A nerve-stimulation treatment for obstructive sleep apnea that originally was approved only for people with body mass indexes (BMIs) in the healthy range recently was extended to patients with BMIs up to 40, a weight range generally described as severely obese.
Apr 4 2024Washington University School of Medicine A nerve-stimulation treatment for obstructive sleep apnea that originally was approved only for people with body mass indexes in the healthy range recently was extended to patients with BMIs up to 40, a weight range generally described as severely obese. A healthy BMI ranges from 18.5 to 24.9.
Our study shows that the more overweight you are, the less likely it is that nerve-stimulation treatment will be effective in treating your sleep apnea." "I'm not saying that we shouldn't put this device in patients with a BMI of 38 or 40. But my job as a physician is to help overweight patients make an informed decision, to better understand their odds of success and realize that the chances of it working for them may be a lot less.
To many patients, hypoglossal nerve stimulation looks like an appealing alternative to CPAP machines. The therapy is driven by a small, battery-operated device implanted just above the ribs. A small wire is run internally up the chest and into the jaw, where it connects to the hypoglossal, a nerve that controls tongue muscles responsible for keeping the upper airway open during sleep.
Landsness, a sleep researcher who treats patients with sleep apnea, was surprised by the changes in the eligibility criteria. To understand how the device performs in people of varying sizes, he and colleagues performed an independent evaluation using data from 78 people with BMIs up to 35 who received implants of the nerve-stimulation device at the Washington University Sleep Medicine Center from 2019 through 2023.
"Body mass index is clearly an important factor in predicting whether hypoglossal nerve stimulation will work for an individual patient," Landsness said. "Our study shows an almost linear relationship between BMI and treatment success. For every unit of BMI increase over 32, the odds of successful treatment decrease by about 17%."
Sleep Apnea Body Mass Index Breathing Medicine Neck Nerve Neurology Obstructive Sleep Apnea Otolaryngology Research Surgery Tongue
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