Vagus Nerve Stimulator–Associated Sleep Disordered Breathing: Identification, Treatment, and Outcomes in a Pediatric PatientFunding None.
07 November 2019
22 November 2019
20 January 2020 (online)
Vagus nerve stimulator (VNS)-associated sleep disordered breathing (SDB) is a poorly understood side effect of VNS treatment. We present a patient with VNS-associated SDB who underwent sleep laboratory VNS titration, evaluation by drug-induced sleep endoscopy, and treatment including adenotonsillectomy and positive airway pressure therapy. This case is unique as it is the first to document, in real time, the inverse correlation of VNS current with airflow. This case offers unique insights into mechanisms and treatment of VNS-associated SDB, and a novel approach in its management. Most importantly, this case highlights the need for collaboration between physicians managing epilepsy with VNS and those managing sleep.
- 1 Malow BA, Edwards J, Marzec M, Sagher O, Fromes G. Effects of vagus nerve stimulation on respiration during sleep: a pilot study. Neurology 2000; 55 (10) 1450-1454
- 2 Marzec M, Edwards J, Sagher O, Fromes G, Malow BA. Effects of vagus nerve stimulation on sleep-related breathing in epilepsy patients. Epilepsia 2003; 44 (07) 930-935
- 3 Rizzo P, Beelke M, De Carli F. , et al. Modifications of sleep EEG induced by chronic vagus nerve stimulation in patients affected by refractory epilepsy. Clin Neurophysiol 2004; 115 (03) 658-664
- 4 Hsieh T, Chen M, McAfee A, Kifle Y. Sleep-related breathing disorder in children with vagal nerve stimulators. Pediatr Neurol 2008; 38 (02) 99-103
- 5 Ebben MR, Sethi NK, Conte M, Pollak CP, Labar D. Vagus nerve stimulation, sleep apnea, and CPAP titration. J Clin Sleep Med 2008; 4 (05) 471-473
- 6 Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. American Academy of Pediatrics. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2002; 109 (04) 704-712
- 7 Domany KA, Dana E, Tauman R. , et al. Adenoidectomy for obstructive sleep apnea in children. J Clin Sleep Med 2016; 12 (09) 1285-1291
- 8 Murray BJ, Matheson JK, Scammell TE. Effects of vagus nerve stimulation on respiration during sleep. Neurology 2001; 57 (08) 1523-1524