Nerve Stimulation for Sleep Apnea Shows Long-Term Heart Benefits

Hypoglossal nerve stimulation (HGNS) for obstructive sleep apnea (OSA) may be associated with some longer-term cardiovascular benefits, though its short-term effects presented a different outlook. This finding emerged from a retrospective cohort study that analyzed data from patients undergoing HGNS therapy.

The study, published in the Journal of Clinical Sleep Medicine, examined a cohort of 1,234 patients with moderate to severe OSA who received HGNS therapy between 2015 and 2022. Researchers compared cardiovascular outcomes in these patients to a matched control group of 2,468 OSA patients who did not receive HGNS. The primary endpoint was a composite of major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and cardiovascular death.

While the short-term follow-up (up to 1 year) did not reveal a significant difference in MACE between the HGNS group and the control group, the long-term follow-up (over 3 years) indicated a statistically significant reduction in MACE for patients treated with HGNS. Specifically, the hazard ratio for MACE in the HGNS group was 0.68 (95% confidence interval 0.51-0.91), suggesting a 32% lower risk of these events.

Further analysis indicated that HGNS therapy was associated with improvements in blood pressure control and a reduction in atrial fibrillation incidence over the long term. The researchers noted that these benefits might be mediated by improved oxygenation, reduced sympathetic nervous system activation, and direct effects of nerve stimulation on cardiac autonomic function. However, they also cautioned that the retrospective nature of the study and potential unmeasured confounders necessitate confirmation through prospective randomized controlled trials.