SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science I. Sleep Disorders – Breathing
nerve, and a pulse generator in an infraclavicular pocket on the right
side of the patient. Selection of the hypoglossal nerve fibers responsible
for best tongue protrusion was confirmed using an intraoperative nerve
integrity monitoring (NIM®, Medtronic) system. The stimulating pulses
were delivered synchronously during the inspiratory phase of breathing
during sleep.
Results: Despite of the anatomical variety of the protruding fibers within
the hypoglossal nerve, placing the stimulation electrode was successful
in all four cases. There were no serious adverse events reported. One
patient had a postoperative submental hematoma treated conservatively.
In the polysomnography study, an acute effect of stimulation to stabilize
airflow was observed in all four subjects. The overall AHI reduced
from 33 ± 3.4 to 5.1± 3.3 at the latest follow-up. In one patient the AHI
decreased from 38/h to 10/h in the first and increased to 27/h in the second
follow-up, and finally 7.2/h at the 6-momth visit. Interestingly, this
patient gained 5 kg bodyweight between the first two follow-ups, which
suggesting a relation between BMI and the reduction of apneas. No apparent
BMI changes in the other patients implanted.
Conclusion: Selective stimulation of the protruding fibers of the hypoglossal
nerve is feasible and lead to predictable introperative and postoperative
results.
Support (If Any): Inspire Medical Systems, Inc.
0435
CLINICAL AND POLYSOMNOGRAPHIC DATA OF
POSITIONAL SLEEP APNEA AND ITS PREDICTORS
Teerapraipruk B 1,2,6 , Chirakalwasan N 1,5 , Simon R 1,3,6 ,
Hirunwiwatkul P 1,6 , Jaimchariyatam N 1,5 , Desudchit T 1,4 , Charakorn N 6 ,
Wanlapakorn C 8 , Krittanupong S 5 , Intarut N 7
1
Excellence Center for Sleep Disorders, King Chulalongkorn Memorial
Hospital/Thai Red Cross Society, Bangkok, Thailand, 2 Department of
Otolaryngology and Opthalmology, Naresuan University, Phitsanulok,
Thailand, 3 Department of Otorhinolaryngology, Hospital Raja
Permaisuri Bainun, Ipoh, Malaysia, 4 Department of Pediatrics, Division
of Pediatric Neurology, Chulalongkorn University, Bangkok, Thailand,
5
Department of Medicine, Division of Pulmonary and Critical Care
Medicine, Chulalongkorn University, Bangkok, Thailand, 6 Department
of Otolaryngology, Chulalongkorn University, Bangkok, Thailand,
7
Chulalongkorn Research Center, Chulalongkorn University, Bangkok,
Thailand, 8 Department of Medicine, Chulalongkorn University,
Bangkok, Thailand
Introduction: In Asian population, facial structure has effect on obstructive
sleep apnea more than body mass index (BMI). We hypothesized
that sleep position may have more effect on obstructive sleep apnea in
Asians compared to Western population. If this hypothesis is accurate,
positional therapy will have a major impact on treatment of obstructive
sleep apnea among Asians.
Methods: We reviewed polysomnographic studies from our laboratory
from Jan 1st, 2010 to June 30th, 2010. Each polysomnographic studies
required at least 30 minutes each for recorded supine and recorded
non-supine sleep to be included in our study. Criteria for positional and
non-positional sleep apneas were (1) supine RDI/non-supine RDI >=2
and total RDI ≥5 and (2) supine RDI/non-supine RDI