Elevated Central and Mixed Apnea Index after Upper Airway Stimulation

Area of Science:

• Sleep Medicine
• Respiratory Physiology
• Medical Device Technology

Background:

• Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated airway collapse during sleep.
• Upper airway stimulation (UAS) is an established treatment for moderate-to-severe OSA, particularly in patients intolerant to positive airway pressure therapy.
• The occurrence and predictors of central and mixed apnea index (CMAI) after UAS implantation require further investigation.

Purpose of the Study:

• To determine the incidence of elevated central and mixed apnea index (CMAI) following upper airway stimulation (UAS) in patients with obstructive sleep apnea (OSA).
• To identify potential demographic, clinical, or device-related predictors of elevated CMAI post-UAS.

Main Methods:

• Retrospective chart review of 141 patients who underwent UAS for OSA between 2014 and 2018.
• Data included demographics, comorbidities, pre- and postoperative polysomnography (PSG) results.
• Elevated CMAI was defined as ≥5; univariate analysis assessed associated factors.

Main Results:

• Five out of 141 patients (3.5%) experienced an elevated CMAI post-UAS.
• No significant associations were found between elevated CMAI and patient demographics (age, sex, BMI), comorbid conditions, or UAS device settings (P > .05).

Conclusions:

• An elevated CMAI after UAS implantation is infrequent.
• Demographics, comorbidities, and UAS device settings are not predictive of central and mixed apneic events post-treatment.
• Elevated CMAI may represent treatment-emergent central apneas.