459 The Effect of Upper Airway Stimulation Therapy on Blood Pressure

Abstract

\n \n \n Upper airway stimulation (UAS) therapy is a novel technique in the treatment of Obstructive Sleep Apnea (OSA). UAS therapy is indicated for patients with moderate to severe OSA who fail therapy with Continuous Positive Airway Pressure (CPAP) and/or the use of a dental appliance. Although research suggests that CPAP can modestly improve patients’ Blood Pressure (BP), little is known about the effect of UAS on BP.\n \n \n \n Via a retrospective cross-sectional cohort study, we identified all patients undergoing UAS surgery at Brook Army Medical Center from July 2015 through July 2020. We captured pre-operative and post-operative data from a structured electronic medical record review, including Polysomnographic data and BP measurements at designated time points. We measured UAS therapy compliance in hours of usage per week. Statistical analysis includes paired T-tests to determine whether changes in BP and AHI were significant when comparing preoperative and postoperative values.\n \n \n \n We report data for 12 patients treated with Upper Airway Stimulation therapy in our cohort. The mean pre-operative Systolic Blood Pressure (SBP) is 128.3±7 mmHg, the mean post-operative SBP is 122.8±10 mmHg with a mean difference of -5.4mmHg (standard error for difference 2.9mmHg). The mean pre-operative Diastolic Blood Pressure (DBP) is 80.0±6 mmHg, the mean post-op DBP is 76.4±8 mmHg, with a mean difference of -3.6mmHg (standard error for difference 1.9 mmHg). Neither of these are statistically significant, with P values of 0.09 and 0.08 respectively. The mean pre-operative Mean Arterial Pressure (MAP) is 96.1±6 mmHg, the mean post-op MAP is 91.9± 8 mmHg, with a mean difference of -4.2 mmHg (standard error for difference 1.7 mmHg). This represents a statistically significant difference with a P value of 0.03. Seven patients carried a pre-operative diagnosis of Hypertension whereas five did not. There is not a statistical difference in BP changes between these subgroups.\n \n \n \n Upper Airway Stimulation surgery appears to decrease SBP, DBP, and MAP measurements with a similar magnitude as Positive Airway Pressure Therapy. In our cohort, only MAP changes appear to reach statistically significance. Further studies are warranted to elucidate the clinical significance of UAS on physiologic parameters such as blood pressure.\n Support (if any):\n