Obstructive Sleep Apnea More Likely Following Vagus Nerve Stimulation

Patients who underwent vagus nerve stimulation treatment were more likely to develop obstructive sleep apnea.

Following vagus nerve stimulation (VNS) implantation, obstructive sleep apnea (OSA) is a common adverse event among patients, according to study results presented at the 2023 Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society, held from June 3 to 7 in Indianapolis, Indiana.

VNS is a treatment option available to patients with intractable epilepsy. While VNS has shown to improve quality of life and decrease seizure frequency, stimulating the vagus nerve can lead to OSA. 

Previous cases of OSA following VNS have been reported, but not evaluated on a large scale. Researchers conducted a meta-analysis to assess the rate of OSA development, following VNS implantation. 

For the study, the researchers used several databases, including PubMed, Scopus, and Embase. The researchers included articles in the analysis if they reported data before and after VNS implantation. They collected data regarding apnea-hypopnea index (AHI), respiratory disturbance index (RDI), or OSA rates following VNS implantation. 

Obstructive sleep apnea is a common adverse effect following VNS treatment and patients should be monitored following implantation.

Data were reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was also used. 

Of the 10 studies included in the analysis, 7 were retrospective and 3 were prospective. A total of 306 patients were included in the study, with a pooled OSA rate of 27.3% (95% CI, 15.1-41.5%). The subgroup analysis revealed no significant differences in OSA rates, following VNS implantation between pediatric (22.1%; 95% CI, 8.2-40.5%) and adult patients (31.9%; 95% CI, 18.9-47.5%; P =.39). 

The pooled analysis had significant heterogeneity (P <.00001; I2, 100%); however, there was no inter-subgroup heterogeneity (I2, 0%).

“Obstructive sleep apnea is a common adverse effect following VNS treatment and patients should be monitored following implantation,” the researchers concluded.


Saleem M, Santhumayor B, Hasan E, Kolesnik M, Bernbaum M. Obstructive sleep apnea following vagus nerve stimulator implantation: a meta-analysis. Abstract presented at: SLEEP 2023; June 3-7, 2023; Indianapolis, IN. Abstract 0541.