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Sleep Medicine

(130) Demographic Disparities in Hypoglossal Nerve Stimulation Surgery

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • RP

    Ryan J. Patrick, MD

    Resident
    University of Rochester Medical Center
    Rochester, New York, United States

    • Co-Author(s)

  • PA

    Paul D. Allen, PhD

    Research Program Manager
    University of Rochester Medical Center
    Rochester, New York, United States

  • NC

    Nicolas Casellas, MD

    Resident Physician; MD.
    University of Rochester Medical Center
    Rochester, New York, USA

    • Co-Author(s)

  • SS

    Shalini Shah, BA

    University of Rochester School of Medicine and Dentistry
    ROCHESTER, NY, USA

    • Senior Author(s)

  • Sveta Karelsky, MD

    Associate Professor
    University of Rochester
    Pittsford, NY, United States

Disclosure(s):
Paul D. Allen, PhD: No relevant relationships to disclose.


Introduction: The aim of this study was to describe sociodemographic characteristics of patients with obstructive sleep apnea (OSA) who did or did not undergo hypoglossal nerve stimulation surgery (HNSS) after drug induced sleep endoscopy (DISE).

Methods: Single-center, retrospective study from adult (>18 years) patients referred to an otolaryngology clinic at a single tertiary care center in Upstate New York between 9/1/2018 to 12/31/2022. Outcome measures included race, ethnicity, sex, marital status, and BMI. Statistical analysis was tests of two proportions. Significance was defined as p< 0.05.

Results: Of the 520 patients who underwent DISE, 207 (40%) patients received OSA treatment with HNSS and 313 (60%) did not. Patients who received a DISE were disproportionately white compared to the population of Monroe County (p < 0.01). In the non-HNSS group, 257 (82%) patients identified as white and 20 (6%) identified as black; in the HNSS group, 187 (90%) patients identified as white and 4 (2%) identified as black, which was statistically significant (p < 0.01).
Similarly, compared to Monroe County, more patients who got DISE were married (p < 0.01). In comparing patients who did and did not undergo HNSS, patients who had a partner had higher rates of HNSS (n=129, 62%) compared to non-HNSS (n=140, 45%) (p < 0.01).
The median BMI was 29.1 kg/m2 (SD +5.3) in the non-HNSS group and 27.8 kg/m2 (SD + 4.2) in the HNSS group. The median age was 54 years (SD +18) years in the non-HNS group and 62 years (SD +10) years in the HNSS group. Most patients in both the non-HNSS group (n=278, 89%) and HNSS (n=182, 88%) were non-Hispanic. There were no gender disparities, although more men frequently had HNSS (n=122, 59%) than non-HNSS (n=202, 65%).

Conclusions: This study describes apparent demographic differences in patients screened with DISE for OSA, who subsequently did or did not undergo HNSS. Our data shows that black race and unmarried patients are less likely than the general population to get a screening DISE and less likely to undergo HNSS. Additional studies identifying potential differences in polysomnogram and DISE findings should be further investigated.