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Scientific Oral Presentation

Sleep Medicine

Impact of Gender on the Outcome of Hypoglossal Nerve Stimulator Therapy in Obstructive Sleep Apnea

Tuesday, October 20, 2026
8:00 AM - 8:06 AM PT
Location: 403B

    Presenting Author(s)

  • William P. Marshall, MD

    Resident Physician
    West Virginia University
    Morgantown, WV, United States

    • Co-Author(s)

  • Ian L. Sunyecz, DO

    Resident Physician
    West Virginia University
    Morgantown, West Virginia, United States

    • Senior Author(s)

  • CM

    Chadi A. Makary, MD

    Associate Professor
    West Virginia University Dept of Oto
    Morgantown, West Virginia, United States

Disclosure(s):
William P. Marshall, MD:

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

Introduction: Hypoglossal nerve stimulator (HGNS) therapy is a commonly used treatment option for obstructive sleep apnea (OSA). Prior evidence on the impact of gender on its outcome has been conflicting.

Methods: Multicenter Retrospective cohort study of adult patients undergoing HGNS treatment for OSA at three different centers from March 2017-October 2025 was performed. Patients’ characteristics and comorbidities were reviewed. The apnea-hypopnea index (AHI) and device usage were analyzed for gender-based differences at baseline and post-treatment.

Results: 158 patients underwent HGNS with 46.2% of them being females. There was no difference in age (64.2 vs 64.1, p=0.969), BMI (30.2 vs 30.5, p=0.587), or voltage level used (1.6 vs 1.4, p=0.076) between females and males respectively. Females had lower preoperative AHI (30.2 vs 35.4, p=0.039) and lower postoperative AHI (13.5 vs 19.4, p=0.026), with females having higher improvement in their AHI at the actual voltage used (-16.1 vs -5.6, p=0.050). Females achieved higher Sher15 levels, both overall (67.1% vs 35.3%, p< 0.001) and at voltage used (65% vs 42.6%, p=0.028). Multivariate logistic regression adjusting for confounders showed that female gender is independently associated with increased odds of achieving Sher15 levels, both overall (OR=3.6, 95% CI of 1.8 to 7.2) and at actual voltage (OR=2.7, 95% CI of 1.1 to 6.6).

Conclusions: Female gender is associated with increased success rate following HGNS therapy for OSA.