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Effects of vagus nerve stimulation on sleep-related breathing in epilepsy patients.

Content Provider	Semantic Scholar
Author	Marzec, Mary L. Edwards, Jonathan B. Sagher, Oren Fromes, Gail Malow, B. A.
Copyright Year	2003
Abstract	PURPOSE To describe the effects of vagus nerve stimulation (VNS) on sleep-related breathing in a sample of 16 epilepsy patients. METHODS Sixteen adults with medically refractory epilepsy (nine men, seven women, ages 21-58 years) underwent baseline polysomnograms (PSGs). Three months after VNS therapy was initiated, PSGs were repeated. In addition, patient 7 had a study with esophageal pressure monitoring, and patient 1 had a continuous positive airway pressure (CPAP) trial. RESULTS Baseline PSGs: One of 16 patients had an apnea-hypopnea index (AHI) >5 (6.8). Treatment PSGs: Five of 16 patients had treatment AHIs >5. Respiratory events were more frequent during periods with VNS activation (on-time) than without VNS activation (off-time; p = 0.016). Follow-up studies: Esophageal pressure monitoring in patient 7 showed crescendos in esophageal pressure during VNS activation, supporting an obstructive pattern. The CPAP trial of patient 1 showed that all respiratory events were associated with VNS stimulation at low CPAP levels. They were resolved at higher CPAP levels. CONCLUSIONS Treatment with VNS affects respiration during sleep and should be used with care, particularly in patients with preexisting obstructive sleep apnea. The AHI after VNS treatment remained <5 in the majority of patients and was only mildly elevated (<12) in five patients. In one patient, CPAP resolved VNS-related respiratory events.
Starting Page	668
Ending Page	682
Page Count	15
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://deepblue.lib.umich.edu/bitstream/handle/2027.42/66447/j.1528-1157.2003.56202.x.pdf?sequence=1
Alternate Webpage(s)	https://deepblue.lib.umich.edu/bitstream/handle/2027.42/66447/j.1528-1157.2003.56202.x.pdf?isAllowed=y&sequence=1
PubMed reference number	12823576v1
Volume Number	44
Issue Number	7
Journal	Epilepsia
Language	English
Access Restriction	Open
Subject Keyword	Continuous Positive Airway Pressure Drug Resistant Epilepsy Inspiration function Patients Polysomnography Sleep Apnea Syndromes Sleep Apnea, Obstructive Vagus Nerve Stimulation Vagus nerve structure
Content Type	Text
Resource Type	Article

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