Anthropometric Measurements Inform Complete Concentric Collapse Status in Patients With Obstructive Sleep Apnea.

Objective: Hypoglossal nerve stimulation in the US requires drug-induced sleep endoscopy to exclude patients with complete concentric collapse. This is an expensive and time-consuming requirement. We hypothesized that supine pharyngeal width, and other demographic and polysomnographic variables would associate with complete concentric collapse. Study Design: Prospective, multicenter cohort study. Setting: 10 centers in the United States with experience selecting patients for and performing airway surgeries for sleep apnea including hypoglossal nerve stimulation implantation. Methods: 600 patients meeting criteria for hypoglossal nerve stimulation underwent measurement of supine pharyngeal width and collection of demographic and polysomnographic data followed by drug-induced sleep endoscopy. Results: 587 patients completed the study. Patients with complete concentric collapse had a higher body mass index (31.2 ± 3.2 vs 29.0 ± 3.4 kg/m Conclusion: Body mass index, neck circumference, and supine pharyngeal width all associate with complete concentric collapse and could potentially be used to determine hypoglossal nerve stimulation candidacy instead of drug-induced sleep endoscopy for most patients thereby reducing both time and cost. (ClinicalTrials.gov NCT05428839: https://clinicaltrials.gov/study/NCT05428839?term=Inspire%20Medical%20systems%20predictor&rank=1).