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BMI May Impact Response to Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
More than three-quarters of patients with obstructive sleep apnea responded to treatment with hypoglossal nerve stimulation (HGNS), according to study results published in JAMA Otolaryngology–Head & Neck Surgery.
“This study provides evidence supporting the use of HGNS as a treatment for obstructive sleep apnea, but sleep medicine clinicians should be aware that higher BMI [body mass index] may affect treatment response,” wrote a research team from Washington University Medical Center in St Louis, St. Louis, Missouri.
The study included 76 patients from the medical center who were implanted with an HGNS device between April 2019 and January 2023. Patients ranged in age from 51 to 68 years, and 75% were men.
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After HGNS device implantation, the median Apnea-Hypopnea Index (AHI) score dropped from 29.3 events per hour to 5.3 events per hour, according to the study. With a treatment response defined as a 50% or higher reduction in AHI score and an AHI score of less than 15 events per hour, the odds of responding to HGNS were 75% lower for patients with a BMI between 32 and 35 compared with patients whose BMI was 32 or less.
The study also looked specifically at 44 patients who slept in a supine position. Among supine sleepers, median AHI score decreased from 46.3 to 21.8 events per hour after HGNS, and 39% achieved a treatment response. Again, higher BMI was associated with lower odds of responding to HGNS in the subgroup.
“Sleep medicine clinicians should consider informing patients that higher BMI and supine sleeping position may decrease therapeutic response to HGNS,” researchers advised. “Future research is needed to replicate these findings in larger, more diverse cohorts, which would facilitate the optimization of treatment strategies and patient counseling for HGNS therapy.”
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