Hypoglossal nerve stimulation in a rabbit model of obstructive sleep apnea reduces apneas and improves oxygenation

Abstract

Based on a prior anesthetized model, we developed an unanesthetized model to evaluate the effects of hypoglossal nerve stimulation (HNS) during sleep. We prepared three rabbits with injections of Hyaluronic Acid in the base of tongue to produce upper airway obstruction followed by HNS implant. Two rabbits were saline controls, and one, a passive control. Measures were sleep, airflow, effort, oxygen saturation and heart rate. HNS with electrodes around the right hypoglossal nerve were adjusted to a level without behaviorally disturbing the animal. During HNS stimulation in the tongue-base injected rabbits, obstructive apneas and hypopneas of intermediate (3 to 7 cycles of respiratory effort) or longer (≥8 cycles) duration were largely eliminated while less clinically relevant shorter events (<3) were unaffected, and oxygen saturation was improved. Control animals exhibited no intermediate or long events. In this model HNS can relieve induced sleep apnea, without disturbing the animal: however, despite being non-canine and of substantial size, the model has its challenges.

Deficiency of Biogenic Amines Modulates the Activity of Hypoglossal Nerve in the Reserpine Model of Parkinson’s Disease

“…The disturbed activity of the hypoglossal motoneurons contributes to the development of obstructive sleep apnea syndrome (OSA) [ 21 , 37 ]. In support of this, numerous scientific reports showed that stimulation of the HG nerve in humans and animals has the benefit of a reduced number of pauses in breathing during sleep [ 38 , 39 , 40 ].…”

Role of surgical hyoid bone repositioning in modifying upper airway collapsibility

“…Most importantly, unlike other animals and like the human, the hyoid bone of the rabbit is mobile with no fixed bony attachments ( Amatoury et al, 2014 ; Amatoury et al, 2015 ). The rabbit model has also been repeatedly used in the fields of respiratory and upper airway physiology with demonstrated applicability of outcomes to humans ( Brouillette and Thach, 1980 ; Olson et al, 1989 ; Isono et al, 1997 ; Kirkness et al, 2003a ; Kirkness et al, 2003b ; Fogel et al, 2005 ; Kairaitis et al, 2006 ; Squier et al, 2010 ; Kairaitis et al, 2012 ; Amatoury et al, 2014 ; Amatoury et al, 2015 ; Amatoury et al, 2016 ; Schiefer et al, 2020 ).…”

Advances in animal models of obstructive sleep apnea

“…It is a feasible idea to establish an OSA animal model by injecting dilatants (such as polytetrafluoroethylene and hydrophilic polyacrylamide gel) into soft tissues of the upper airway, such as the tongue or the soft palate, which can cause persistent swelling and narrowing of the upper airway soft tissues (32)(33)(34)(35)(36)(37). Polytetrafluoroethylene (PTFE) is an inert swelling agent used in the treatment of vesicoureteral reflux.…”