This publication, co-authored with 9 leading U.S. academic surgeons from Harvard, University of Pennsylvania, Vanderbilt, and other top institutions, presents the results of the PREDICTOR study. This study looked at whether simple body measurements can help doctors decide if patients with obstructive sleep apnea (OSA) need a special test called drug-induced sleep endoscopy (DISE) before getting a device called hypoglossal nerve stimulation (HNS).
HNS is a treatment for people with moderate to severe OSA who can’t use the standard CPAP machine. Currently, everyone who wants HNS must have DISE to check for a specific throat collapse pattern called complete concentric collapse (CCC), which makes HNS less effective. However, DISE is expensive, time-consuming, and requires sedation.
My coauthors and I studied 600 patients and measured their body mass index (BMI), neck circumference, and the width of their throat while lying down (supine pharyngeal width, or SPW). SPW was a measurement that I had previously developed. In a previous publication, I had shown that this measurement did provide a reasonable assessment of the likelihood of CCC and also provided strong predictive information about the likelihood of good response to Inspire hypoglossal nerve stimulation therapy for obstructive sleep apnea.
In this study, we found that people with CCC tended to have a higher BMI, larger necks, and smaller throat widths. By using these simple measurements, doctors could predict who is unlikely to have CCC and might not need DISE. For example, if a patient has a BMI below 31.6, a neck circumference under 45 cm, and a throat width above 18 mm, they are much less likely to have CCC.
Using these measurements could save time and money, and help more patients get the treatment they need without unnecessary procedures.