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Purpose <p>Real-world predictors of early response to hypoglossal nerve stimulation (HGNS) remain inadequately characterized. We aimed to examine baseline characteristics, oximetry patterns, and adjunctive therapies associated with treatment response in a routine clinical HGNS cohort.</p> Methods <p>We conducted a retrospective cohort study of adults receiving HGNS at a tertiary sleep center (2019–2025). Treatment response was defined as apnea-hypopnea index by 4% criteria (AHI4%) &lt; 15 events/hour on first post-implant polysomnography. Baseline demographics, polysomnography characteristics including oximetry banding patterns, adjunctive medication exposure, and device adherence were compared between responders and non-responders using Wilcoxon rank-sum and Fisher exact tests.</p> Results <p>Among 56 implanted patients, 35 had post-implant polysomnography with complete AHI4% data. Twenty-eight (80%) were responders; median AHI4% decreased from 27.1 to 7.0 events/hour. Responders had lower body mass index (28.6 vs. 31.1&#xa0;kg/m², <i>p</i> = 0.035) and baseline AHI4% (20.3 vs. 37.5 events/hour, <i>p</i> = 0.021). All non-responders demonstrated oximetry banding patterns compared to 77% of responders (<i>p</i> = 0.16). Response rates using AHI3% criteria were markedly lower (31% [11/36]).</p> Conclusions <p>Lower BMI was associated with early HGNS response. Oximetry banding and adjunctive pharmacotherapy were common among non-responders, suggesting opportunities for combination therapeutic approaches. The substantial gap between AHI4% and AHI3% response rates highlights persistent arousal-based disturbances that may warrant additional intervention.</p>

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Characterizing early response and adherence to hypoglossal nerve stimulation: real-world evidence from a single-center cohort

  • 期刊论文

  • 发表日期：

    2026年4月22日

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  • Po-Yang Tsou,
  • Robert J. Thomas,
  • Daniel Vena,
  • Jacqueline Chang,
  • Anjali Ahn

摘要

Purpose

Real-world predictors of early response to hypoglossal nerve stimulation (HGNS) remain inadequately characterized. We aimed to examine baseline characteristics, oximetry patterns, and adjunctive therapies associated with treatment response in a routine clinical HGNS cohort.

Methods

We conducted a retrospective cohort study of adults receiving HGNS at a tertiary sleep center (2019–2025). Treatment response was defined as apnea-hypopnea index by 4% criteria (AHI4%) < 15 events/hour on first post-implant polysomnography. Baseline demographics, polysomnography characteristics including oximetry banding patterns, adjunctive medication exposure, and device adherence were compared between responders and non-responders using Wilcoxon rank-sum and Fisher exact tests.

Results

Among 56 implanted patients, 35 had post-implant polysomnography with complete AHI4% data. Twenty-eight (80%) were responders; median AHI4% decreased from 27.1 to 7.0 events/hour. Responders had lower body mass index (28.6 vs. 31.1 kg/m², p = 0.035) and baseline AHI4% (20.3 vs. 37.5 events/hour, p = 0.021). All non-responders demonstrated oximetry banding patterns compared to 77% of responders (p = 0.16). Response rates using AHI3% criteria were markedly lower (31% [11/36]).

Conclusions

Lower BMI was associated with early HGNS response. Oximetry banding and adjunctive pharmacotherapy were common among non-responders, suggesting opportunities for combination therapeutic approaches. The substantial gap between AHI4% and AHI3% response rates highlights persistent arousal-based disturbances that may warrant additional intervention.