0697 Early Sleep Apnea Termination By Bone-conducted Sound Stimulation Reduces Oxygen Desaturation Magnitude And Duration

Abstract

Introduction Obstructive sleep apneas (OSA) usually end with an oxygen desaturation and/or an arousal. In most epidemiological studies, OSA-associated oxygen desaturations are stronger predictors of cardiovascular morbidity than OSA-associated arousals. The aim of this study was to determine if induction of a premature arousal by a bone-conducted sound stimulation shortly after the onset of an event can reduce the magnitude of OSA-associated oxygen desaturation. Methods Eight severe OSA patients (2 women, 45 [20-68]y.o.) underwent polysomnography at the Lausanne University Sleep Center (CIRS). Short acoustic stimulations were administered every second sleep apnea by remote control using a Dreem® headband worn by the patients. Acoustic stimulations were administered by bone conduction. The magnitude(%) and the duration(s) of the oxygen desaturations following these prematurely-terminated apneas were compared with previous and following non-acoustic stimulated sleep apnea events. Results Analysis of 549 paired (stimulated-unstimulated) respiratory events in N1(14.2%), N2(69.9%), N3(4.2%), and REM sleep (9.6%) showed a 30.3% reduction in oxygen desaturation amplitude (mean difference±SD: -1.9±2.8%, p<0.0001), a 39.6% decrease in desaturation duration (-5.7±9.2 seconds, p<0.0001), and a 21.4% decrease in apnea duration (-3.4±7.2 seconds, p<0.0001) in stimulated apneas compared to the previous and subsequent non-stimulated apnea events. When analyzed individually, each patient showed a significant improvement following acoustic stimulation of events. Sound-associated discomfort was rated 1.14±1.53 on an 8 points scale (8=worst). Of the 68.6±38 administered sound stimuli per patient, only 6.8% of were perceived by the patients. A reduction in the desaturation amplitude occurred in each sleep stage but was milder in N3. Conclusion Bone-conducted sound stimuli applied trough a headband during the apneas decreased duration and magnitude of OSA-associated oxygen desaturation. These were well tolerated and often not perceived by the patient. This new treatment approach should be further investigated, with monitoring of its effect on cardiovascular parameters and daytime sleepiness. Support Customized Dreem headbands were provided by Dreem company