0579 HYPOGLOSSAL NERVE STIMULATION: A HIGHLY EFFECTIVE, LOW MORBIDITY ALTERNATIVE FOR TREATMENT OF OBSTRUCTIVE SLEEP APNEA IN SELECT CPAP-INTOLERANT PATIENTS

Abstract

Introduction: Obstructive Sleep Apnea is an increasingly prevalent medical condition with deleterious effects on both patient health and quality of life. While the current gold standard of OSA treatment, continuous positive airway pressure (CPAP), is highly effective, current estimates of patient compliance are between 40-60%. Additionally, traditional surgical treatment of OSA is associated with significant morbidity and inconsistent results. The effectiveness of treatment of select CPAP-intolerant patients with hypoglossal nerve stimulation has been demonstrated in the multi-institutional Stimulation Treatment for Apnea Reduction (STAR) trial. We report the outcome measures and therapy adherence data in a cohort of patients treated with hypoglossal nerve stimulation post-FDA approval. Methods: An institutional review board-approved, retrospective review of cases performed by a single surgeon at an academic medical center was performed. The first 25 cases treated with hypoglossal nerve stimulation therapy were included. Patients were selected based on the criteria established by the FDA in their approval of the Inspire® device. Data collected included demographics, body mass index (BMI), apnea-hypopnea index (AHI), device usage (hrs/week), procedure- and therapy- related complications, and length of hospitalization after procedure. Results: Mean age was 67.6 ± 8.9 years, with 40% female. Mean BMI was 27.8 ± 2.9 kg/m2. Mean AHI (38.5 ± 18.6 to 6.5 ± 13.2; P <5 while 96% (24/25) achieved a treatment AHI <10. The mean device use was 49.5 ± 10.4 hours/week. Ninetytwo percent of patients were discharged on the day of surgery (23/25). No major adverse events occurred. Conclusion: In appropriately selected CPAP-intolerant patients, hypoglossal nerve stimulation therapy results in significant improvement in objective OSA measures, and is associated with low morbidity and high therapy adherence. These results further validate the current patient selection criteria for the use of hypoglossal nerve stimulation in the treatment of OSA.