Overview

Overview

Obstructive sleep apnea (OSA) results in a reduction in genioglossus muscle (innervated by CN XII) electromyography activity, which results in collapse of a correlative area of the oropharynx. Standard therapies for OSA, such as positive airway pressure, are often difficult to tolerate, thus, rendering OSA untreated or suboptimally treated, which translates into increased negative health consequences. Therefore, the development of innovative alternative therapies is important. Upper airway neurostimulation is a system of unilateral CN XII stimulation, consisting of an implantable pulse generator, stimulation lead, and respiratory sensing electrode. Our group is a site for the ADHERE (Adherence and Outcome of Upper Airway Stimulation for OSA International Registry) registry, which was designed to monitor this transition of upper airway neurostimulation use from trial to clinical practice. We are focused on the investigation of the influence of upper airway neurostimulation on patient reported outcomes, blood pressure based upon continuous ambulatory blood pressure monitoring, and evaluation of predictors of upper airway neurostimulation success and adherence. Along the lines of neurostimulation, we have also examined phrenic nerve stimulation for the treatment of central sleep apnea.

Contact Information

Tina Waters
waterst@ccf.org

Funding Sources

2016-current - ADHERE Upper Airway Stimulation Therapy Registry, PI: T Waters

2013-2015 - Clinical Trial of Phrenic Nerve Stimulation in Central Sleep Apnea. Respicardia, PI: W Tang

Publications

Publications

  1. Upper Airway Stimulation vs Positive Airway Pressure Impact on BP and Sleepiness Symptoms in OSA. Walia HK, Thompson NR, Strohl KP, Faulx MD, Waters T, Kominsky A, Foldvary-Schaefer N, Mehra R., Chest. 2019 Jul 9.
  2. ADHERE registry investigators. Post-approval upper airway stimulation predictors of treatment effectiveness in the ADHERE registry. Heiser C, Steffen A, Boon M, Hofauer B, Doghramji K, Maurer JT, Sommer JU, Soose R, Strollo PJ Jr, Schwab R, Thaler E, Withrow K, Kominsky A, Larsen C, Kezirian EJ, Hsia J, Chia S, Harwick J, Strohl K, Mehra R; Eur Respir J. 2019 Jan 3;53(1)
  3. Previous Surgery and Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.  Kezirian EJ, Heiser C, Steffen A, Boon M, Hofauer B, Doghramji K, Maurer JT, Sommer JU, Soose RJ, Schwab R, Thaler E, Withrow K, Kominsky A, Larsen CG, Hsia J, Mehra R, Waters T, Strohl K., Otolaryngol Head Neck Surg. 2019 Nov;161(5):897-903.
  4. Previous Surgery and Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea. Kezirian EJ, Heiser C, Steffen A, Boon M, Hofauer B, Doghramji K, Maurer JT, Sommer JU, Soose RJ, Schwab R, Thaler E, Withrow K, Kominsky A, Larsen CG, Hsia J, Mehra R, Waters T, Strohl K., Otolaryngol Head Neck Surg. 2019 Nov;161(5):897-903.
  5. Uvulopalatopharyngoplasty vs CN XII stimulation for treatment of obstructive sleep apnea: A single institution experience. Shah J, Russell JO, Waters T, Kominsky AH, Trask D., Am J Otolaryngol. 2018 May - Jun;39(3):266-270. PMID: 29540289.
  6. Comparative Impact of Upper Airway Stimulation to Positive Airway Pressure in Changes in Epworth Sleepiness Scale and Blood Pressure in Obstructive Sleep Apnea. Walia HK, Thompson N, Waters T, Kominsky A, Trask D, Foldvary-Schaefer N, Mehra R., Associated Professional Sleep Societies. Baltimore, MD June 2018.
  7. Impact of Hypoglossal Nerve Stimulation on Early Patient Reported Outcomes: The Cleveland Clinic Experience Associated Professional Sleep Societies. Waters T, Wang L, Mehra R, Kominsky A, Trask D., Boston, MA, June 2017.
  8. On Behalf of the Adhere Registry Investigators Upper Airway Stimulation for Obstructive Sleep Apnea – Results from the Adhere Registry Associated Professional Sleep Societies. Doghramji K, Schwab R, Strollo P, Mehra R, Strohl KP, Iber C., Baltimore, MD June 2018.
  9. On Behalf of the Adhere Registry Investigators. Response to Upper Airway Stimulation in Older Adults with Moderate to Severe Obstructive Sleep Apnea. Strollo PJ, Withrow K, Schell A, Soose R, Mehra R, Schwab R, Strohl KP, Doghramji K, Associated Professional Sleep Societies. Baltimore, MD June 2018.
  10. On Behalf of the Adhere Registry Investigators, Predictors of Success of Upper Airway Stimulation for Obstructive Sleep Apnea. Schwab R, Doghramji K, Strollo P, Mehra R, Keenan, Strohl KP, Iber C., Associated Professional Sleep Societies. Baltimore, MD June 2018.
  11. Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea. Mehra R, Doghramji K, Schwab R, Strollo P, Strohl KP. – Results from the Adhere Registry. American Thoracic Society 2018.
Members & Collaborations