PHOTO: SHUTTERSTOCK

Allegheny Health Network physicians have begun using a pacemaker-like device for patients with central sleep apnea, which occurs in roughly one out of three patients diagnosed with heart failure.

AHN is the first health system in Western Pennsylvania to implant the device, remedē. It has been FDA-approved since 2017.

“It feels great to offer our patients a therapy for a form of sleep apnea that’s not common but has adverse consequences if it’s untreated,” says pulmonologist and sleep medicine specialist Dr. Daniel Shade, director of the AHN Sleep Disorders Center; Shade was one of the physicians who oversaw the first implant at Allegheny General Hospital in December. 

“The common modalities we use, CPAP, BiPAP, oxygen, are sometimes difficult for patients to tolerate, and this seems to be more tolerable and has good outcomes,” he says.

The device is implanted in the chest in a minimally invasive outpatient procedure. It has been implanted in three patients in Western Pennsylvania so far. 

Central sleep apnea differs from the more common obstructive sleep apnea. Obstructive sleep apnea is caused by airflow blockage in the upper airway, but central sleep apnea occurs when the brain fails to send signals to the diaphragm, disrupting regular breathing. In severe cases, the body may go into fight-or-flight response, which affects the cardiovascular system. Remedē works by stimulating a nerve to regulate breathing.

While obstructive sleep apnea is identified more easily by snoring and noticeably disruptive sleep, the symptoms of central sleep apnea — insomnia, unexplained night wakings, fatigue — are common and make it hard to diagnose.

Cardiologists who are treating patients with a degree of heart failure or atrial fibrillation will screen patients for sleep apnea through a portable home test or an in-lab sleep study. If they’re positive for central sleep apnea, their doctor can refer them for further evaluation to see if they’re a candidate for remedē.