New treatment for patients with obstructive sleep apnea syndrome

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1) Animal study: To investigate the possible effectiveness of Genioglossus muscle (GG) stimulation on upper airway resistance in six anesthetized dogs. The upper airway was isolated from the lower airway by transecting the cervical trachea and the pressure flow relationship of the upper aireay was obtained by applying constant negative pressure (5, 10 and 20 cm H_2O) to the proximal cut end of the trachea. Upper airway resistance (Rua) was significantly reduced by stimulation. below 50Hz Rua decreased markedly as frequency increased, but above 50Hz Rua approached a minimum value.2) Clinical study: We examined the effects of percutaneous electrical stimulation of the GG muscle in patients with odstructive sleep apnea symdrome (OSAS) during sleep. Using an apnea demend-type stimulator which we have developed, submental electrical stimulation was triggered five seconds after onset of apnea, which was recorded by tracheal breathing sound, and was stopped immediately after breathing resumed or after ten seconds at the longest. With submental stimulation, the apnea index, longest apnea duration, and the number of times per hour that oxygen saturation dropped below 85% decreased significantly, compared to control nights. These findings suggest that the apnea demand-type stimulator may be a non-invasive and effective treatment for OSAS.