An implant for obstructive sleep apnea — a serious sleep malady in which breathing stops for 10 seconds to 2 minutes many times an hour each night — works best in people who have a body mass index (BMI) below 32. To qualify for the device, called a hypoglossal nerve stimulator, a person over 18 diagnosed with moderate-to-severe obstructive sleep apnea must be unable to adapt or refuse to wear a CPAP mask, the gold standard treatment for obstructive sleep apnea. Currently, the implant surgery — which costs between $50,000 and $100,000, is approved and covered by Medicare and many insurance companies for people with a BMI of up to 40. A new study published in the journal JAMA Otolaryngology looked at the BMI of patients who had received the implant. The study was conducted by the Washington University School of Medicine in St. Louis. The study found that for people with a BMI of more than 32, the device was unsuccessful 75% of the time. As currently defined, a BMI between 18.5 and 24.9 is a healthy weight, between 25 and 29.5 is overweight, between 30 and 34.9 is obese, between 35 and 39.5 is Class 2 obesity, and anything over 40 is morbidly obese. Dr. Eric Landsness, Assistant Professor of Neurology and Sleep Medicine at Washington University School of Medicine, pointed out that there’s a huge unmet need of patients that are suffering with sleep apnea and not able to tolerate CPAP. “As a sleep doctor, I want this treatment to be given to patients, but I want it to be given to the right patients, the ones who will benefit the most.”
