0749 Positive Changes in Patient Reported Outcomes in Mid-Term and Long-Term Patients Treated with Hypoglossal Nerve Stimulation Therapy
Year: 2025
Type: conference-abstract
Abstract: Introduction While hypoglossal nerve stimulation (HNS) is an effective therapeutic option for obstructive sleep apnea(OSA), improvement in mid-term and long-term patient reported outcomes (PROs) and influence of adherence remains understudied. We hypothesize that mid- and long-term PROs improve in dose dependent fashion with increased adherence, measured by validated questionnaires: Epworth Sleepiness Scale(ESS), Insomnia Severity Index (ISI), Patient Health Questionnaire-9(PHQ-9). Methods Consecutive HNS implanted patients (2015-2021) with available follow up data N=72 at Cleveland Clinic are included. Adherence was measured by weekly hours of usage at 3-months and 1 and 2 years. Paired t-tests evaluated PRO changes, and Spearman correlations assessed relationships between adherence and PRO changes. Mixed effects models examined the effect of adherence on PRO changes, adjusted for age, gender, and body mass index (BMI). Statistical significance was set at p< 0.05. Results Mean age 62.7±9.3 years, 32.4% female, 91.4% white. Usage averaged 42.0±15.0, 37.5±15.2, 33.8±15.1 hr/week at 3-months, 1 & 2 yrs respectively. Significant (all p-values < 0.05) improvements in scores were noted at each time points: ESS –3.4±4.4, -3.3±4.6, -2.3±3.9; ISI –4.8±6.2, -4.0±6.0, -4.3±7.5; PHQ-9 –3.3±4.4, -3.7±5.5, -3.6±5.4 respectively. At 1-yr higher weekly usage significantly correlated with reduction in ESS (Spearman’s rho = -0.32, p = 0.031). In adjusted model, every 10 hours incremental weekly usage led to significant improvements in ESS [beta = -0.37 (-0.7, -0.03), p = 0.033] and ISI [beta = -1.00 (-1.58, -0.42), p < 0.001] but not PHQ-9 [beta = -0.32 (-0.69, 0.05, p=0.094]. Secondary analysis showed higher pre-implant ESS was associated with greater ISI [beta = -2.04 (-3.32, -0.76), p < 0.001] and PHQ-9 [beta = -1.22 (-2.16, -0.27), p < 0.001] improvements. Conclusion Self-reported PROs show mid- and long-term improvement in sleepiness, insomnia severity and depression scores post HNS treatment. Our findings suggest that with every 10 hours/week of usage, there is a dose dependent improvement in sleepiness (ESS) and insomnia (ISI), although increased adherence does not influence improvement in depression score. This improvement might be related to improvement in baseline sleepiness. Based on our findings we plan to conduct further research in a larger cohort to provide in-depth understanding of such correlations. Support (if any)
Source: SLEEP
Authors: Justin Park, Jinu Johnson, Nicolas Thompson, Vaibhav Ramprasad, Vaishal Shah
Institution: Cleveland Clinic
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410502712