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BMI predictive of success in upper airway stimulation treatment

Higher BMI was associated with lower success of upper airway stimulation treatment for obstructive sleep apnea, according to findings presented at SLEEP 2018, the Annual Meeting of the Associated Professional Sleep Societies.

“Upper airway stimulation is a treatment option for patients with moderate-to-severe obstructive sleep apnea (OSA) who cannot adhere to continuous positive airway pressure,” Richard J. Schwab, MD, professor of medicine at the hospital of the University of Pennsylvania, and colleagues wrote in an abstract. “This study analyzed predictors of success using treatment outcomes collected in the Adhere registry, the largest data collection of [upper airway stimulation] in real-world clinical practice.”

In the multicenter, observational registry, researchers collected baseline demographic and sleep study data from 430 patients with OSA (mean age, 59.5 years; 80% male; baseline BMI, 29.3 kg/m²; baseline apnea hypopnea index, 36.5 events/hour). They conducted univariate logistic regression to investigate the association between baseline characteristics — age, sex, race, apnea-hypopnea index and BMI — and success of upper airway stimulation therapy. Treatment success was defined as a reduction of at least 50% and an apnea-hypopnea index of less than 20 at 12 months after implantation.

At 12 months, 155 patients had completed the sleep study. Researchers found that these patients now had an average apnea-hypopnea index of 10.6 events/hour, for a treatment success rate of 80%. Based on the univariate model, a 1 kg/m² increase in baseline BMI correlated to 14% lower odds of success at 12 months (OR = 0.86; P = .006).

“Identifying factors that predict [upper airway stimulation] treatment responsiveness (such as lower levels of BMI) is beneficial in development of personalized medicine strategies,” the researchers wrote. – by Melissa J. Webb

Reference:

Schwab RJ, et al. Predictors of success for upper airway stimulation for obstructive sleep apnea. Presented at: SLEEP 2018, the Annual Meeting of the Associated Professional Sleep Societies; June 2-6; Baltimore.

Disclosures: The study was supported by Inspire Medical Systems, Inc.