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Scientific Oral Presentation

Sleep Medicine

Impact of Early Postoperative Complications on Long-term Hypoglossal Nerve Stimulator Usage in Obstructive Sleep Apnea

Monday, October 19, 2026
1:12 PM - 1:18 PM PT
Location: 403B

    Presenting Author(s)

  • SL

    Sophia Linguiti, BA

    Medical Student
    Thomas Jefferson University, United States

    • Co-Author(s)

  • Anika S. Walia, BA

    Research Fellow/ Medical Student
    Thomas Jefferson University
    Boston, Massachusetts, United States

  • UT

    Udeerna Tippabhatla, BA

    Medical Student
    Thomas Jefferson University, United States

  • SH

    Sarah Harrington, BA

    Medical Student
    Thomas Jefferson University - SKMC, United States

  • Janvi J. Shukla

    Research Fellow
    Thomas Jefferson University, Department of Otolaryngology Head and Neck Surgery
    Philadelphia, PA, United States

    • Senior Author(s)

  • Colin T. Huntley, MD

    Associate Professor and Vice Chair for Education
    Thomas Jefferson University
    Philadelphia, PA, United States

Disclosure(s):
Janvi J. Shukla:

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

Introduction: Hypoglossal nerve stimulator (HGNS) offers effective therapy for obstructive sleep apnea (OSA) in select patients, but treatment success depends on consistent long-term device usage. Although early postoperative complications are rare, their influence on subsequent adherence to HGNS therapy has not been well characterized.

Methods: 813 patients who underwent HGNS implantation between 2015 and 2023 were reviewed. Patients without recorded device usage data were excluded. Sixteen patients who experienced postoperative complications, including bleeding, infection, hematoma, pneumothorax, or readmission within 30 days, were matched 1:1 with controls based on age, sex, and a modified Charlson Comorbidity Index (CCI). Longitudinal usage data (hours/week) were analyzed using analysis of covariance to assess the association between complication status and rate of usage change over time.

Results: Patients with complications demonstrated a steeper decline in HGNS usage compared with matched controls (adjusted mean difference = –9.2 hours/week, p=0.07, Cohen’s d=0.87). A higher proportion of patients in the complications group exhibited low usage defined as < 20 hours/week (12.5% vs. 31.2%). Estimated marginal means (EMMs; adjusted for CCI) at specific timepoints revealed no group difference at baseline (p=0.128). However, significant differences emerged by 6 months (difference=12.3 hrs/week, p=0.004, n=12+11) and widened progressively at 12 months (17.7 hrs/week, p=0.005, n=9+2) and 24 months (28.7 hrs/week, p=0.025, n=2+3), though data were limited at later timepoints.

Conclusions: Early postoperative complications within 30 days of HGNS implantation are associated with lower long-term device utilization. While these events remain rare, patients who experience early complications may require enhanced postoperative surveillance and counseling to promote sustained engagement with therapy.