Effect of Hypoglossal Nerve Stimulation on Metabolic Outcomes: Preliminary Results from a Randomized Crossover Trial

Monday, October 19, 2026

1:54 PM - 2:00 PM PT

Location: 403B

Presenting Author(s)

AL

Allison Lin, BS

Medical Student
Columbia University Irving Medical Center
New York, New York, United States

Co-Author(s)

Maria V. Suurna, MD

Professor
University of Miami
Miami, Florida, United States
AK

Ashutosh Kacker, MBBS, MD

Professor
Weill Cornell Medicine
New York, NY, United States
Eric J. Kezirian, MD, MPH

Professor-in-Residence
UCLA
Los Angeles, CA, United States
SJ

Sanja Jelic, MD

Professor
Columbia University Irving Medical Center
New York, New York, United States
Marie-Pierre St-Onge, PhD

Professor
Columbia University Irving Medical Center
New York, New York, United States

Senior Author(s)

Yi Cai, MD

Director of Sleep Surgery
Columbia University
New York, New York, United States

Disclosure(s):

Ashutosh Kacker, MBBS, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Eric J. Kezirian, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The metabolic outcomes of hypoglossal nerve stimulation (HNS) for obstructive sleep apnea are unknown. We present preliminary results from the first randomized trial to examine the effect of HNS on insulin resistance (IR) and energy expenditure (Eexp).

Methods: In our ongoing randomized crossover trial, participants previously stabilized on HNS undergo 2-4 weeks each of HNS withdrawal (HNS-off) and active HNS (HNS-on), with 1 week of HNS-on between study phases. At the end of each phase, fasting glucose and insulin are assessed. A subset of participants undergoes doubly labeled water (DLW) technique to measure Eexp. Data were analyzed using paired t-tests. IR was measured by homeostasis model assessment of IR (HOMA-IR). Target enrollment is n=30.

Results: Data from 11 participants (mean age 65.1±5.1 years, body mass index 27.4±2.8 kg/m2; 8 male; DLW n=3) were available for the analyses. Apnea-hypopnea index was higher with HNS-off (23.1±13.1) than HNS-on (13.9±8.2, p=0.011). Fasting glucose did not differ during HNS-off versus HNS-on for the overall cohort (111.7± 20.0 vs 105.4±24.0 mg/dL, p=0.48) nor for the 8 participants that had undergone 4 weeks in each study phase (114.3±23.2 vs 104.0±28.1 mg/dL, p=0.40). Similarly, insulin levels (9.13±10.70 vs 10.47±11.88 µIU/mL, p=0.44) and HOMA-IR (2.81±3.75 vs 2.96±3.72, p=0.74) did not differ between HNS-off and HNS-on, including for participants that had undergone 4 weeks in each study phase. Eexp was comparable during HNS-on and HNS-off (2559±95 vs 2488±225 kcal/day, p=0.54).

Conclusions: Preliminary results from a small sample in our randomized trial show no significant differences in fasting glucose, insulin, IR, and Eexp between HNS-on and HNS-off. Results will be updated as our trial continues.