Does race-ethnicity affect upper airway stimulation adherence and treatment outcome of obstructive sleep apnea?

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Abstract

STUDY OBJECTIVES: Untreated obstructive sleep apnea (OSA) is associated with excessive daytime sleepiness, decreased quality of life, and cardiovascular disease. Positive airway pressure (PAP) is the first-line therapy for OSA, however, adherence is difficult. Upper airway stimulation (UAS) is an FDA approved treatment of OSA. The objective of this study was to evaluate for a difference in treatment efficacy and adherence of upper airway stimulation therapy for OSA between individuals who are White and non-White using data from the ADHERE registry.METHODS: ADHERE registry is a multicenter prospective study of real-world experience of UAS for treatment of OSA in the US and Europe. Propensity score matching was used to create a balanced data set between the White and non-White groups. T-tests at a significance level of 5% were used to compare numeric values between groups.RESULTS: There were 2,755 participants of the ADHERE registry. 27 were excluded due to not having a race identified. 125 participants identified as non-White, 2,603 identify as White, and 27 did not provide race information. Propensity score matching was used to select 110 participants with 55 White and 55 non-White for the non-inferiority analysis. We did not find a difference in adherence, treatment AHI, changes in Epworth Sleepiness Scale Score, or clinical global impression after intervention score between White and non-White individuals.CONCLUSIONS: Our study found that there was no statistically significant difference in adherence or efficacy with UAS therapy between White and non-White individuals. However, the percent of non-White people implanted is low which suggests a need to expand access to this therapy for non-White populations with OSA who cannot tolerate PAP therapy.

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