American Journal of Otolaryngology · Sep 25, 2026

Evaluating the impact of hypoglossal nerve stimulator therapy on cardiovascular and metabolic outcomes in sleep apnea patients: A retrospective cohort analysis

By Lampkin HB, Storm LK, Mcminn ME et al.

Obstructive sleep apnea is associated with comorbidities such as obesity, type 2 diabetes mellitus, and hypertension. While continuous positive airway pressure therapy has been shown to improve these conditions, the impact of hypoglossal nerve stimulation remains less defined. This retrospective cohort study aimed to evaluate the effect of hypoglossal nerve stimulation on blood pressure, mean arterial pressure, hemoglobin A1c, and body mass index in patients with obstructive sleep apnea. Adult patients who underwent hypoglossal nerve stimulator implantation between February 2017 and June 2024 at a tertiary academic medical center were included. Exclusion criteria included device removal, transfer of care following activation, or loss to follow-up. Of 210 patients, 141 met inclusion criteria, with age ranging 18 to 87 years, and 60.3% male. Over a two-year follow-up, systolic and diastolic blood pressures fluctuated without reaching statistical significance, while mean arterial pressure demonstrated a downward trend that approached significance at the two-year time point. Hemoglobin A1c and body mass index also varied over time without significant change. The mean Apnea-Hypopnea Index improved substantially from 36.0 at baseline to 5.9 at titration follow-up, and overall institutional compliance with hypoglossal nerve stimulation therapy was 83.5%. In this cohort, hypoglossal nerve stimulation significantly improved obstructive sleep apnea severity but did not result in significant changes in blood pressure, hemoglobin A1c, or body mass index. The observed trend toward lower mean arterial pressure suggests a potential cardiovascular benefit, warranting further investigation into the broader metabolic effects of hypoglossal nerve stimulation in patients with obstructive sleep apnea.

doi.org/10.1016/j.amjoto.2026.104951Open accessPubMed 42998374Interventions