Abstract
Vagus nerve stimulator (VNS)-associated sleep disordered breathing (SDB) is a poorly
understood side effect of VNS treatment. We present a patient with VNS-associated
SDB who underwent sleep laboratory VNS titration, evaluation by drug-induced sleep
endoscopy, and treatment including adenotonsillectomy and positive airway pressure
therapy. This case is unique as it is the first to document, in real time, the inverse
correlation of VNS current with airflow. This case offers unique insights into mechanisms
and treatment of VNS-associated SDB, and a novel approach in its management. Most
importantly, this case highlights the need for collaboration between physicians managing
epilepsy with VNS and those managing sleep.
Keywords
vagus nerve stimulator - sleep disordered breathing - drug-induced sleep endoscopy
