Source: Annual Congress 2011 - Obstructive sleep apnoea in children and adults
Disease area: Sleep and breathing disorders

Abstract

We studied a second generation Upper Airway Stimulation system (Inspire Medical Systems, Inc) in OSA with an attempt to identify baseline predictors of therapy success.
Moderate-to-severe OSA patients who failed, or were intolerant of, continuous positive airway pressure were included. The study was conducted in 2 phases. In Phase 1, patients were enrolled with broad selection criteria. In Phase 2, patients were enrolled using selection criteria derived from the experience in Phase 1.
20 of 22 patients enrolled in Phase 1 (2 exited the study) were examined for factors predictive of a response (AHI < 20 and 50% reduction from baseline at last post-implant). Among responders (n=6) in Phase I, AHI reduced from 35.8 ± 14.5 (mean ± SD) at baseline to 9.5 ± 7.4 events/hr (p<0.05) at the last follow-up, and ODI reduced 14.4 ± 8.3 to 5.3 ± 4.7 (p<0.05) accordingly. Among non-responders, AHI remained unchanged from 46.9 ± 19.4 to 51.4 ± 26.6; similarly, ODI remained from 36.8 ± 25.5 to 32.9 ± 21.3. Responders had both a BMI ≤ 32 and AHI ≤ 50, and were free of predominant palatal airway collapse. Phase 2 patients (n= 8) selected using these responder criteria showed significant reduction in AHI from 38.9 ±9.8 at baseline to 10.4 ± 11.0 at last follow-up (p<0.05) and ODI from 32.1 ±24.0 to 9.5 ± 10.2 (p< 0.05).

We conclude that site of obstruction, baseline AHI, and BMI may be important therapy success predictors.

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Citations should be made in the following way:
W. De Backer, J. Verbraecken, J. Maurer, L. Knaack, A. Oliven (Edegem, Belgium; Mannheim, Dortmund, Germany; Haifa, Israel). Feasibility of implanted upper airway nerve stimulation therapy to treat obstructive sleep apnea. Eur Respir J 2011; 38: Suppl. 55, 3238

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