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Pacemaker treats sleep apnea

Experimental device works for many patients who can’t use breathing machines

BREATHE IN, BREATHE OUT  An electronic pacemaker (neurostimulator) implanted just beneath the skin of the chest gets signals from a sensor between ribs (fourth intercostal region) whenever the chest expands. The pacemaker shoots an impulse to a lead attached to the hypoglossal nerve, which controls the muscle at the base of the tongue. This causes the tongue to protrude, opening the throat just in time for the person to inhale — all while asleep.

An implantable gizmo can halt obstructive sleep apnea, a nighttime breathing disorder that disrupts rest and robs the body of oxygen. The experimental device, an electronic pacemaker that syncs breathing with opening of the throat, relieved sleep apnea in two-thirds of people who tested it.

The volunteers had moderate-to-severe sleep apnea but couldn’t tolerate a standard treatment with a breathing machine that requires wearing a mask. That machine, called CPAP for continuous positive airway pressure, delivers air at a steady pace to keep airways open. Beyond CPAP, few treatments are available for severe sleep apnea, says study coauthor Ryan Soose, an otolaryngologist at the University of Pittsburgh Medical Center. “Other solutions are needed,” he says, and the pacemaker “comes at it in a really unique way, mainly targeting the anatomy of the throat.”

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