Evaluating changes in hypoglossal nerve stimulator use over time and long-term adherence

Area of Science:

• Sleep Medicine
• Biomedical Engineering

Background:

• Obstructive sleep apnea (OSA) affects millions globally.
• Hypoglossal nerve stimulation (HGNS) offers an alternative treatment for OSA.
• Long-term patient adherence to HGNS therapy is not well understood.

Purpose of the Study:

• To evaluate patient phenotypes and longitudinal patterns of HGNS use.
• To identify predictors of long-term HGNS adherence in OSA patients.

Main Methods:

• Retrospective analysis of 59 OSA patients who underwent HGNS implantation (2017-2023).
• Assessment of HGNS usage patterns up to 9 months post-device activation.
• Statistical analysis including repeated measures ANOVA, Cochran's Q tests, and k-means clustering.

Main Results:

• Mean patient age was 62.7 years, BMI 28.5 kg/m², and AHI 38.7 events/hour; 78% were male and 98.3% White.
• HGNS usage decreased significantly over the first 9 months (p < 0.001).
• Estimated adherence rate was 52.5% at 9 months; cluster analysis did not reveal associations with HGNS use.

Conclusions:

• HGNS use shows a significant decline within the initial 9 months after activation.
• Further investigation into the reasons for decreased HGNS use is necessary.
• Standardized adherence definitions and granular usage metrics are recommended for future HGNS studies.