Anthropometric Measurements Inform Complete Concentric Collapse Status in Patients With Obstructive Sleep Apnea

Area of Science:

• Sleep Medicine
• Otolaryngology
• Medical Devices

Background:

• Hypoglossal nerve stimulation (HNS) is an effective treatment for obstructive sleep apnea (OSA).
• Current HNS protocols in the US mandate drug-induced sleep endoscopy (DISE) to exclude patients with complete concentric collapse (CCC).
• DISE is a costly and time-consuming procedure, posing a barrier to HNS candidacy evaluation.

Purpose of the Study:

• To investigate whether supine pharyngeal width (SPW), demographic, and polysomnographic variables can predict CCC.
• To identify alternative, less invasive methods for assessing HNS candidacy.
• To reduce the reliance on DISE for patient selection for HNS.

Main Methods:

• A prospective, multicenter cohort study involving 600 patients meeting HNS criteria.
• Measurement of SPW, collection of demographic data, and polysomnographic data.
• All patients underwent DISE following initial assessments.

Main Results:

• 587 patients completed the study.
• Patients with CCC exhibited higher body mass index (BMI) and neck circumference, and lower SPW compared to those without CCC.
• Significant associations were found between BMI, neck circumference, SPW, and CCC (P < .001 for BMI and neck circumference, P = .008 for SPW).

Conclusions:

• BMI, neck circumference, and SPW are significant predictors of CCC.
• These variables can potentially replace DISE for determining HNS candidacy in most patients.
• Implementing these measures could substantially decrease the time and cost associated with HNS patient selection.