About a third of patients with heart failure suffer from central sleep apnea, a serious health condition in which the brain fails to send signals to the diaphragm to take a proper breath.
It’s a condition that not only disrupts breathing, but can cause further damage to the heart.
A new treatment for central sleep apnea is now being used in Pittsburgh — a pacemaker-like device called Remedē that stimulates a nerve in the chest to send electrical signals to the diaphragm.
“The treatments for central sleep apnea have historically not been well tolerated in general,” said Dan Shade, a pulmonologist and director of the AHN Sleep Disorders Center. “Finally, Remedē is available.”
The first patient at AHN had the device implanted in January, and the second patient received one in April. A third and fourth patient are in the pipeline, said Shade, and doctors are awaiting data from the implanted devices to see how well they are performing.
In a study conducted before the device was approved by the FDA in 2017, data showed that 88% of patients had a reduction in the number of sleep apnea events and 78% said that their quality of life had improved.
Since its approval in 2017, the device has been upgraded with a smaller battery pack, said Shade.
Implantation of the device came through a collaboration between AHN’s Sleep Medicine Center and its Cardiovascular Institute.
Central sleep apnea is different from the more common obstructive sleep apnea, which is caused by airflow blockages. Obstructive sleep apnea also has an approved pacemaker-like device, but instead of stimulating a nerve to send a signal to the diaphragm, it stimulates a nerve at the base of the tongue to open the upper airway.
Both types of sleep apnea can cause damage to the heart and other health problems.
“The problem with both types of apneas is that you get this combination of intermittent low oxygen levels and a counterregulatory mechanism — a burst of cortisol, a burst of adrenaline — and this can occur all night long,” said Shade. “It raises your heart rate, your sugars and wakes you up. This is why people with varying types of sleep apnea can have worsening hypertension, atrial fibrillation, glucose control and of course sleep deprivation.”
While classic symptoms of obstructive sleep apnea are loud snoring and waking up gasping for air, central sleep apnea symptoms are different and may include severe morning headaches and dry mouth.
About 75% of central sleep apnea patients have heart failure and/or atrial fibrillation; it is also associated with opioid use or a congenital genetic cause.
Anya Sostek: asostek@post-gazette.com
First Published: May 19, 2024, 9:30 a.m.
Updated: May 20, 2024, 3:11 p.m.
