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Scientific Oral Presentations

Sleep Medicine

Session: Scientific Oral Presentations 1 - Sleep Medicine

Evaluation of Hypoglossal Nerve Stimulation for Patients With Obstructive Sleep Apnea and Pulmonary Comorbidities

Saturday, September 28, 2024
4:24 PM – 4:30 PM EDT
Location: MBCC, 238-239
Disclosure(s):
Alison Y. Choi, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Rachel L. Whelan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mazen El Ali, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan J. Soose, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Thomas M. Kaffenberger, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hypoglossal nerve stimulation (HGNS) is an effective surgical treatment for patients with moderate-to-severe obstructive sleep apnea (OSA) who are intolerant to continuous positive airway pressure (CPAP). We aim to assess whether OSA patients with comorbid pulmonary diseases including asthma, chronic obstructive pulmonary disease (COPD), and hypoventilation syndromes also benefit from UAS and if there are differences in response compared to those without pulmonary comorbidities.

Methods: A single-center retrospective review of 229 patients with OSA who underwent UAS implantation in 2011-2021 was performed. Patients were categorized into OSA alone (OSAa) and OSA with pulmonary comorbidities (OSAp). Those without postoperative polysomnography data and OSAp patients missing pulmonary function tests were excluded. Demographics, polysomnography data, OSA severity metrics, and adherence data from device downloads were collected. Analysis was performed with nonparametric paired and unpaired t-tests using Prism 10.

Results: A total of 131 patients were included in the study; OSAa had 103 patients and OSAp had 28 patients. Of the OSAp patients, 64% had asthma, 57% had COPD, and 43% had hypoventilation syndromes. BMI pre and post-implantation and device adherence were not significantly different between groups. OSAa apnea-hypopnea index (AHI), Epworth Sleepiness Scores (ESS), oxygen (O2) nadir, and SaO2 <90% time significantly improved after implantation (p < 0.0001 for all). OSAp AHI (p < 0.0001), ESS (p = 0.0002), and O2 nadir (p = 0.0095) significantly improved after implantation. Change in O2 nadir was significantly greater in OSAa patients compared to OSAp (+8.4%, +2.7%; p = 0.045), but there was no significant difference in change in AHI, ESS, and SaO2 <90% time between the two groups.

Conclusions: Our study supports HGNS as an effective alternative for OSAp patients. Similar improvement in OSA metrics was observed between patients with and without pulmonary comorbidities. The difference in O2 nadir, however, may warrant further investigation.

    Presenting Author(s)

  • Alison Y. Choi, BS

    Medical Student
    University of Pittsburgh School of Medicine
    Ann Arbor, MI, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Rachel L. Whelan, MD

    Assistant Professor, Department of Otolaryngology
    University of Pittsburgh
    PGH, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Mazen El Ali, MD

    Clinical Assistant Professor, Division of Pulmonary, Allergy and Critical Care Medicine
    University of Pittsburgh
    pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Ryan J. Soose, MD

    Associate Professor
    University of Pittsburgh
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • TK

    Thomas M. Kaffenberger, MD

    Assistant Professor, Department of Otolaryngology
    University of Pittsburgh
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.