Higher body mass index, supine sleeping position may decrease therapeutic response
By Lori Solomon HealthDay Reporter
THURSDAY, April 18, 2024 (HealthDay News) — Hypoglossal nerve stimulation (HGNS) helps to reduce obstructive sleep apnea (OSA) but has a decreased response in some patients, according to a study published online April 4 in JAMA Otolaryngology-Head & Neck Surgery.
Rutwik M. Patel, D.O., from Washington University in St. Louis, and colleagues investigated whether HGNS therapy is effective for patients with OSA and whether HGNS can treat supine OSA. The analysis included 76 adults with OSA implanted with HGNS.
The researchers found that 78 percent of participants achieved a treatment response. There was a clinically meaningful reduction observed in the median Apnea-Hypopnea Index (AHI), from 29.3 events per hour preimplantation to 5.3 events per hour postimplantation (Hodges-Lehman difference, 23.0). Patients with a body mass index (BMI) of 32 to 35 kg/m2 had lower odds of responding to HGNS versus those with a BMI of 32 kg/m2 or less (odds ratio, 0.25). Seventeen of the 44 patients who slept in a supine position (39 percent) achieved a treatment response, as measured by a clinically meaningful reduction in median supine AHI (46.3 events per hour preimplantation versus 21.8 events per hour postimplantation [Hodges-Lehman difference, 24.6]). BMI was associated with lower odds of responding to HGNS with supine AHI treatment response (odds ratio, 0.39), although the imprecision of the estimate prevents making a definitive conclusion.
“Sleep medicine clinicians should consider informing patients that higher BMI and supine sleeping position may decrease therapeutic response to HGNS,” the authors write.
Several authors disclosed financial ties to industry.
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