Model-based analysis of implanted hypoglossal nerve stimulation for the treatment of obstructive sleep apnea
| dc.contributor.author | Cornelius,Jason | |
| dc.contributor.author | M Dweiri, Yazan | |
| dc.contributor.author | D Johnson, Matthew | |
| dc.contributor.author | ETAL.. | |
| dc.date.accessioned | 2025-12-04T09:45:59Z | |
| dc.date.available | 2025-12-04T09:45:59Z | |
| dc.date.issued | 2021 | |
| dc.description | Obstructive sleep apnea (OSA), which affects over 18 million adults in the United States [1], is characterized by frequent sleep disruptions that stem from tongue muscle relaxation and airway blockage. The standard of care for treating OSA is the use of positive airway pressure (PAP) systems, which while effective, are limited by high non-adherence rates that range from 46% to 83% [2]. Hypoglossal nerve stimulation (HNS) is established as another safe and effective treatment option for patients with moderate to severe OSA, especially for those who cannot adhere to PAP in both controlled study [3] and clinical practice [4, 5]. These studies have shown HNS reduced OSA severity as well as improved daytime sleepiness and other quality of life measures that are associated with OSA [3–6]. | |
| dc.description.abstract | Study Objectives Individuals with obstructive sleep apnea (OSA), characterized by frequent sleep disruptions from tongue muscle relaxation and airway blockage, are known to benefit from on-demand electrical stimulation of the hypoglossal nerve. Hypoglossal nerve stimulation (HNS) therapy, which activates the protrusor muscles of the tongue during inspiration, has been established in multiple clinical studies as safe and effective, but the mechanistic understanding for why some stimulation parameters work better than others has not been thoroughly investigated. Methods In this study, we developed a detailed biophysical model that can predict the spatial recruitment of hypoglossal nerve fascicles and axons within these fascicles during stimulation through nerve cuff electrodes. Using this model, three HNS programming scenarios were investigated including grouped cathode (---), single cathode (o-o), and guarded cathode bipolar (+-+) electrode configurations. Results Regardless of electrode configuration, nearly all hypoglossal nerve axons circumscribed by the nerve cuff were recruited for stimulation amplitudes <3 V. Within this range, monopolar configurations required lower stimulation amplitudes than the guarded bipolar configuration to elicit action potentials within hypoglossal nerve axons. Further, the spatial distribution of the activated axons was more uniform for monopolar versus guarded bipolar configurations. Conclusions The computational models predicted that monopolar HNS provided the lowest threshold and the least sensitivity to rotational angle of the nerve cuff around the hypoglossal nerve; however, this setting also increased the likelihood for current leakage outside the nerve cuff, which could potentially activate axons in unintended branches of the hypoglossal nerve. Keywords: obstructive sleep apnea, hypoglossal nerve stimulation, computational model, stimulation settings, electrode configuration, nerve cuff | |
| dc.identifier.citation | Johnson, M. D., Dweiri, Y. M., Cornelius, J., Strohl, K. P., Steffen, A., Suurna, M., ... & Ni, Q. (2021). Model-based analysis of implanted hypoglossal nerve stimulation for the treatment of obstructive sleep apnea. Sleep, 44(Supplement_1), S11-S19. | |
| dc.identifier.doi | https://doi.org/10.1093/sleep/zsaa269 | |
| dc.identifier.uri | https://repository.adu.ac.ae/handle/1/7824 | |
| dc.language.iso | en | |
| dc.publisher | Oxford University Press | |
| dc.title | Model-based analysis of implanted hypoglossal nerve stimulation for the treatment of obstructive sleep apnea | |
| dc.type | Article |