Poster · Sleep Medicine
Patients Treated with Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea in Hawaii: A Single-Center Study
Karalyn Fong1,2, Ethan Arakaki2, Maxwell Heidelberg2, Maya Kimura2, Candace Miyaki, DO2, Barbara Pitts, PhD2, Enrique Carrazana1, MD, Kore Liow, MD1,2
- 1 John A. Burns School of Medicine, University of Hawaiʻi at Mānoa, Honolulu, HI
- 2 Memory Disorders Center, Hawaiʻi Pacific Neuroscience, Honolulu, HI
Background: Inspire therapy, a type of Hypoglossal nerve stimulation (HNS), is a second-line treatment for select patients with moderate-to-severe obstructive sleep apnea (OSA) who are intolerant of positive airway pressure (PAP) therapy. Despite the increasing use of HNS therapy in recent years, the demographic and clinical characteristics of patients receiving HNS therapy remain poorly described, particularly among Native Hawaiian and Asian/Pacific Islander populations.
Methods: We conducted a retrospective chart review of patients receiving Inspire therapy who are followed at the Hawaiʻi Pacific Neuroscience Sleep and Wake Center. Patients were identified in the electronic medical record using the ICD-10 code Z45.42 for management of an implantable neurostimulator, and cross-referenced with the Inspire SleepSync patient management platform. Demographic and clinical data were collected from the electronic medical record, with Inspire therapy-related data supplemented by the Inspire SleepSync patient management platform.
Results: Thirty-eight patients receiving Inspire therapy were identified. Patients were predominantly male (73.7%), with a mean age of 61 years. Mean body mass index (BMI) and neck circumference were 28.70 kg/m2 and 40.93 cm, respectively. Common comorbidities included hypertension (34.2%), hyperlipidemia (23.7%), and asthma (23.7%). Fifty percent of patients identified as Caucasian, followed by Asian (39.5%), Native Hawaiian (13.2%), Hispanic (5.3%), and Native American (2.6%). Mean apnea-hypopnea index (AHI) identified by polysomnography before and after Inspire implantation decreased from 36.8 to 11. Epworth Sleepiness Score (ESS) decreased from 9.11 to 6.92 following implantation.
Conclusion: This study describes the demographic and clinical characteristics of patients treated with Inspire therapy at a single center in Hawaii. In future studies, we plan to evaluate upper airway collapse patterns identified by drug-induced sleep endoscopy (DISE) to examine differences in HNS candidacy and airway collapse among Native Hawaiian and Asian/Pacific Islander populations.