Minimally Invasive Electrical Stimulation Of The Nerve Hypoglossal for the Treatment of Obstructive Sleep Apnea.

Study Overview
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Brief Summary
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Minimally invasive electrical stimulation of the nerve hypoglossal for the treatment of obstructive sleep apnea. To demonstrate the correct stimulation of the medial branches of the hypoglossal nerve and tongue protrusion using a minimally invasive implantation technique in patients with OSA.

Detailed Description
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Study title: Minimally invasive electrical stimulation of the nerve hypoglossal for treatment for obstructive sleep apnea. Study device: Medtronic 8-contact Vectris subcompact or compact electrode. Study design: This is an initial feasibility study that seeks to determine the safety and effectiveness of a minimally invasive technique to implant a hypoglossal nerve stimulation electrode in patients with obstructive sleep apnea. Subjects meeting study eligibility criteria will be implanted with a Medtronic 8-contact Vectris subcompact or compact electrode. In the follow-up visits, quality of life and sleepiness scales (Epworth) will be performed, and on days 4 and 7 a control polysomnography. All results will be compared with the baseline data obtained at the start of the study. Study Size: Up to 30 subjects may be enrolled to achieve a number of implanted subjects between 10 to 20. Study Duration: Total expected duration per subject is approximately 10 days. The study is estimated to take 6 months. Objective of the study: The main objective is to evaluate the safety and effectiveness of a minimally invasive technique to implant a hypoglossal nerve stimulation electrode in patients with obstructive sleep apnea.

Official Title
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Minimally Invasive Electrical Stimulation Of The Nerve Hypoglossal for the Treatment of Obstructive Sleep Apnea.

Conditions
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Obstructive Sleep Apnea

Intervention / Treatment
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* Device: Medtronic 8-contact Vectris subcompact or compact electrode.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >22 and <75 years Moderate or severe apnea (Apnea-Hypopnea Index, AHI, between 1550 per hour and <25% of central apneas) Failure of continuous positive airway pressure (CPAP) therapy defined as the inability to eliminate obstructive sleep apnea and hypopnea syndrome (OSAHS) corresponding to an AHI greater than 20/h despite the use of CPAP. No tolerance to CPAP: to. Inability to use CPAP (more than 5 nights a week; more than 4 hours a night). b. Unwillingness to use CPAP (for example, a patient returns the CPAP system after trying to use it). Patients willing and able to give their informed consent. Willing and able to have a pacing system temporarily implanted, and use the patient programmer to activate the stimulation. Willing and able to return for all follow-up visits and sleep studies and able to fill out questionnaires. Exclusion Criteria: Body mass index (BMI) >32 kg/m. Central or mixed apneas > or = 25%. Patients who are pregnant or planning to become pregnant. Presence of a complete collapse at the level of the palate corroborated by drug-induced endoscopy (DISE). Surgical resection or radiation therapy for cancer or congenital malformations of the larynx, tongue, or throat. Significant comorbidities that make the patient unable or inappropriate to participate in the trial. Patients with a history of lack of response to electrical stimulation of the hypoglossal nerve. Patients with the presence of other implantable electrical devices such as: spinal cord stimulator, pacemaker, cochlear implant, peripheral nerve stimulator, etc.

Ages Eligible for Study
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Minimum Age: 22 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Device Feasibility
Intervention Model: Single Group Assignment
Interventional Model Description: Subjects meeting study eligibility criteria will be implanted with a Medtronic 8-contact Vectris subcompact or compact electrode.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Subjects implanted with a Medtronic 8-contact Vectris subcompact or compact electrode.<br>Subjects meeting study eligibility criteria will be implanted with a Medtronic 8-contact Vectris subcompact or compact electrode. | Device: Medtronic 8-contact Vectris subcompact or compact electrode.<br>* Subjects meeting study eligibility criteria will be implanted with a Medtronic 8-contact Vectris subcompact or compact electrode.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Apnea-Hypopnea Index (AHI) | Demonstrate an AHI reduction from baseline of 50% and an AHI less than 20 on follow-up polysomnography | 6 months | 
| Oxygen Desaturation Index (ODI) | Demonstrate at least a 25% reduction in the ODI from the initial value. | 6 months | 
| Security | The primary safety objective is to assess the incidence of events Adverse events related to the device and the insertion technique | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obstructive sleep apnea, hypopnea syndrome