SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients

Kenny P Pang; Peter M Baptista J; Ewa Olszewska; Itzhak Braverman; Marina Carrasco Llatas; Srivinas Kishore; Sudipta Chandra; Hyung Chae Yang; Yiong Huak Chan; Kathleen Ann Pang; Edward Benjamin Pang; Brian Rotenberg

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SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients

Author: Kenny P. Pang ¹ ; Peter M Baptista J ² ; Ewa Olszewska ³ ; Itzhak Braverman ⁴ ; Marina Carrasco Llatas ⁵ ; Srivinas Kishore ⁶ ; Sudipta Chandra ^{7
,

8} ; Hyung Chae Yang ⁹ ; Yiong Huak Chan ¹⁰ ; Kathleen Ann Pang ¹ ; Edward Benjamin Pang ¹¹ ; Brian Rotenberg ¹²
Author Information

1. Department of Otolaryngology, Asia Sleep Centre, Paragon, Singapore
2. Department of Otolaryngology, Clinica Universidad de Navarra, Pamplona, Navarra, Spain
3. ENT Department, Medical University of Bialystok, Poland
4. Department of Otolaryngology Head and Neck Surgery, Hillel Yaffe Medical Center, Technion Faculty Medicine, Haifa, Israel
5. ENT Department, Hospital Universitario Dr. Peset. Valencia. Spain
6. Otolaryngology Department, Nova Specialty Hospital, Hyderabad, India
7. ENT Department, Belle Vue Clinic &
8. Hospital, Kolkata, India
9. Otolaryngology Department, Chonnam National University Hospital, Korea
10. Biostatistics Unit, School of Medicine, National University Singapore, Singapore
11. Student, Medicine Faculty, University of Glasgow, Scotland
12. 2 Otolaryngology Department, Western University, London, Ontario, Canada
Publication Type:Journal Article
Keywords: OSA; sleep apnoea; surgical outcomes; success rate; AHI
From: The Medical Journal of Malaysia 2020;75(2):117-123
CountryMalaysia
Language:English
Abstract: Objective: To demonstrate SLEEP-GOAL as a more holistic and comprehensive success criterion for Obstructive Sleep Apnoea (OSA) treatment. Methods: A prospective 7-country clinical trial of 302 OSA patients, who met the selection criteria, and underwent nose, palate and/or tongue surgery. Pre- and post-operative data were recorded and analysed based on both the Sher criteria (apnoea hypopnea index, AHI reduction 50% and <20) and the SLEEP-GOAL. Results: There were 229 males and 73 females, mean age of 42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05), mean body mass index (BMI) decreased from 27.9±4.2 to 26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to 14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT) improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean duration of oxygen <90% decreased from 32.6±8.9 minutes to 7.3±2.1 minutes (p<0.05). The overall success rate (302 patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment, based on fulfilment of two major and two minor or better, the success rate (based on SLEEP-GOAL) was 69.8%. Based solely on the Sher criteria, 63 patients who had significant blood pressure reduction, 29 patients who had BMI reduction and 66 patients who had clinically significant decrease in duration of oxygen <90% would have been misclassified as “failures”. Conclusion: AHI as a single parameter is unreliable. Assessing true success outcomes of OSA treatment, requires comprehensive and holistic parameters, reflecting true end-organ injury/function; the SLEEP-GOAL meets these requirements