Abstract
Upper airway stimulation (UAS) has been shown to reduce severity of obstructive sleep apnea (OSA). The aim of this registry was to identify predictors of UAS therapy response in an international multicenter registry. Patients who underwent UAS implantation in the US and Germany were enrolled in an observational registry. Data collected included patient characteristics, apnea-hypopnea index (AHI), Epworth Sleepiness Scale, objective adherence, adverse events, and patient satisfaction measures. Post hoc univariate and multiple logistic regression were performed to evaluate factors associated with treatment success. Between October 2016 and January 2018, 508 participants were enrolled from 14 centers. Median AHI was reduced from 34.0 to 7.0 events·h−1, median ESS reduced from 12 to 7 from baseline to final visit at 12-month post-implant. In post hoc analyses, for each 1-year increase in age, there was a 4% increase in odds of treatment success. For each 1 unit increase in BMI, there was 9% reduced odds of treatment success. In the multivariable model, age persisted in serving as statistically significant predictor of treatment success.
In a large multicenter international registry, UAS is an effective treatment option with high patient satisfaction and low adverse events. Increasing age and reduced BMI are predictors of treatment response.
Footnotes
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Conflict of interest: Dr. Heiser reports grants and personal fees from Inspire Medical Systems (Maple Grove, MN, USA), during the conduct of the study; grants and personal fees from Inspire Medical Systems (Maple Grove, MN, USA), outside the submitted work.
Conflict of interest: Armin Steffen has received reimbursement of conference fees and travel and accommodation expenses, fees for preparing scientific continuing professional development or other events, funding for research he himself initiated, and fees for conducting clinical studies on related subjects from inspire Medical System, Inc.
Conflict of interest: Dr. Boon reports grants from Inspire Medical, during the conduct of the study; personal fees and other from Inspire Medical, grants from Inspire Medical, outside the submitted work.
Conflict of interest: Dr. Hofauer reports personal fees from Inspire Medical Systems, during the conduct of the study.
Conflict of interest: Dr. Doghramji reports grants from Inspire Medical Systems, during the conduct of the study; grants and personal fees from Inspire Medical Systems, outside the submitted work.
Conflict of interest: Dr. Maurer reports grants from Inspire Medical, personal fees from Inspire Medical, during the conduct of the study; grants from Imthera, grants from Revent, grants from Philipps, personal fees from Revent, personal fees from GlaxoSmithKline, personal fees from Heinen und Löwenstein, personal fees from Weinmann, personal fees from Sissel Novacare, personal fees from ResMed, personal fees from Olympus, personal fees from Neuwirth Medical, personal fees from Medtronic, outside the submitted work.
Conflict of interest: Dr. Soose reports other from Inspire Medical Systems, during the conduct of the study; other from Galvani Bioelectronics, other from Invicta Medical, outside the submitted work.
Conflict of interest: Dr. Strollo reports grants and personal fees from Inspire Medical Systems, personal fees from Philips-Respironics, grants and personal fees from Jazz Pharmaceuticals, personal fees from Itamar Medical, outside the submitted work.
Conflict of interest: Dr. Schwab reports grants from Inspire Medical Systems, during the conduct of the study.
Conflict of interest: Dr. Thaler reports other from Inspire, outside the submitted work.
Conflict of interest: Dr. Withrow has nothing to disclose.
Conflict of interest: Dr. Kominsky has nothing to disclose.
Conflict of interest: Dr. Larsen has nothing to disclose.
Conflict of interest: Dr. Kezirian reports grants from Inspire Medical Systems, during the conduct of the study; other from Nyxoah, other from Pillar Palatal, other from Cognitive Life Science, other from Split Rock Scientific, other from Gerard Scientific, other from Berendo Scientific, other from ReVENT Medical, grants from Autonomic Technologies, outside the submitted work; In addition, Dr. Kezirian has a patent Magnap issued, a patent Endoscopic Device and System issued, a patent Head and Neck Exercise Methods pending, and a patent Airway and Airflow Factors issued.
Conflict of interest: Dr. Hsia has nothing to disclose.
Conflict of interest: Dr. Chia has nothing to disclose.
Conflict of interest: Dr. Harwick has nothing to disclose.
Conflict of interest: Dr. Strohl reports grants from Inspire Medical Systems, during the conduct of the study; other from Sommetrics and other from Galvani Bioelectronics, outside the submitted work.
Conflict of interest: Dr. Mehra reports grants from Inspire, during the conduct of the study; grants from NIH, other from Philips Respironics, other from Resmed, from American Academy of Sleep Medicine, from Up to Date, outside the submitted work.
Conflict of interest: Prof. Sommer reports grants, personal fees and non-financial support from Inspire, ImThera, Regis Medical, Nyxoah, Phillips, MedEl, and personal fees from Neucomed, during the conduct of the study.
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