0628 An Observational Report of Clinical Outcomes Among Veterans with Obstructive Sleep Apnea Treated with Hypoglossal Nerve Stimulation

Abstract

Abstract Introduction The efficacy of positive airway pressure (PAP) therapy in the management of obstructive sleep apnea (OSA) is limited by inadequate patient adherence. Hypoglossal nerve stimulation (HNS) is an FDA approved PAP-alternate surgical treatment option that is available for patients with poor PAP tolerance. The purpose of this pilot study was to review outcome measures and adherence data for patients treated with HNS therapy in a military veteran population. Methods Methodology involved a retrospective chart review of 30 PAP intolerant cases referred for HNS treatment over the course of 2 years. The inclusion criteria were Body Mass Index (BMI) < 35 kg/m2, Apnea Hypopnea Index (AHI) of 15-65/hour and drug induced sleep endoscopy (DISE) showing antero-posterior pharyngeal collapse. Qualified veterans proceeded to HNS implantation. Variables for analysis included BMI, Epworth sleep scale (ESS), DISE results, pre- and post-treatment AHI and adherence data. Results Of the 30 veterans, 17 proceeded to DISE. 15 had partial or complete AP collapse and 2 had concentric collapse. 12 veterans proceeded to HNS implantation. 6 veterans who completed HNS titration studies showed an average improvement of 77% from baseline AHI. There was significant decrease in mean AHI from 43.95/hour to 10.52/hour. The mean ESS decreased from 13 to 11. The mean compliance was 6.66 hours/night. Conclusion This limited veteran observational study supports that HNS is an effective treatment option for the management of PAP-intolerant patients with OSA. Our preliminary data suggests improved treatment adherence. Future prospective large-scale cohort studies should be considered. Support The authors declare no conflicts of interest nor any financial support