School of Medicine

The Pulse

Dr. Kevin McLaughlin Performs First Hypoglossal Nerve Stimulation in Pediatric Patient in Gulf South

Obstructive sleep apnea affects 22 million Americans. When left untreated, obstructive sleep apnea can cause vehicle and workplace accidents, worsening mood and memory, stroke, heart attack, and even death. It occurs when the airway collapses during sleep and blocks the flow of oxygen to the brain. The brain senses a lack of oxygen and wakes the body up just long enough to take a breath, then falls back asleep. This cycle repeats throughout the night and causes poor, disruptive sleep.

Children are not immune to obstructive sleep apnea, or the adverse health impacts of poor sleep. The vast majority of children who suffer from obstructive sleep apnea are typically treated through a tonsillectomy and adenoidectomy. Many of these patients see a tremendous improvement on quality of life and cognitive outcomes, generally attributed to better sleep quality.

Dr. Kevin McLaughlin, a Clinical Assistant Professor with LSU Health in Baton Rouge, explained that obstructive sleep apnea is extremely prevalent in children with Down syndrome, but that the root cause of the apnea is different. Children with Down syndrome have midfacial hypoplasia, enlarged tongues, more narrow throats, and baseline low muscle tone, all of which make them more prone to obstructive sleep apnea. These repeated obstructions in breathing can cause oxygen deprivation, carbon dioxide retention, and repeated awakenings that prevent children from getting a good night's sleep. Children with Down syndrome have difficulty participating in sleep studies as well as using CPAP therapy.

Dr. McLaughlin believes that a relatively new treatment for adults with obstructive sleep apnea can benefit children with Down syndrome as well. Hypoglossal nerve stimulation has been used to treat more than 5,000 adults worldwide who suffer from moderate to severe obstructive sleep apnea but cannot tolerate CPAP therapy.

Dr. McLaughlin recently implanted the first hypoglossal nerve stimulator in the Gulf South in a pediatric patient with autism and Down's. He notes that this is an off-label use of the Inspire Therapy.

“This is a very promising treatment for pediatric Down's patients,” Dr. McLaughlin said. “We want to treat everyone with sleep apnea, but for children with Down's the potential benefits are exponentially increased. There was a small study done on three patients, and the neurocognitive improvements were jaw dropping.”