患有唐氏综合征和阻塞性睡眠呼吸暂停的成年人接受舌下神经刺激治疗。
Adults with Down syndrome and obstructive sleep apnea treated with hypoglossal nerve stimulation.
作者信息
Huyett Phillip, Santoro Stephanie L, Oreskovic Nicolas M, Skotko Brian G
机构信息
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
出版信息
J Clin Sleep Med. 2025 Apr 1;21(4):619-625. doi: 10.5664/jcsm.11452.
STUDY OBJECTIVES
We aimed to examine the feasibility, adherence to therapy, and efficacy of hypoglossal nerve stimulation in adults with Down syndrome and obstructive sleep apnea.
METHODS
Adults patients with Down syndrome who met criteria for hypoglossal nerve stimulation were prospectively enrolled. Objective adherence was extracted from a cloud-based compliance database. Preoperative sleep studies were compared to follow-up testing performed no sooner than 3 months after device activation.
RESULTS
Eleven adults with Down syndrome underwent implantation of hypoglossal nerve stimulation between May 2021 and July 2024. Median age was 27 years (interquartile range 26, 33), body mass index 28.5 kg/m (26.5, 32.4), 27% were female, and patients had severe obstructive sleep apnea (apnea-hypopnea index 40 events/h, 28.4, 42.9). All patients were successfully implanted on an outpatient basis with no postoperative complications or readmissions and activated on schedule at 1 month after surgery. Adherence data show nightly usage longer than 4 hours was 100% and 96% of nights and a median of 9.2 and 8.5 hours/night in the first 30 and 90 days, respectively. Seven patients have undergone follow-up testing and the median entire-night apnea-hypopnea index was reduced by 76%. All patients experienced a > 50% decrease in apnea-hypopnea index and to less than 15 events/h. Median time spent below 88% improved from 2.0% (0.3, 5.0) to 0.2% (0, 0.6), and oxygenation nadir improved from 79.0% (75.5, 85) to 88.0% (86.5, 91).
CONCLUSIONS
In this small initial cohort, hypoglossal nerve stimulation appears to be a safe, well-tolerated, and efficacious treatment option for adults with Down syndrome with moderate-to-severe obstructive sleep apnea and positive airway pressure therapy intolerance.
CITATION
Huyett P, Santoro SL, Oreskovic NM, Skotko BG. Adults with Down syndrome and obstructive sleep apnea treated with hypoglossal nerve stimulation. 2025;21(4):619-625.
研究目的
我们旨在研究舌下神经刺激对患有唐氏综合征和阻塞性睡眠呼吸暂停的成年人的可行性、治疗依从性及疗效。
方法
前瞻性纳入符合舌下神经刺激标准的唐氏综合征成年患者。客观依从性数据从基于云的依从性数据库中提取。将术前睡眠研究结果与设备激活后至少3个月进行的随访测试结果进行比较。
结果
2021年5月至2024年7月期间，11名患有唐氏综合征的成年人接受了舌下神经刺激植入术。中位年龄为27岁（四分位间距26, 33），体重指数为28.5 kg/m²（26.5, 32.4），27%为女性，患者患有重度阻塞性睡眠呼吸暂停（呼吸暂停低通气指数为40次/小时，28.4, 42.9）。所有患者均在门诊成功植入，无术后并发症或再次入院情况，并在术后1个月按时激活设备。依从性数据显示，在前30天和90天中，每晚使用时间超过4小时的比例分别为100%和96%，每晚使用时间中位数分别为9.2小时和8.5小时。7名患者接受了随访测试，整个夜间呼吸暂停低通气指数中位数降低了76%。所有患者的呼吸暂停低通气指数均下降了>50%，降至低于15次/小时。低于88%血氧饱和度的时间中位数从2.0%（0.3, 5.0）改善至0.2%（0, 0.6），最低血氧饱和度从79.0%（75.5, 85）改善至88.0%（86.5, 91）。
结论
在这个小型初始队列中，对于患有中度至重度阻塞性睡眠呼吸暂停且不耐受气道正压通气治疗的唐氏综合征成年人，舌下神经刺激似乎是一种安全、耐受性良好且有效的治疗选择。
引用文献
Huyett P, Santoro SL, Oreskovic NM, Skotko BG. Adults with Down syndrome and obstructive sleep apnea treated with hypoglossal nerve stimulation. 2025;21(4):619-625.
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