At the Sleep 2014 scientific conference in Minneapolis earlier this month, Patrick J. Strollo, Jr., MD from the University of Pittsburgh and colleagues presented 18-month outcomes from the STAR trial of Upper Airway Stimulation for treatment of obstructive sleep apnea.  STAR Trial results at 12 months have been published in January 2014 in the New England Journal of Medicine, and this presentation showed that results at 18 months were similar to those at 12 months.  The median apnea-hypopnea index (meaning that half of all study participants had values higher and lower) decreased from 29.3 events/hour before receiving the device to 9.0 and 9.7 events/hour at 12 and 18 months, respectively.  The proportion who achieved a major reduction in the apnea-hypopnea index (a decrease of 50% to a value below 20) was stable at 69% (vs. 65% at 12 months).

Why do these results matter for sleep apnea treatment?

These results are important because any treatment for sleep apnea ideally shows consistent outcomes over time.  The United States Food and Drug Administration provided approval for the Upper Airway Stimulation System based on 12 month results (more than just what I have summarized here, of course), but it is reassuring that the device maintains its benefit over a longer period of time.  At Keck Medicine of USC, we are in discussions with Inspire Medical Systems, the manufacturer of the device, and expect to be the only center in Southern California offering Upper Airway Stimulation for patients with obstructive sleep apnea, starting in the next 1-2 months.  Inspire has identified a number of centers of excellence around the country with the necessary combination of surgical expertise and a close collaboration with a sleep medicine team.  I am fortunate to work with excellent sleep medicine physicians at Keck Medicine of USC but also throughout the region in taking care of patients.  Patients with sleep apnea who are unable to tolerate positive airway pressure therapy (such as CPAP or BiPAP) would need to be referred to see me, and we will schedule an appointment to discuss sleep apnea treatment that will work well for them.

At each of the Inspire centers, physicians will be giving lectures to patients and physicians about this treatment. Please contact Inspire Medical Systems or me if you are interested in learning more or attending one of my talks.

 

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