Effect of calf muscle electrical stimulation on rostral fluid shift, snoring and obstructive sleep apnea

Vena, Daniel; Lyons, Owen D.; Fernie, Geoff; Popović, Miloš R.; Malta, Daniela; Alshaer, Hisham; Yadollahi, Azadeh

doi:10.1016/j.sleep.2019.01.035

Cited by 4 publications

(2 citation statements)

References 35 publications

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“…Electrical stimulation has also been applied to the muscles of the tongue to cause muscle contraction and increase strength and fatigue resistance and has been shown to reduce time spent snoring [175]. Daytime electrical stimulation of muscles while seated has been shown to reduce leg fluid, decrease the sleep-related fluid shift from the legs to the neck and reduce snoring, presumably by mucosal water content in the peripharyngeal tissues, thereby decreasing pressure applied to the pharynx and decreasing airway narrowing and collapsibility [176]. Finally, a recent electrophysiology experiment in a single participant with OSA reported that neurostimulation of the ansa cervicalis branch innervating the sternothyroid muscle can increase inspiratory airflow and retropalatal area during sedation, presumably by increasing tracheal traction and decreasing pharyngeal collapsibility [177].…”

Section: Other Stimulation Techniquesmentioning

confidence: 99%

Novel avenues to approach non-CPAP therapy and implement comprehensive obstructive sleep apnoea care

2021

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Recent advances in obstructive sleep apnoea (OSA) pathophysiology and translational research have opened new lines of investigation for OSA treatment and management. Key goals of such investigations are to provide efficacious, alternative treatment and management pathways that are better tailored to individual risk profiles to move beyond the traditional, continuous positive airway pressure (CPAP)-focused, “one size fits all”, trial and error approach which is too frequently inadequate for many patients. Identification of different clinical manifestations of OSA (clinical phenotypes) and underlying pathophysiological phenotypes (endotypes), that contribute to OSA have provided novel insights into underlying mechanisms and have underpinned these efforts. Indeed, this new knowledge has provided the framework for precision medicine for OSA to improve treatment success rates with existing non-CPAP therapies such as mandibular advancement devices and upper airway surgery, and newly developed therapies such as hypoglossal nerve stimulation and emerging therapies such as pharmacotherapies and combination therapy. These concepts have also provided insight into potential physiological barriers to CPAP adherence for certain patients. This review summarises the recent advances in OSA pathogenesis, non-CPAP treatment, clinical management approaches and highlights knowledge gaps for future research. OSA endotyping and clinical phenotyping, risk stratification and personalised treatment allocation approaches are rapidly evolving and will further benefit from the support of recent advances in e-health and artificial intelligence.

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Section: Other Stimulation Techniquesmentioning

confidence: 99%

Novel avenues to approach non-CPAP therapy and implement comprehensive obstructive sleep apnoea care

2021

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“…In patients with high volume states [43–47], increased neck volume due to rostral fluid shift) may contribute to OSA pathogenesis [48]. Although fluid overload indirectly affects upper airway collapsibility by increasing tissue pressure [48–50], it was recently hypothesized in animal model that fluid overload can also contribute to OSA pathogenesis by reducing genioglossus activity [51].…”

Section: Upper Airway Muscles Pathophysiology In Obstructive Sleep Ap...mentioning

confidence: 99%

Upper airway muscles: influence on obstructive sleep apnoea pathophysiology and pharmacological and technical treatment options

Perger

Taranto‐Montemurro

2021

Current Opinion in Pulmonary Medicine

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Purpose of reviewObstructive sleep apnoea (OSA) is highly prevalent with numerous deleterious effects on neurocognitive and cardiovascular health. It is characterized by collapse of the upper airway during sleep, due to the decrease in both basal and compensatory UA muscle activities. However, the leading treatment, continuous positive airway pressure, is often poorly tolerated. This review presents latest works focusing on novel interventions targeting upper airway muscles to alleviate OSA severity.Recent findingsIn the last years, researchers have focused on the development of alternative treatment strategies targeting UA muscle activation, including pharmacological and nonpharmacological interventions.SummaryAmong the nonpharmacological treatments, hypoglossal nerve stimulation aims to increase upper airway muscle phasic activity during sleep through electrical stimulation, while myofunctional therapy improves the activity and coordination of upper airway dilator muscles.Regarding OSA pharmacotherapy, recent findings strongly suggest that selective norepinephrine reuptake inhibitors such as atomoxetine and reboxetine, when administered with antimuscarinics such as oxybutynin, can alleviate OSA in most patients increasing pharyngeal dilator muscles activity during sleep. New combinations of norepinephrine reuptake inhibitors and antimuscarinics have further been explored with variable success and animal models showed that leptin, thyrothropin releasing hormone analogues and gene therapy hold potential for the future of OSA pharmacotherapy.

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The effects of resistance exercise on obstructive sleep apnea severity and body water content in older adults: A randomized controlled trial

et al. 2022

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Effect of calf muscle electrical stimulation on rostral fluid shift, snoring and obstructive sleep apnea

Cited by 4 publications

References 35 publications

Novel avenues to approach non-CPAP therapy and implement comprehensive obstructive sleep apnoea care

Novel avenues to approach non-CPAP therapy and implement comprehensive obstructive sleep apnoea care

Upper airway muscles: influence on obstructive sleep apnoea pathophysiology and pharmacological and technical treatment options

The effects of resistance exercise on obstructive sleep apnea severity and body water content in older adults: A randomized controlled trial

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