{"id":1806,"date":"2019-07-24T20:08:58","date_gmt":"2019-07-24T20:08:58","guid":{"rendered":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/?p=1806"},"modified":"2019-07-24T20:08:58","modified_gmt":"2019-07-24T20:08:58","slug":"cooper-offers-innovative-therapy-for-patients-with-central-sleep-apnea","status":"publish","type":"post","link":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/2019\/07\/24\/cooper-offers-innovative-therapy-for-patients-with-central-sleep-apnea\/","title":{"rendered":"Cooper Offers Innovative Therapy for Patients with Central Sleep Apnea"},"content":{"rendered":"

Last November, Cooper became the first health care facility in the eastern United States\u2014and one of only 24 in the entire nation\u2014to offer a newly FDA-approved device for patients with central sleep apnea (CSA). Called the remed\u0113\u00ae (sounds like remedy) sleep system from Respicardia\u00ae, Inc., the implantable device treats CSA by activating the nerve that sends signals to the diaphragm to stimulate breathing.<\/p>\n

\u201cUnlike the more common obstructive sleep apnea, in which breathing disruptions are caused by upper airway obstruction, central sleep apnea occurs when the brain fails to send signals to the diaphragm, triggering lapses in breathing that can last from a few seconds to minutes,\u201d explains John A. Andriulli, DO, FACC, electrophysiologist and Director of the Arrhythmia Device Program at Cooper University Health Care.<\/p>\n

This can lead to poor sleep and raise a patient\u2019s risk of health problems, including hypertension, myocardial infarction, stroke, obesity, and diabetes.<\/p>\n

\u201cCentral sleep apnea is a serious disorder that negatively affects quality of life as well as overall cardiovascular health,\u201d he emphasizes. \u201cWhat\u2019s more, it often occurs in cardiac patients, especially those with congestive heart failure, increasing mortality risk.\u201d<\/p>\n

Before remed\u0113 was FDA clearedfor use, the primary treatment option for CSA was adaptive Servo ventilation (ASV), a type of positive airway pressure that continuously monitors a patient\u2019s breathing. However, this option is not specifically tailored for treating CSA; rather, it is used in adults who have either CSA or obstructive sleep apnea.<\/p>\n

The remed\u0113 device\u2014for which Cooper served as a study site for the initial investigational device exemption (IDE) trial\u2014 gives CSA patients a better option tailored to their specific disorder, especially those with congestive heart failure.<\/p>\n

\u201cIt\u2019s like a pacemaker in that it\u2019s implanted in the chest with several leads that pace the phrenic nerve and monitor a person\u2019s lung function during sleep,\u201d Dr. Andriulli says. Implantation is a simple outpatient procedure.<\/p>\n

\u201cClinical testing showed that patients with central sleep apnea had a 50 percent or better reduction of apnea during sleep using remed\u0113,\u201d he continues, noting that this compared to an 11 percent reduct ion among those who didn\u2019t have the system implanted. \u201cTwo other secondary endpoints were improved quality of life and improved sleep,\u201d he adds.<\/p>\n

\"\"

The remede\u00ae system is a battery powered device placed under the skin in the upper chest
area with two small thin wires (leads), one to deliver the therapy (stimulation lead) and one
to sense breathing (sensing lead). This system continuously and automatically monitors and
stabilizes the breathing pattern, restoring sleep throughout the night.<\/p><\/div>\n

Dr. Andriulli also points out that patients in the trial who had heart failure demonstrated a 5 percent improvement in ejection fraction and, at six months post-implantation, a reduction in hospital admissions related to heart failure.<\/p>\n

\u201cThe study wasn\u2019t designed to study these secondary endpoints, however, so there is another ongoing study to validate these further,\u201d he adds.<\/p>\n

If you have a patient who you think may benefit from the remed\u0113 sleep system, the first step is to order a sleep study to demonstrate that central sleep apnea is the culprit.<\/p>\n

\u201cMany patients have mixed obstructive sleep apnea and central sleep apnea,\u201d Dr. Andriulli says. \u201cBut in order for the remed\u0113 device to be indicated, the patient must predominantly have CSA.<\/p>\n

\u201cOnce that\u2019s confirmed, the patient can be referred to Cooper, where pulmonologist Ramya Lotano, MD, FCCP, a sleep expert, will validate the findings, then refer the patient to me for implantation,\u201d he continues.<\/p>\n

\u201cNow that we can offer a treatment that\u2019s been proven beneficial for patients with central sleep apnea, I urge my colleagues to be more aggressive about screening for this sleep disorder\u2014particularly among their patients with congestive heart failure,\u201d he adds.<\/p>\n

\n

To schedule an appointment with Dr. Andriulli, patients may call the Cooper cardiology office in Voorhees at 856.325.6700. To schedule an appointment with Dr. Lotano, patients may call the Cooper pulmonary office in Cherry Hill at 856.536.1500.<\/p>\n","protected":false},"excerpt":{"rendered":"

Last November, Cooper became the first health care facility in the eastern United States\u2014and one of only 24 in the entire nation\u2014to offer a newly FDA-approved device for patients with central sleep apnea (CSA). Called the remed\u0113\u00ae (sounds like remedy) sleep system from Respicardia\u00ae, Inc., the implantable device treats CSA by activating the nerve that … [Read more…]<\/a><\/span><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[161],"tags":[],"class_list":{"0":"entry","1":"post","2":"publish","3":"author-rmineo","4":"post-1806","6":"format-standard","7":"category-technology"},"_links":{"self":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1806","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/comments?post=1806"}],"version-history":[{"count":1,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1806\/revisions"}],"predecessor-version":[{"id":1809,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1806\/revisions\/1809"}],"wp:attachment":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/media?parent=1806"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/categories?post=1806"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/tags?post=1806"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}