United States: Recent data on the newest implant have shown that the procedure greatly helped people who were above normal weight but had estimated body mass index (BMI) exceptions. The surgery worked efficiently, if not extremely.
The eligibility for the Hypoglossal Nerve Stimulator, or alternatively, the device, includes patients over 18 years old with a formal diagnosis of moderate or severe OSA who cannot tolerate or accept wearing a continuous positive airway pressure or CPAP, which is the standard treatment for patients affected by obstructive sleep apnea.
More about the study
In the new study, which was published on Thursday in JAMA Otolaryngology-Head & Neck Surgery, 76 patients were studied to examine their body mass index, who had received the implant. Dr. Landsness, an assistant professor of neurology and medicine at Washington University School of Medicine in St. Louis, is the lead author.
Presently, the operation, with a cost range from USD 50,000 up to USD 100,000, is included in the coverage packages of Medicare and most insurers for individuals with a BMI up to 40.
According to CNN health reports, Landsness stated, “We found for people with a BMI of more than 32, the device might be unsuccessful up to 75% of the time,” and, “It was a linear relationship: For each unit increase in BMI beyond 32, the odds of successful treatment decreased by approximately 17%.”
According to the current definition, a BMI that lies between 18.5 and 24.9 is considered a healthy weight; if it lies between 25 and 29.5 is overweight; between 30 and 34.9 is obese; between 35 and 39.5 is class 2 obesity; however,, anything above 40 is “severe” or class 3 obesity, which was also be called as morbid obesity.
Additionally, when the weight of people below a BMI is 18.5, then they are taken as underweight individuals.
According to the study, in those people who slept on their backs or who are also called lying in a ‘supine position,’ the implant was found to be less successful.
The study’s results confirm the papers before claiming that the device also affirmed the device’s efficacy, but, “it also raises questions about whether obesity or supine sleeping limit its effectiveness,” as said Kristen Knutson, a sleep specialist and an associate professor of neurology and preventive medicine at Northwestern University Feinberg School of Medicine Chicago. She was not part of the study.
Landsness added, “There’s a huge unmet need of patients that are suffering with obstructive sleep apnea and not able to tolerate CPAP,” and, “But this is a surgery, which always carries risk, and it’s expensive, so as doctors we need to be sure the stimulator is the right choice for that patient.”
More about Hypoglossal nerve stimulator
The FDA first approved the hypoglossal nerve stimulator in the US in 2014. Since then, the device has been implanted in 60,000 people already, globally.
The surgeon then places the definite-size cardiac pacemaker, almost like a small instrument, nickeled below the skin near the collarbone, as CNN Health reported.
A second implant is performed at the base of the lower jawbone and attached to a nerve impacting the movement of the tongue. Both implants are connected through a wire that goes around the neck.
Responding to signals of breathing from remote control, the device acts to detect each breath and electically activates the tounge in such a way that it is kept from blocking the airway.
Landsness added, “It’s opening your airway by stimulating your tongue to basically move forward,” and, “The biggest complaint we hear from people is that sometimes their tongue feels tired because that muscle is stimulated over and over again.”