{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:30:49Z","timestamp":1789630249184,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To provide the ADHERE registry Upper Airway Stimulation (UAS) outcomes update, including analyses grouped by body mass index (BMI) and therapy discomfort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>ADHERE captures UAS outcomes including apnea\u2010hypopnea index (AHI), Epworth sleepiness scale (ESS), therapy usage, patient satisfaction, clinician assessment, and safety over a 1\u2010year period. BMI \u226432\u2009kg\/m<jats:sup>2<\/jats:sup> (BMI<jats:sub>32<\/jats:sub>) and 32\u2009&lt;\u2009BMI \u226435\u2009kg\/m<jats:sup>2<\/jats:sup> (BMI<jats:sub>35<\/jats:sub>) group outcomes were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One thousand eight hundred forty\u2010nine patients enrolled in ADHERE, 1,019 reached final visit, 843 completed the visit. Significant changes in AHI (\u221220.9, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001) and ESS (\u2212 4.4, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001) were demonstrated. Mean therapy usage was 5.6\u2009\u00b1\u20092.2\u2009hr\/day. Significant therapy use difference was present in patients with reported discomfort versus no discomfort (4.9\u2009\u00b1\u20092.5 vs. 5.7\u2009\u00b1\u20092.1\u2009hr\/day, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01). Patients with discomfort had higher final visit mean AHI versus without discomfort (18.9\u2009\u00b1\u200918.5 vs. 13.5\u2009\u00b1\u200913.7\u2009events\/hr, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01). Changes in AHI and ESS were not significantly different. Serious adverse events reported in 2.3% of patients. Device revision rate was 1.9%. Surgical success was less likely in BMI<jats:sub>35<\/jats:sub> versus BMI<jats:sub>32<\/jats:sub> patients (59.8% vs. 72.2%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). There was a significant therapy use difference: 5.8\u2009\u00b1\u20092.0\u2009hr\/day in BMI<jats:sub>32<\/jats:sub> versus 5.2\u2009\u00b1\u20092.2\u2009hr\/day in BMI<jats:sub>35<\/jats:sub> (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.028).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Data from ADHERE demonstrate high efficacy rates for UAS. Although surgical response rate differs between BMI<jats:sub>32<\/jats:sub> and BMI<jats:sub>35<\/jats:sub> patient groups, the AHI and ESS reduction is similar. Discomfort affects therapy adherence and efficacy. Thus, proper therapy settings adjustment to ensure comfort is imperative to improve outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:2616\u20132624, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29755","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T11:50:31Z","timestamp":1626695431000},"page":"2616-2624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Impact of Body Mass Index and Discomfort on Upper Airway Stimulation: ADHERE Registry 2020 Update"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7032-0902","authenticated-orcid":false,"given":"Maria V.","family":"Suurna","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Weill Cornell Medicine\/New York Presbyterian Hospital  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1044-492X","authenticated-orcid":false,"given":"Armin","family":"Steffen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of L\u00fcbeck  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurits","family":"Boon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Chio","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Ohio State University  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Copper","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery St. Antonius Hospital  Nieuwegein The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena Dhanda","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Cincinnati College of Medicine  Cincinnati Ohio U.S.A."},{"name":"Department of Surgical Services Cincinnati Veterans Affairs Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado  Denver Colorado U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Hanson","sequence":"additional","affiliation":[{"name":"Otolaryngology, St. Cloud Ear, Nose, Throat Clinic St. Cloud  Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6301-2891","authenticated-orcid":false,"given":"Clemens","family":"Heiser","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Technische Universit\u00e4t M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4637-3630","authenticated-orcid":false,"given":"Colin","family":"Huntley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kent","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center  Nashville Tennessee U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Kansas University Medical Center  Andover Kansas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Manchanda","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care, Sleep and Occupational Medicine Indiana University School of Medicine and Indiana University Health  Indianapolis Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim T.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine, Department of Otorhinolaryngology, Head and Neck Surgery University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University  Mannheim 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