Researchers Will Soon Start Trying Out a Tongue 'Pacemaker'
A pacemaker-like device that would send mild electrical jolts to the tongues of sleep-apnea sufferers while they snooze could be the key to a full night of Z's. Scientists from the Minneapolis-based Inspire Medical Systems will soon begin to test the novel treatment, the Associated Press reports. They hope that by the end of January they will enroll 100 U.S. and European patients whose condition is caused by a slack tongue. Two other companies will begin similar testing. A common cause of obstructive sleep apnea is a combination of a slack tongue and relaxed throat muscles. Breathing can be blocked as long as 30 seconds and as often as 30 times an hour. Those with the condition may be largely unaware other than not feeling rested in the morning, or they may suddenly awaken, gasping for air. The tongue is a muscle, and the idea of a pacemaker is to control it by giving it mild electrical shocks to keep it from relaxing and blocking the airway. Doctors will implant the device beneath the skin near the collarbone and wire it to a nerve in the tongue. It will sense when a person takes a breath, triggering the zap. This new approach, while only in its initial stages, could prove more effective than CPAP, the current standard treatment in which users don a mask at bedtime that blows air through the nose to keep airways open. Many apnea sufferers say the masks are uncomfortable and make them feel claustrophobic. Obstructive sleep apnea, which the National Institutes of Health estimates affects 12 million Americans, may lead to high blood pressure, strokes, heart attacks, heart disease, obesity, and type 2 diabetes.
Sleep apnea can be triggered or worsened by many factors, U.S. News's Lindsay Lyon reported in 2009. Here are four of them.
1. Weight gain. Excess pounds can bulk up tissues in and around the airway, making the airway more vulnerable to collapse as muscles relax during sleep, says Alejandro Chediak, medical director of the Miami Sleep Disorders Center and past president of the American Academy of Sleep Medicine. Likewise, heavier people tend to have thicker necks, which can also be a factor, says David Schulman, director of the Emory Sleep Lab in Atlanta. Although thin folks can develop apnea, more than half of those with the condition are overweight, according to the National Heart Lung and Blood Institute (NHLBI).
Frustratingly, the condition itself can add pounds. Evidence suggests that it may increase the appetite for unhealthful foods, according to a 2008 study in the Journal of Clinical Sleep Medicine which found that people with severe forms of the disorder, especially women, were more likely to make poor food choices than those with mild or no cases. Additionally, sleep deprivation, a hallmark of sleep apnea, seems to interfere with hormones that normally suppress appetite, says Chediak. While shedding pounds may alleviate or eliminate sleep apnea if weight is the root cause—weight loss surgery, for example, has been shown to ease it in the morbidly obese—there's "no compelling evidence" that treating sleep apnea will make people melt pounds, Chediak says.
2. Alcohol. A muscle relaxant, alcohol can slacken throat tissues more than usual during sleep, making the airway more vulnerable to obstruction. Although the effect usually dissipates as the alcohol clears the body during the night, cutting down may help.
3. Medications. The particular culprits are muscle relaxants and sleep aids. "If you're taking muscle relaxants, you're going to expose yourself to greater snoring and sleep apnea," says Chediak, and "the vast majority of sleeping medications have a muscle relaxant property." Sleeping pills also lengthen the episodes when breathing stops, because "more respiratory compromise" is needed to wake the brain up to restore normal breathing, he says.
4. Sleep position. Sleeping on your back typically makes sleep apnea worse and sleeping on your side makes it better, says Schulman. That has to do with how and where weight falls on the airway.
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