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. A healthy BMI ranges from 18.5 to 24.9.
The expanded eligibility criteria for the treatment provide more sleep apnea patients with access to the increasingly popular therapy, known as hypoglossal nerve stimulation. However, new research from Washington University School of Medicine in St. Louis indicates that the likelihood of successful nerve-stimulation treatment drops significantly as a patient’s weight rises above a healthy range.
The study, which appears April 4 in JAMA Otolaryngology-Head & Neck Surgery, is based on a retrospective analysis of treatment success in 76 sleep apnea patients with BMIs of less than 35.
“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,” said senior author Eric C. Landsness, MD, PhD, an assistant professor of neurology.
“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.”
Obstructive sleep apnea is caused by relaxation of muscles in the mouth and throat when a person is asleep. Muscle slumping can cause a partial or complete blockage of airflow and oxygen supply, especially in people with large tongues, thick necks and narrow airways. Blockages may cause people with sleep apnea to stop breathing for seconds (sometimes more than a minute), until they startle themselves awake and gasp for breath, a cycle that often repeats through the night. Untreated sleep apnea can cause serious health problems, including excessive daytime sleepiness, headaches, strokes, irregular heart rhythms and other cardiovascular issues.