{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T05:15:12Z","timestamp":1772860512175,"version":"3.50.1"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004168","name":"Universit\u00e4t zu L\u00fcbeck","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004168","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sleep Breath"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with obstructive or central sleep apnea are primarily treated with positive airway pressure treatment. There are novel implantable options targeting either obstructive sleep apnea using hypoglossal nerve stimulation (HNS) or central sleep apnea using phrenic nerve stimulation (PNS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with sleep apnea were implanted with both HNS and PNS devices, and their response to each therapy was monitored using home sleep tests as well as Epworth Sleepiness scale (ESS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We evaluated our concurrent neurostimulation approach in two patients. Both patients were implanted with two neuromodulation devices: The first case suffered from treatment emergent central sleep apnea after HNS activation for primarily obstructive sleep apnea (apnea\u2013hypopnea index\/AHI 54\/h). The central portion resolved under PNS (AHI 23.7\/h). The second case suffered from predominantly central sleep apnea (AHI 82\/h). Here, the PNS device was implanted first, resulting in a subsequent reduction of the central portion. The residual obstructive sleep apnea was addressed using HNS (AHI 5.4\/h). No interaction between the HNS and PNS systems was noticed in either of the two patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In selected cases, a concurrent treatment with hypoglossal and phrenic nerve stimulation\u00a0may lead to improvement of sleep apnea and patient satisfaction in a safe manner.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11325-023-02939-5","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T04:10:09Z","timestamp":1699243809000},"page":"905-908","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Concurrent hypoglossal and phrenic nerve stimulation in patients with obstructive and treatment emergent central sleep apnea"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1044-492X","authenticated-orcid":false,"given":"Armin","family":"Steffen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Sch\u00f6bel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Vogler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl-Ludwig","family":"Bruchhage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland Richard","family":"Tilz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,11,6]]},"reference":[{"key":"2939_CR1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s00405-021-06902-6","volume":"79","author":"A Steffen","year":"2022","unstructured":"Steffen A, Heiser C, Galetke W et al (2022) Hypoglossal nerve stimulation for obstructive sleep apnea: updated position paper of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Eur Arch Otorhinolaryngol 79:61\u201366","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2939_CR2","doi-asserted-by":"crossref","unstructured":"Suurna MV, Steffen A, Boon M, et al.; ADHERE Registry Investigators (2021) Impact of body mass index and discomfort on upper airway stimulation: ADHERE Registry 2020 update. Laryngoscope 131:2616\u20132624","DOI":"10.1002\/lary.29755"},{"key":"2939_CR3","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1378\/chest.11-3223","volume":"142","author":"TJ Ku\u017aniar","year":"2012","unstructured":"Ku\u017aniar TJ, Morgenthaler TI (2012) Treatment of complex sleep apnea syndrome. Chest 142:1049\u20131057","journal-title":"Chest"},{"key":"2939_CR4","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1177\/0194599820912740","volume":"162","author":"J Patel","year":"2020","unstructured":"Patel J, Daniels BL et al (2020) Elevated central and mixed apnea index after upper airway stimulation. Otolaryngol Head Neck Surg 162:767\u2013772","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2939_CR5","doi-asserted-by":"crossref","unstructured":"Costanzo MR, Ponikowski P, Javaheri S, et al. for remed\u00e9 System Pivotal Trial Study Group (2016) Transvenous neurostimulation for central sleep apnea: a randomised controlled trial. Lancet. 388:974\u2013982","DOI":"10.1016\/S0140-6736(16)30961-8"},{"key":"2939_CR6","doi-asserted-by":"crossref","unstructured":"Costanzo MR, Javaheri S, Ponikowski P, et al. for remed\u0113\u00aeSystem Pivotal Trial Study Group (2021) Transvenous phrenic nerve stimulation for treatment of central sleep apnea: five-year safety and efficacy outcomes. Nat Sci Sleep. 13:515\u2013526","DOI":"10.2147\/NSS.S300713"}],"container-title":["Sleep and Breathing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-023-02939-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11325-023-02939-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-023-02939-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T16:31:20Z","timestamp":1717000280000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11325-023-02939-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,6]]},"references-count":6,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["2939"],"URL":"https:\/\/doi.org\/10.1007\/s11325-023-02939-5","relation":{},"ISSN":["1520-9512","1522-1709"],"issn-type":[{"value":"1520-9512","type":"print"},{"value":"1522-1709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,6]]},"assertion":[{"value":"30 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2023","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2023","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee (Ethic committee of the University of Luebeck; Germany) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.For this retrospective type of study, formal consent is not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Armin Steffen works as a consultant for Inspire Medical, Inc. and ZOLL Respicardia, Inc. Christoph Sch\u00f6bel received honoraria and travel expenses for invited talks on behalf of Inspire Medical, Inc., outside the submitted work. Julia Vogler, Karl-Ludwig Bruchhage, and Roland R. Tilz have nothing to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}