{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:16:51Z","timestamp":1771039011220,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":51,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Two young males with refractory epilepsy of unknown aetiology were referred for vagus nerve stimulation (VNS). Sleep disturbances emerged following VNS parameter changes. In Patient 1, video\u2010polysomnogram (PSG) disclosed snoring and catathrenia in non\u2010REM sleep. Central apnoea also occurred, but more rarely. In Patient 2, video\u2010PSG showed mixed apnoea with desaturation and episodes of stridor followed by a catathrenia\u2010like sound. A drug\u2010induced sleep endoscopy (DISE) revealed, during VNS OFF time, glossoptosis, \u201ctrap door\u201d of the epiglottis, and paresis of the left side of the larynx and ipsilateral vocal cords. During ON time, there were periods of pharyngeal collapse, in which video\u2010PSG revealed patterns suggestive of both obstructive and central sleep apnoea. All these sleep\u2010related phenomena were coincident with VNS ON time. In the first patient, VNS parameter adjustment was sufficient to successfully reverse all the symptoms, whereas the other patient required concomitant treatment with continuous positive airway pressure. The data broaden our knowledge about sleep disorders related to VNS, in particular stridor and catathrenia. We suggest that central sleep apnoea may be associated with laryngeal occlusion. DISE may be considered in selected cases as a valuable clinical tool to evaluate, in a single session, the effectiveness of multiple VNS parameter changes on respiration and laryngeal side effects. [<jats:italic>Published with video sequences<\/jats:italic>].<\/jats:p>","DOI":"10.1684\/epd.2020.1223","type":"journal-article","created":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T11:17:34Z","timestamp":1609845454000},"page":"790-796","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Complex sleep\u2010disordered breathing after vagus nerve stimulation: broadening the spectrum of adverse events of special interest"],"prefix":"10.1002","volume":"22","author":[{"given":"Miguel","family":"Oliveira Santos","sequence":"first","affiliation":[{"name":"Department of Neurosciences and Mental Health, Hospital de Santa Maria Centro Hospitalar Universit\u00e1rio Lisboa Norte  Lisbon Portugal"},{"name":"Institute of Physiology Unit, Instituto de Medicina Molecular, Faculty of Medicine University of Lisbon  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