Results: Twelve patients (all male, age: 51.2± 9.0 years) underwent DISE; fifteen patients (all male, age: 50.4 ±10.2 years) underwent awake laryngoscopy and eleven patients had both. During both awake and DISE, higher stimulation amplitudes had a graded response in enlarging airway size, with a larger percent increase during DISE.The titrated amplitude increased airway size by ∼200% during DISE.Conclusion: Upper airway stimulation increases airway size during awake and improves airway collapse during sedation. Increasing stimulation amplitudes enlarges both palatal and tongue-base airway size compared to periods of no stimulation in both awake and DISE.