Hypoglossal nerve stimulator patient usage: Patterns and trends over time

Area of Science:

• Sleep Medicine
• Neurosurgery
• Biomedical Engineering

Background:

• Obstructive sleep apnea (OSA) affects millions globally, with hypoglossal nerve stimulation (HNS) offering an alternative to CPAP for intolerant patients.
• Consistent HNS device usage is crucial for treatment efficacy, yet detailed usage patterns remain understudied.

Purpose of the Study:

• To characterize granular usage patterns of hypoglossal nerve stimulation (HNS) in patients with obstructive sleep apnea (OSA).
• To identify patient and OSA-related factors associated with HNS usage.
• To analyze trends in HNS usage over time.

Main Methods:

• A prospective database of 50 patients implanted with HNS was merged with the Inspire Cloud usage database.
• Patient and OSA characteristics were summarized and analyzed for associations with usage patterns using Wilcoxon rank-sum tests.
• Usage trends over time were examined in the overall cohort and stratified by initial usage levels.

Main Results:

• Median HNS usage was 94% of nights for 5.8 hours per night.
• Higher post-operative apnea-hypopnea index was associated with slightly fewer nights of usage.
• Median nightly usage decreased from 6.8 hours on Day 1 to 5.76 hours by Day 361, with the most significant decline in patients with lowest initial usage.

Conclusions:

• Most patient and OSA characteristics were not significantly associated with HNS usage.
• HNS usage tends to decrease over time, particularly in patients with lower initial adherence.
• Interventions are needed to improve HNS usage patterns and optimize clinical outcomes for OSA patients.