(1319) Demographics and Disparities of Hypoglossal Nerve Stimulation in a Southeastern State

Introduction: Hypoglossal nerve stimulation (HNS) significantly improves objective measures of obstructive sleep apnea (OSA) severity, but demographic characteristics and post-operative outcomes across groups remain poorly defined. This retrospective analysis examines
demographic, polysomnographic, and lifestyle factors among HNS patients.

Methods: A retrospective chart review of adults who underwent HNS implantation for OSA at a single Southeastern U.S. health system between August 2014 and January 2025. Extracted data included demographics, pre- and post-operative apnea-hypopnea index (AHI), Epworth Sleepiness Scale, and SpO2 nadir. We reported mean (SD) values and calculated mean percent (%) AHI reduction with 95% confidence intervals (CI).

Results: A total of 413 patients (70.9% male) were included, predominantly White (88.6%), with 10.4% Black and 1% other races. Mean age was 64.1 (11.8) and mean BMI was 29.8 (3.8). Most patients lived in urban areas and were retired. Fellowship-trained surgeons treated significantly older patients than non-fellowship-trained surgeons (p < 0.05). Mean AHI decreased from 35.1 (95% CI, 33.2 – 37.0) preoperatively to 15.5 (95% CI, 12.4 – 18.7) post-operatively, a mean reduction of 18.2 (95% CI, 14.3 – 22.1).

Conclusions: HNS significantly improved AHI. Most patients were disproportionately White, male, urban-dwelling, and retired. Fellowship-trained surgeons treated older patients, possibly reflecting referral patterns or case complexity. These findings underscore potential demographic and socioeconomic disparities in access to HNS, which may contribute to ongoing inequities in OSA care amid rising prevalence.