Treatment-emergent central sleep apnea after initiation of hypoglossal nerve stimulator.

Abstract

Treatment emergent central sleep apnea occurs when primary obstructive sleep apnea improves with positive airway pressure treatment, but central events emerge or persist. While documented with positive airway pressure and other treatment modalities, emergence of central sleep apnea has rarely been reported with hypoglossal nerve stimulation. In this case report, we present two patients who developed central apnea during hypoglossal nerve stimulator titration with emergence of central events at higher voltages. Central apneas resolved in both patients at follow-up when maintained at stable voltages; however, in one patient, central apnea recurred upon trialing higher voltages. These cases demonstrate that treatment emergent sleep apnea can also be considered as a potential consequence of treatment of obstructive sleep apnea with hypoglossal nerve stimulator.